Trans clinics face puberty-blocker ban for under-17s Sunday Times 29.11.20

The original article is here.

Transgender clinics could face legal blocks on prescribing puberty-blocking drugs to children aged 16 and under after a landmark judgment this week.

If Keira Bell, 23, wins her case on Tuesday, doctors could be required to persuade judges before they can prescribe puberty-blockers to children.

Bell, who as a girl said she wanted to become a boy, was given puberty blockers at the age of 16 after being referred to Britain’s first gender identity clinic, at the Tavistock and Portman NHS Trust in London.

At the age of 17 she received cross-sex hormones and at 20 had a double mastectomy. She now lives as a woman and fears the treatment may have damaged her ability to have children.

She took the case because she feared the experimental treatment threatened children’s future fertility and sex life and believes they do not have the capacity to consent. The loser in the case is likely to appeal to the Supreme Court.

Three judges at the divisional court will rule on whether children aged 16 and under can give informed consent for being injected with puberty-blocking drugs or cross-sex hormones. Bell’s lawyers argued that children of that age have too little experience of life to understand the potential consequences. The court will also decide if children aged up to 18 can give consent.

The Tavistock argued that expert clinicians should be able to make calls on the basis of thorough assessments. Fenella Morris QC, representing the trust, told the court that it was “a radical proposal” to suggest children were incapable of giving informed consent.

Since 1985, doctors have relied on the Gillick competence test, which balances a range of factors including age, maturity and understanding to decide whether a child can consent. Parents lose their right to decide under this test.

In recent years hundreds of youngsters seen at the Tavistock were prescribed the blockers, sometimes against their parents’ wishes.

The youngest was 10. The most common blocker used is triptolerin, which is licensed to treat advanced prostate cancer in men, chemically castrate male sex offenders and halt very early puberty. It is not licensed for gender dysphoria.

Adult NHS clinics also treat children aged 17 and over with blockers and cross-sex hormones. Professor Michael Biggs, a professor of sociology at Oxford, said: “If Keira won, this would have an effect all around the English speaking world. It would be a very significant ruling.”

According to legal documents, the Tavistock started referring children as young as 11 or 12 for the puberty-blocking drugs from 2014 and is still doing so. In the year up to March, 161 children under 16 were prescribed triptolerin or similar drugs. In 2009, 40 girls under 18 were referred to the Tavistock for gender treatment in England. By 2017 this had soared to 1,806.


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