RecruitingObservational

PATHWAYS HORIZON: A longitudinal observational study

The PATHWAYS Horizon study aims to understand and improve support for children and young people in the UK who feel their gender identity is different from the sex they were assigned at birth. This study will follow young people attending NHS gender services and their parents. It will track how their physical and emotional well-being changes, and what care and support they receive as they grow up. By collecting information through questionnaires, researchers hope to fill gaps in our knowledge about how gender identity develops and which treatments are most helpful. The goal is to provide better information for young people, parents, and healthcare professionals to make informed decisions about care.

At a glance

Status

Recruiting

Enrolment target

3,600

Start

01 Oct 2025

Estimated completion

30 Jun 2028

Gender incongruence

What is this study about?

The PATHWAYS Horizon study is designed to explore how the NHS can offer the best possible support to children and young people who feel that their gender identity is different from the sex they were given at birth. This feeling is called gender incongruence. In the UK, there are special NHS gender services that offer support, including talking therapies and sometimes medical treatments. However, we don't fully understand how these young people's feelings and identities develop over time, or which treatments are most effective and helpful for them.

This study will involve young people who visit UK NHS Gender Services, along with their parents, if they wish to take part. Researchers will track their physical health, how they feel socially and emotionally, and the support they receive over several years. This will help us learn more about their needs and how services can best help them and their families.

The information gathered from PATHWAYS Horizon is really important. It will provide new and valuable evidence that will help young people with gender incongruence, their parents, and healthcare professionals make informed choices about the care and support options that are most likely to be beneficial for them. The study is run by King's College London and funded by the National Research Collaboration Programme (NRCP).

Key takeaways

Aims to improve support for young people with gender incongruence.
Open to 5-18 year olds attending UK NHS Gender Services.
Involves completing questionnaires about well-being and care.
Helps healthcare professionals make better decisions.
Participation is voluntary and confidential.
Study runs until 2031.

Who may be eligible?

This study is open to all children and young people attending NHS Children & Young People’s Gender Services (CYP-GS) across the UK. It doesn't matter if you've just been referred or have already had an appointment.

If you are under 16, both you and your parent or legal guardian need to agree for you to take part. If you are 16 or older, you can agree to take part yourself. For parents, if you want to share information about your child for the study, you can also join.

The study is for young people between 5 and 18 years old.

Could this study suit you?

Answer these quick questions to see if you may be eligible. This is a guide only — the research team makes the final call.

Are you between 5 and 18 years old?
Are you attending an NHS Children & Young People’s Gender Service in the UK?
If under 16, do you and your parent/guardian both agree to take part?
If 16 or over, do you agree to take part?
Are you able to complete questionnaires?

Answer every question to see your result.

What does participation involve?

If you decide to take part, the study will ask you to fill out several questionnaires. These questionnaires will ask about your feelings, how you behave, your quality of life, your mental health, and how gender incongruence affects you. Your parent or guardian will also complete similar questionnaires from their point of view. There are no special medications or extra visits involved beyond your usual NHS care, but participation might mean more check-ins with the study team. The study started in December 2024 and is expected to run until January 2031, so it will follow participants for several years.

Potential risks and benefits

By taking part, you'll be contributing to really important research that aims to improve care and support for young people with gender incongruence. While some questionnaires might feel a bit personal or take some time, any discomfort is expected to be minimal. There's also the very small chance of feeling some emotional sadness or having your privacy accidentally impacted. However, strict measures are in place to manage these risks and keep your information safe and confidential. Remember, you can choose to stop participating in the study at any time, for any reason, without it affecting your NHS care.

Locations (3)

Great Ormond Street Hospital for Children
Approximate
London, England
University Hospitals Bristol and Weston NHS Foundation Trust
City only
Bristol, England
Alder Hey Children's Hospital Trust
City only
Liverpool, England

Common questions

What is gender incongruence?

It's when a person feels their gender identity is different from the sex they were assigned at birth.

Who can join the study?

Any child or young person (aged 5-18) attending an NHS Gender Service in the UK, and their parents, can take part if they wish.

What will I have to do if I join?

You'll fill out some questionnaires about your feelings, well-being, and how gender incongruence affects you. Parents will also complete questionnaires.

Will joining the study change my medical care?

No, joining will not change your regular NHS medical care, but you might have more contact with the study team.

When does the study finish?

The study aims to run until January 2031.

How to find out more

Emily Simonoff

PATHWAYSEnquiries@kcl.ac.uk - Official trial record

Always speak to your GP or specialist before deciding to take part in a study.