PATHWAYS is a programme of research that aims to find out how the NHS can best support children and young people with gender incongruence.
The programme of research has been designed following recommendations made in the 2024 review by Dr Hilary Cass that said this is an area in which more research and evidence is needed.
The programme includes PATHWAYS HORIZON, TRIAL, CONNECT and VOICES.
PATHWAYS has been commissioned and funded by NHS England and the National Institute of Health and Care Research (NIHR), and is co-sponsored King's College London and South London and Maudsley NHS Foundation Trust.
PATHWAYS HORIZON is a longitudinal observational study that is the first in the programme of research.
This study was given ethics approval in July 2025.
PATHWAYS TRIAL is a study that will explore how puberty suppressing hormones (medicines that pause puberty) impact the physical, social, and emotional wellbeing of young people with gender incongruence.
This study was given ethics approval in November 2025.
We have not yet receive applications for PATHWAYS CONNECT or VOICES.
The PATHWAYS programme of research has attracted significant attention in the media which has resulted in a number of Freedom of Information requests and complaints being made to us.
To help explain our role in the review of this programme of research we have written about the things that Research Ethics Committees consider when reviewing research applications, and how we manage concerns about studies that are being reviewed.
PATHWAYS documents
As an organisation we are committed to transparency in research and with this in mind we have made documents about the ethics review of the study available for anyone to view.
Documents are also available on the King’s College London website for PATHWAYS HORIZON and TRIAL.