The National Institute for Health and Care Research (NIHR) has announced a £10 million investment into its PATHWAYS project, aimed at developing and evaluating interventions for young people experiencing gender-related distress. While the inclusion of psychosocial factors is a positive step, the project’s reliance on NHS Gender Services as its primary research setting is deeply problematic.
“Our Duty is concerned that this research is being conducted within NHS Gender Clinics, which many well-informed and sensible parents are deliberately avoiding due to their established record of poor safeguarding,” said a spokesperson for Our Duty. “The recruitment process automatically excludes families who have chosen alternative, non-medicalised approaches to their child’s distress.”
The Flaws in PATHWAYS’ Approach
Limited Parental Representation:
Despite claims that parents and young people have shaped the study’s design, Our Duty—a leading voice for parents concerned about the harms of gender ideology—was not consulted. This exclusion raises serious questions about the objectivity of the research and whether it will fairly represent the full spectrum of parental concerns.
Selection Bias in Participants:
The PATHWAYS study will only include young people and families currently engaged with NHS Gender Services. This introduces an inherent bias, as it excludes families who have rejected the affirmative model in favour of psychological support addressing underlying mental health issues, trauma, autism, or social influences.
Ethical Concerns Over Puberty Blocker Trials:
The PATHWAYS Trial proposes a two-year study of puberty blockers (GnRHa) on young people, despite significant evidence that these drugs carry irreversible harms, including bone density loss, cognitive impacts, and potential sterility. Conducting a clinical trial under these conditions raises profound ethical concerns.
Ignoring the Voices of Detransitioners:
While the project includes a ‘PATHWAYS Voices’ component to capture patient experiences, it makes no mention of detransitioners—those who regret their medical transition and have spoken out about the lack of adequate psychological assessment before being put on a medical pathway. Their exclusion suggests a predetermined bias towards affirmation rather than a neutral investigation of outcomes.
The Risk of Wasted Public Funds
Rather than allocating £10 million towards research that reinforces a flawed model of care, public funds would be better spent investigating why increasing numbers of young people are experiencing gender distress in the first place. Addressing the impact of social contagion, internet influence, and comorbid mental health conditions should be the priority.
“Unless NIHR ensures a genuinely balanced study that includes parents who have safeguarded their children from gender ideology, this project will fail to produce meaningful, ethical, and scientifically valid conclusions,” the Our Duty spokesperson added.
Our Duty calls on NIHR to broaden the scope of PATHWAYS to include families who have rejected medical intervention and to centre safeguarding, rather than ideology, in its research approach.
