James Esses — psychotherapist, former criminal barrister, founder of Just Therapy, co-founder of Thoughtful Therapists, founder/coordinator of the Declaration for Biological Reality, Honorary Fellow at the Centre for Heterodox Social Science, University of Buckingham.

Jamie, Lauren, and Cori are joined by James Esses ahead of the July 26th High Court judicial review of the PATHWAYS puberty blocker trial. James — alongside Keira Bell and the Bayswater Support Group — is a claimant in the case challenging the Health Research Authority and MHRA’s decision to approve the trial. This conversation covers the trial’s history, the regulatory reversal that let it proceed, and what’s legally at stake this weekend for the children already enrolled.

PATHWAYS Trial:

- 2024:UK bans puberty blockers for pediatric gender dysphoria outside of clinical research, following the Cass Review.

- PATHWAYS approved as the sanctioned research exception — a King’s College London / South London and Maudsley NHS Trust study of GnRH analogues in patients under 16, commissioned by NHS England and the National Institute for Health and Care Research.

- February 11, 2026: MHRA writes to trial sponsors raising safety concerns.

- February 23, 2026: Health Secretary Wes Streeting confirms to Parliament that the trial has been paused.

- Early 2026: Bell, Bayswater Support Group, and Esses file for judicial review against the HRA and MHRA, arguing the regulators failed to properly weigh foreseeable risk to cognition, bone density, and fertility against anticipated benefit.

- June 2026: MHRA approves a modified protocol — minimum age requirement, updated patient information — clearing PATHWAYS to proceed, subject to the outcome of the judicial review.

- Recruitment date: Originally set for August 1, 2026, pending the court’s decision.

- July 26, 2026: High Court hears the judicial review.

Further Reading:

- Sex Matters coverage of the trial pause and judicial review

- Transgender Trend on the modified protocol

- The Free Press on the trial’s approval to enroll 11-year-olds

- James Esses’s Substack and Just Therapy directory

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