Wes Streeting

I thank the right hon. Gentleman for his question and for how he puts his criticism, too. As I said earlier, and for the avoidance of doubt, I know what my responsibilities are. I understand the decisions that I take in this office and that I am accountable for those decisions. I do not resile from that. I am following clinical advice; I think that is the right thing to do in this area. On the question of sex, the right hon. Gentleman is right: sex is immutable. Even if there has been treatment with hormones or surgery, underlying biology none the less means that trans women, for example, would still need to be screened and treated bearing in mind their biological sex, and the opposite is true for trans men. We have to draw that distinction between biological sex and gender identity. Whatever my discomfort and personal views about this particular trial or about the notion of young people using puberty blockers in this way, I cannot ignore, and should convey faithfully to the House, conversations that I have had with trans young people and adults. They have described in powerful and unforgettable terms not just the life changing, but the life enhancing experience that they have had. I am thinking particularly of the university student I met; if she walked into this Chamber now, we would assume that she was born female. She is living her best life and described in very powerful and unforgettable terms the impact that treatment has had for her and her quality of life. At the same time, I think of high-profile cases such as Keira Bell’s. That is why we have to tread extremely carefully in this area, to follow evidence and to build an evidence base. It is also why these are such finely balanced judgements and why I can be simultaneously uncomfortable with the permanent ban that I put in place and uncomfortable with the clinical trial. I hope that I have reassured people that I think very deeply about these issues before taking decisions.