The UK is Restarting a Puberty Blocker Trial Despite 25 Years of Evidence - Carrie Clark (#4)
Carrie Clark, Director of Genspect UK, brings forensic detail to a conversation that Stella O'Malley and Mia Hughes refuse to keep at the surface. This episode is a careful dissection of a £10 million NHS trial that Clark argues is built on selective science, activist framing, and an institutional unwillingness to reckon with what came before. For anyone trying to understand why the Cass Review was not the end of the story, this conversation is essential listening.
When the Cass Review landed, many assumed British medicine had finally confronted its failures on paediatric gender care and would now proceed with caution. This episode challenges that assumption. Stella O'Malley and Mia Hughes sit down with Carrie Clark to examine what the NHS is actually planning next, and the picture is unsettling. A new study — the Pathways study — is being positioned as rigorous research, yet Clark's reading of its design raises serious doubts about whether it was ever intended to produce genuinely open findings. Clark is Director of Genspect UK, an organisation that advocates for non-medical approaches to gender distress in young people. She comes to this conversation not as a polemicist but as someone who has read the documents, tracked the consultations, and followed the institutional manoeuvring the Pathways study represents. What she gives Stella and Mia is rare: a detailed, specific account of how a study can be constructed so that its conclusions are effectively shaped before the data is gathered. The £10 million budget makes this more alarming, not less. Among the concerns she raises are the absence of exclusion criteria for young people with significant mental health difficulties or autism, the use of activist language in the research framing, and the study's continued reliance on the Dutch Protocol — a body of research whose methodological weaknesses have been documented extensively, yet which persists as the primary justification for medicalising children experiencing gender distress. The conversation is careful and specific throughout, favouring close attention to what the study design actually says over easy outrage. Perhaps the most striking section concerns what the NHS has chosen not to do. The roughly 9,000 children who passed through the now-closed Tavistock clinic have not been systematically followed up. Clark and the hosts explore what that omission means — not just for those individuals, but for any claim that a new study is genuinely interested in outcomes. The episode also examines the exclusion of detransitioners from the consultation process, a decision that strikes at the heart of what honest clinical inquiry should look like. The conversation surfaces two further pieces of research that deserve wider attention: Tavistock's own Early Intervention Study, whose results appear to have been shelved rather than published, and a US study by Joanna Olson-Kennedy whose findings remain unavailable to the public. Together they form part of a broader pattern — the persistent difficulty of accessing data that might complicate the case for medical intervention in gender-distressed youth. Clark, Stella, and Mia return to this pattern throughout, and it gives the episode its cumulative weight.
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