UK high court rules kids younger than 16 can't consent to puberty blockers; detransitioner wins case

The Tavistock and Portman NHS Foundation Trust building in London, England.
The Tavistock and Portman NHS Foundation Trust building in London, England. | YouTube/Sky News

A U.K. high court on Tuesday ruled against the Tavistock clinic, the NHS' sole gender clinic, in favor of a detransitioner who said she was harmed by puberty blockers and cross-sex hormones prescribed to her when she was a teenager. 

In a much-awaited ruling, the case of 23-year-old Keira Bell reached its conclusion when the judges ruled that children younger than 16 lack the maturity to give informed consent to the experimental treatments that alter the body. Bell, along with another unnamed claimant, brought the suit against the Tavistock and Portman NHS Trust, which operates the gender identity development service. The unnamed claimant is a mother of a 15-year-old child, who is autistic and is on the waiting list for treatment at the clinic.

Bell claimed in the suit that the gender-transition drugs irreparably damaged her body and have likely made her sterile. While she opted to undergo a gender transition, in her witness statement Bell said she made a "brash decision" as a teenager in an attempt to find confidence and happiness and did not understand the risks or long-term repercussions. Her attorneys argued in October that no child in the midst of puberty is able to give adequate informed consent.

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“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers,” the judges agreed in the ruling. “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.”

“Given the long-term consequences of the clinical interventions at issue in this case, and given that the treatment is as yet innovative and experimental, we recognize that clinicians may well regard these as cases where the authorization of the court should be sought prior to commencing the clinical treatment.”

Bell said outside the court Tuesday that she was "delighted" with the result of the judicial review.

“This judgment is not political, it’s about protecting vulnerable children … I’m delighted to see that common sense has prevailed,” said Bell, The Guardian reported. 

The high court ruled that in cases involving teenagers younger than 18, doctors might need to consult the courts for authorization and provided additional guidelines as to how young people suffering from gender dysphoria are to be treated.

The ruling also noted that the court asked Tavistock for statistics regarding the number of youth referred to GIDS for puberty-blocking drugs who had a diagnosis of autism spectrum disorder. However, the clinic did not provide the court with that data from its patient records.

The high court also noted that this lack of data analysis and apparent lack of record keeping of children with autism was "surprising." Thus, the judges could not determine the proportion of young people who were considered capable of giving consent under the Gillick standard, the test by which capability of giving consent to medical interventions is measured in the U.K.

What is known as Gillick competency in the U.K. centers around a 1985 case that was decided in the House of Lords in Gillick v. West Norfolk and Wisbech Area Health Authority in which lawmakers debated whether a child younger than 16 could be prescribed contraception by and with the discretion of a physician, without parental consent.

In a statement on its website Tuesday, the trans-critical group TransgenderTrend called the ruling a "watershed moment" and a "damning indictment of clinical practice" at the Tavistock facility, and urged the government to move in other areas to lessen the influence of the ideology that led Bell and others down a pathway of permanent medical harm.

"On the basis of the landmark judgment handed down in court today, the government needs to take action to remove all transgender guidance and resources from schools and social services departments to safeguard children and prevent any further teaching of this ideology to children as ‘fact,’" the group said, noting that the root of gender ideology is the denial of biological sex.

"This case has shone a light on the worst and most unforgivable result of the institutional capture throughout society by the gender lobby: the medical experiment on children’s healthy bodies, with serious irreversible and lifelong consequences."

Paul Conrathe, the attorney who represented Bell and the other claimant, said the ruling was “a historic judgment that protects children who suffer from gender dysphoria. … This may have led to hundreds of children receiving this experimental treatment without their properly informed consent.”

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