Mother sues Tavistock child gender clinic over treatments The Times 12.10.19

The original article is here.

England’s first NHS child gender clinic is being threatened with legal action over its use of “experimental” treatments for children as young as 11.

The case, being brought by the mother of a patient aged 15 and a nurse who worked at the service, argues that hormone-blocking treatments are being unlawfully administered to children who cannot properly consent.

The pair are asking judges to ban the clinic from giving the treatment to children unless a court decides that it is in their best interests. They have accused the Tavistock and Portman NHS Trust, which runs the gender identity development service (Gids) in north London, of misleading families about the nature of the treatment.

They argue that children and their parents are not adequately told of the risks and cannot give informed consent because of the centre’s “inaccurate and potentially misleading” description of hormone blockers. The trust rejects their claims.

The mother who is bringing the case says she opposes the treatment that doctors at the clinic plan to give her daughter, who has autism and is awaiting assessment for reassignment therapy. She says her daughter is among many children with autism being treated at the clinic. She wants the treatment of all children to stop until the clinic’s practices are reviewed and more is known about the effects of hormone blockers.

She is supported by Sue Evans, 62, a psychotherapist and mental health nurse from Beckenham, southeast London, who worked at the unit from 2003-07. She is concerned by how quickly children were referred for hormone treatment.

The case comes after mounting pressure on the clinic over its use of hormone blockers, which delay puberty and sexual development for children who want to change gender. Hormone blockers are described by the trust as reversible. But a letter setting out the case says families are not told that risks include loss of fertility and probably of the ability to have an orgasm.

The Times revealed in April that five clinicians had resigned from the service amid concerns that vulnerable children struggling with their sexuality were wrongly diagnosed as transgender.

The Tavistock and Portman NHS Trust said: “It is not appropriate for us to comment in detail in advance of any proposed legal proceedings. The GIDS is one of the longest-established services of its type in the world with an international reputation for being cautious and considered. Our clinical interventions are laid out in nationally-set service specifications.NHS England, monitor our service very closely. The service has a high level of reported satisfaction and was rated good by the Care Quality Commission.”

An NHS spokesman said: “The priority has to be to deliver safe and effective treatment, so the NHS has recently confirmed we are reviewing all available evidence so as to publish an updated service specification next year.”

What the law says

Young people aged 16 or 17 years are presumed in law, like adults, to have the capacity to refuse or consent to medical treatment, but there is an overriding duty to act in a child’s best interests (Anne-Marie Hutchinson writes). Parents or an NHS trust can apply for a court order authorising or preventing treatment against the patient’s wishes. For children under 16, a competence test is applied. In this case, doctors would assess whether the patient fully understood doctors’ advice, and was mature enough to grasp the treatment and its consequences. Even if clinicians feel a child is competent, parents can apply for a court order preventing the treatment. An NHS trust can also apply to a court for permission to treat if it is unsure about the patient’s competency. The court would hear evidence on whether the treatment was necessary and in the child’s best interests. The court would also appoint a guardian to represent the child and ensure their wishes and feelings were put before the court.

Anne-Marie Hutchinson, QC (Hon), is a partner at Dawson Cornwell