NHS’s Tavistock clinic in court battle over gender transition The Times 08.10.20

The original article is here.

A woman given hormones by the NHS to change her gender launched a legal challenge today to stop children receiving the same treatment unless ordered by a court.

Keira Bell, 23, from Cambridge, who was treated for gender dysphoria as a teenager, began a legal challenge to the NHS’s Tavistock clinic in London, saying she had not understood the nature of the treatment at the time.

She has since sought to reverse her transition and returned to living as a woman. She is supported by the mother of a 16-year-old girl who wants to transition to live as a boy. The mother wishes to remain anonymous and is referred to in court papers as Mrs A.

Ms Bell and Mrs A say that children are unable to give valid informed consent to treatments such as hormone suppressants at puberty and, once they reach their mid-teens, cross-sex hormones.

The pair are seeking a judicial review as a means to ban any such treatment for children under 18 unless their parents have obtained an order from a court declaring it to be necessary.

The Tavistock and Portman NHS Trust, supported by NHS England, opposes the move, saying that such treatment should be decided on a case-by-case basis after thorough assessments by qualified specialists.

It is considered a test case for the nature and scope of transgender healthcare for children in England, which has seen a huge increase in demand in recent years, with 2,590 referrals to the Tavistock clinic in 2018, of which three quarters related to natal girls.

Ms Bell and Mrs A, represented by Jeremy Hyam, QC, say that a child going through puberty is not capable of properly understanding the nature and effects of hormone blockers, and therefore cannot make an informed choice to go ahead.

Mr Hyam told the court that four fifths of children with gender dysphoria grow out of it past puberty and become gay, lesbian or bisexual.

Ms Bell and Mrs A further argue that the use of hormone blockers to address gender dysphoria does not have an adequate evidence base to support it, and is effectively an experimental treatment that should have a stricter legal, ethical and regulatory framework.

They also say that advice given to children being treated at the clinic is misleading because it gives the impression that hormone-blocking treatment is fully reversible, whereas evidence, they say, remains unclear on whether that is the case.

In a submission to the court, Ms Bell said: “I am a . . . woman left with no breasts, a deep voice, body hair, a beard, affected sexual function and who knows what else that has not yet been discovered.

“It is only recently that I started to think about having children and, if this is ever a possibility, I have to live with the fact that I will not be able to breastfeed my children.”

She said that having the treatment was “a brash decision as a teenager” as she was trying to find confidence and happiness, and “the rest of my life will be negatively affected”.

The trust, represented by Fenella Morris, QC, says in papers submitted to the court that it provides services lawfully, according to a specification from NHS England.

It says that a ban on such treatment for children would be inconsistent with the law’s treatment of teenagers aged 16 and 17, who are able to marry, enter a civil partnership, have sex or have an abortion.

The trial is being heard by Dame Victoria Sharp, president of the Queen’s Bench Division, with Mr Justice Lewis and Mrs Justice Lieven, and is expected to last for two days, with a judgment to follow in several weeks’ time.

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