Judges have approved the advancement of a trial in a case against the Tavistock gender clinic in London where a 23-year-old woman says she was severely harmed by experimental treatments as part of a gender transition when she was a teenager.
The legal action against the Tavistock and Portman NHS Trust, the lone gender identity clinic in the nation, comes amid heightened scrutiny about gender identity policies and the use puberty-blocking drugs, cross-sex hormones, and body-altering surgeries, and whether minors are capable of giving informed consent to such experimental practices.
According to the Sunday Times, one of the most senior judges on the U.K.'s highest court, Justice Supperstone, said it was “plainly arguable” that England's first pediatric child gender clinic was not acting lawfully when it referred children to go on hormonal agents meant to halt normal pubertal development.
Supperstone granted permission for a full trial in the divisional court before the end of July.
Lawyers for Keira Bell, a 23-year-old who underwent a hormonal transition at the clinic when she was a teenager, will argue that indeed children cannot give consent. The opposition, however, maintains that the experimental treatments save the lives of youth who self-identify as the opposite sex.
Bell was referred to the Tavistock Gender Identity Development Service (GIDS) when she was 16, and has said that after three appointments she was prescribed puberty blockers, the BBC reported Sunday. She now believes the risks of the drugs were never adequately explained to her and that the process to transition her both chemically and surgically was fast-tracked.
"I should have been challenged on the proposals or the claims that I was making for myself," she told the BBC. "And I think that would have made a big difference as well. If I was just challenged on the things I was saying."
Bell took the puberty-blocking drugs for a year and then continued down the transition pathway with testosterone, which caused her voice to deepen and facial hair growth. She had her breasts amputated three years ago. Last year she decided to quit taking cross-sex hormones.
"Initially, I felt very relieved and happy about things. But I think as the years go on you start to feel less and less enthusiastic or even happy about things," Bell said.
"You can continue and dig yourself deeper into this hole or you can choose to come out of it and have the weight lifted off your shoulders."
Bell now accepts herself as female and is angry about how she was treated at the gender clinic.
"I feel I could say anything to my 16-year-old self and I might not necessarily listen at that time. And that's the point of this case, when you are that young you don't really want to listen," she said.
"So I think it's up to these institutions, like the Tavistock, to step in and make children reconsider what they are saying, because it is a life-altering path."
When Bell was asked about how important it was for her to transition as a teen, she indicated that the process was gradual as she read more information on the internet about what was involved. Yet upon starting with the experimental drugs, "one step led to another," she said.
Defenders of medicalized gender transition routinely insist that puberty-blocking drugs are fully reversible.
Rates of gender dysphoria in youth, particularly among girls, have risen astronomically in the U.K. in the past decade.
Critics of transgender ideology, especially as it relates to medicalizing young people, often point out that a significant number of youth being transitioned are on the autism spectrum, are gender-nonconforming, or are experiencing same-sex attraction and will likely go on to identify as gay or lesbian if left alone.
Gender confusion is often accompanied by other psychiatric comorbidities that can go unexplored or treated by clinicians intent on affirming transgender identities, critics say.
Polly Carmichael, who heads the Tavistock clinic, maintains that the facility is welcoming the judicial review and that treating gender dysphoric youth is a complicated matter.
"This is a really complex area with strong feelings on all sides. And at its center, the young people we work with — they come to us in often really great distress around their sense of themselves," she said.
She went on to assert that youth who come to the clinic feel their body does not match their "gender identity."
The amorphous term gender identity has no material definition yet is employed by transgender activists and their allies as though it is an innate and immutable trait of their existence. Thus, they insist, their self-declared gender is their most authentic identity which should be recognized in society and on legal documents such as birth certificates.
In July, former GIDS staff psychologist Kirsty Enwistle penned an open letter to Carmichael arguing that a culture of evasive deception existed at the clinic and that medical treatments lacked a robust evidence base. Other clinicians with similar concerns have resigned in protest of the facilities practices.
The NHS announced in February that it was revisiting its rules around permitting children to take the experimental drugs without parental approval as well as forming a task force of doctors to conduct a formal review of puberty blockers.