01 December 2020 20:32

Kevin Sinfield Rob Burrow Leeds Rhinos

High Court ruling on puberty blockers protects teenagers, says woman who sued NHS

Standing outside the High Court, Keira Bell said that she hoped today's judgment marked the end of gender clinics "playing God with our bodies [by] experimenting on the young and vulnerable with untested, harmful drugs". With her deep masculine voice, facial hair and the loss of her breasts to a double mastectomy, Bell bears on her own body the scars of irreversible treatments she began at Tavistock's GIDS (gender identity development service) clinic at the age of 16. December 1st saw a court hearing go ahead involving Keira Bell and Tavistock and Portman NHS Trust. Twenty-three-year-old Keira Bell won a court case on December 1st after she took legal action against Tavistock and Portman NHS Trust. At the age of 16, she was prescribed puberty blockers and cross-sex hormones by doctors at the gender identity clinic.

According to Woman's Place UK, "GIDS put Keira Bell on a pathway that began with puberty blockers at 16, cross-sex hormones at 17, and resulted in a double mastectomy by the age of 20". The high court has ruled that children under 16 who wish to undergo gender reassignment can only consent to having puberty blockers if they are able to understand the nature of the treatment. As reported by the BBC, the court said that "It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers. It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers." The Tavistock and Portman NHS Trust is the only gender identity clinic for children in the UK. At the age of 16, Keira Bell went to the Tavistock clinic wanting to transition to male, however, today the 23-year-old is now detransitioning.

However, gender identity can often be a controversial topic and many Tweets of support for Keira have been matched with comments of disagreement as well as many who are concerned for trans young people under 16 wishing to seek medical treatment. Keira Bell has won her legal case against the NHS's only gender identity development service (GIDS) for under-18s, after the High Court found that children are unlikely to be able to give informed consent for taking puberty-blocking drugs. Keira has since regretted her transition and no longer identifies as a man, which is why she decided to try to prevent gender clinics steering other vulnerable young women towards irreversible and damaging interventions. Their judgment, deferred from October, concludes that it is 'highly unlikely' that a child aged 13 or under would ever be able to give informed consent to being treated with puberty blockers. The court also ruled that it would be appropriate for clinicians to involve the court in cases where there may be any doubt as to whether the long-term interests of a 16- or 17-year-old would be served by the clinical interventions of blockers and hormones.

Last year it was reported that one of the Tavistock foundation's governors resigned after accusing GIDS of dismissing a damning internal report which said that the service was 'not fit for purpose.' A number of parents had accused the service of fast-tracking young people into a transgender identity, and there were accusations – including by Dr David Bell, who had written the report in his capacity as then staff governor – that the service was failing to fully consider psychological and social factors in a young person's background, such as bereavement or autism, which might have an influence on their decision to transition. It was also revealed that 35 psychologists had resigned from GIDS in the space of three years, with many concerned about the service 'over-diagnosing' young people with gender dysphoria. In recent years GIDS has prescribed puberty blockers for children as young as 10-years-old. The huge jump in cases of girls presenting with gender dysphoria and seeking treatment in the past few years may be partly because in 2014 GIDS director Polly Carmichael appeared on CBBC and appeared to promote the use of puberty blockers. A woman who was given puberty blockers when she was 16 before later "detransitioning" has said she is "delighted" at a High Court ruling that she believes will give more protection to teenagers with gender dysphoria.

Keira Bell, 23, brought legal action against the Tavistock and Portman NHS Trust, which runs the UK's only gender identity development service for children. Three judges have said that children aged 13 and under are highly unlikely to be able to give their competent consent for treatment. They also stated that it was "doubtful" that 14 and 15 year olds would understand the long-term risks of gender reassignment treatment. In a judgment, Dame Victoria Sharp - sitting with Lord Justice Lewis and Mrs Justice Lieven - said that children under 16 needed to understand "the immediate and long-term consequences of the treatment" to be able to consent to the use of puberty blockers. Announcing the court's decision, Dame Victoria said that "in order for a child to be competent to give valid consent the child would have to understand, retain and weigh" a number of factors, including "the immediate consequences of the treatment in physical and psychological terms" and the fact that "the vast majority of patients taking puberty blocking drugs proceed to taking cross-sex hormones and are, therefore, a pathway to much greater medical interventions".

Ms Bell and Mrs A's solicitor Paul Conrathe said the ruling was "an historic judgment that protects children who suffer from gender dysphoria".