Debate contribution: Cass Assessment Report for Gender Identity Services

Debate contribution by Mr Mike Nesbitt on 16 February 2026.

MLA

Mr Mike Nesbitt

Party at the time

Ulster Unionist Party

Date

16 February 2026

Type

Debate contribution (made as a minister)

Business

Questions for Urgent Oral Answer

Heading

Cass Assessment Report for Gender Identity Services

Assembly identifier

Official Report component 5391634

Read the official Assembly record

Text

No Northern Ireland child is involved in the trial yet. When the issue came up, the idea of a trial was a concept — there was no detail to it — and the Ulster Unionist Party supported the principle of a clinical trial. Clinical trials have been around for a very long time and they have been, by and large, extremely effective in advancing medical and social care into the 21st century. However, it became clear to me that the judicial review has a chance of success. As I said in my statement, I do not want to drag children and their families unnecessarily into the courts and into a squabble that might descend into party political interests. I found it a difficult decision, because I have sat with families who want puberty blockers for their young ones, because they believe that that is in their best interests. Those families love their children and want to do the best thing by them. However, Dr Cass and then the Commission on Human Medicines made it clear that it is dangerous, outside a research or clinical setting, to allow children access to puberty blockers. The Member points out that I have come on a journey, and the position that the journey has taken me to has led me to pause our participation in the clinical trial, pending the outcome of the judicial review.

The Member's language is most unwelcome. "Guinea pigs" is very emotive. As I said in answer to Mrs Dodds, clinical trials are well established.

I do not believe that any person who is involved with King's College London, which has been commissioned by the Department of Health and Social Care in London, or anyone in the Department, the UK Government or this House is out to treat children as guinea pigs or to bring them to any harm. The Member and I disagree on many things, and that is fair enough, but being sensitive to the young people, their families and their communities is more important to me than what the Member thinks.

I understand the Member's strong feelings. She is echoing the First Minister by calling it a disgraceful decision. All that I can say to the Member is that it was a decision that came to me. Ultimately, it was not about discriminating against people, nor was it about health inequalities. Rather, it was about protecting young people. It seems to me that there is evidence, which we will have aired in the judicial review, on whether or not it is safe to conduct the clinical trial.

I have not done as the Member suggests. Dr Cass came for, from memory, three days and assessed our gender identity service and our plans for it. The Member will be aware that, as part of all this, I made a promise to make a pretty significant investment — some £806,000, initially — in the gender identity service. That was because, when I sat with those parents and some of the children, they made the point that the only reason that they were going to private providers was because the gender identity service existed in name only. There was not even a waiting list for new patients. New patients could not get into the service. It was because of that that they felt that they had no alternative, and, because they loved their sons and their daughters, they were finding the money to go to private providers. One of the briefings that I received told me that one private provider is Spanish but lives in Romania and prescribes out of Singapore. There is no way that you can consider that to be a safe way of prescribing something like a puberty blocker, which Dr Cass says is not safe except in a clinical setting. She was talking about the principle of a clinical trial. It appears, however, that the detail of the clinical trial, which has emerged since there was agreement in the Executive in December 2024, is open to question. One way or another, that question will be resolved by the judicial review.

I cannot predetermine or guess the outcome of the judicial review. I have made clear, however, that should the judicial review give a green light to the King's College London clinical trial, I will take that matter back to Executive colleagues to take their views before coming to a view as to whether the Northern Ireland Assembly should continue to support participation in that trial.

At all times since taking up position, I have tried to rely on medical and clinical advice. I am sure that the Member has heard me say before that the best advice that Professor Rafa Bengoa gave me was, "Remember that you want to be really tight in your outcomes but loose in how you get there, because you're not a nurse, a GP, a clinician, a surgeon or a hospital administrator. So, listen to the people who know best". This is an incredibly sensitive, emotive and controversial area where there are different views. I am not using people; I am trying to protect people. The judicial review has become very important in my mind, so I think that it is worth taking that pause to see where that leads us. I do not accept that it necessarily inevitably leads to a second judicial review, but we need to try to get to a reasonable consensus on what is best for those young people.

That is part of the rationale and the objective of the clinical trial by King's College London.

930 words. Text as published by the Northern Ireland Assembly.

Assessment

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Assessed 21 October 2026 at 14:55 UTC by jev-1.13.0 (requested as typesafe/jev) under rubric 2026.10-r9, methodology 1.9.

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