In a controversial case concerning the use of puberty blockers for children who are confused about their gender, the British Court of Appeal ruled Friday that doctors can prescribe such experimental drugs without parental consent.
Overturning a High Court ruling, which had concluded last year that it was “highly unlikely” that a child aged 13 or younger would be able to consent to taking puberty blockers, the court said Friday that doctors, not the courts, will decide whether their patients can properly consent to taking such treatment, The Telegraph reported.
“The court was not in a position to generalize about the capability of persons of different ages to understand what is necessary for them to be competent to consent to the administration of puberty blockers,” the Lord Chief Justice Lord Burnett, with Sir. Geoffrey Vos and Lady Justice King, said in the judgment, The Times reported. “It placed patients, parents and clinicians in a very difficult position.”
The high court’s decision was appealed by the nation’s sole gender clinic, the Tavistock and Portman National Health Service Trust in London, in June. And the Trust is now in talks with NHS England to ascertain the ruling’s impact on its practice.
The original case was brought about in part by Keira Bell, a 23-year-old detransitioned woman who underwent the experimental treatment at the Trust’s facility as a teenager.
Bell had her breasts amputated as a young adult and then wound up regretting the entire gender transition later in her life. Bell argued in her case that she was incapable of understanding the risks of the medical interventions and that she is now likely not able to ever have children because of how the drugs compromised her fertility.
Bell was quoted as saying that she was “surprised and disappointed” by the decision of the appeal court but doesn’t regret having filed the lawsuit. “It has shone a light into the dark corners of a medical scandal that is harming children and harmed me,” she said, adding that she plans to appeal the ruling to the Supreme Court.
The high court ruling last year, which now stands overturned, required doctors to obtain what is known as a “best interests” order from a judge before they could prescribe such drugs to youth. At issue in the case was the “Gillick competence” test, which holds that parental rights in the United Kingdom pertaining to medical treatment end when the child achieves enough understanding and intelligence to understand what is being proposed.
The Gillick standard, from which the competence phrase is derived, centers around a 1985 case that was decided in the House of Lords. In Gillick v. West Norfolk and Wisbech Area Health Authority, lawmakers debated whether an under-16 minor could be prescribed contraception without parental consent.
In March, the high court ruled that parents would be allowed to give consent for their minor children to take puberty-blocking drugs without having to gain a judge’s approval.
The use of synthetic hormones to block the puberty processes of children experiencing gender dysphoria has faced increased scrutiny in recent years.
A study published in PLOS One followed a cohort of youth treated at the Tavistock clinic and found that the use of puberty blockers was shown to have stunted their bone growth. Of the 44 children who went on the puberty-suppressing drugs, 43 continued to cross-sex hormones.
Last June, the NHS updated its policy on puberty blockers by removing the claim that the experimental drugs prescribed to transgender-identifying youth are “fully reversible,” and said it’s unknown what the short-term and long-term effects will be on a person's bones, physical body and mental health.