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Trans children can take puberty blockers if they understand 'consequences' of treatment
1 December 2020, 14:27
Trans children are only allowed to take puberty blockers as long as they understand "the immediate and long-term consequences of the treatment" to be able to consent, the High Court has ruled.
The ruling is a victory for those concerned about the impact of the treatment on young people but has disappointed trans campaigners who believe it should be more accessible.
Judges concluded that it is “doubtful” under-16s could understand “the long-term risks and consequences” of the treatment, and that it is “highly unlikely” that children under 13 would be able to give consent.
Keira Bell, who began taking puberty blockers at 16 before "detransitioning", said she is "delighted to see that common sense has prevailed" after winning her case against the Tavistock and Portman NHS Trust.
In the judgment, Dame Victoria Sharp - sitting with Lord Justice Lewis and Mrs Justice Lieven, said their ruling was only on the informed consent of a child or a young person, not whether puberty blockers (PBs) were appropriate themselves.
The judges said: "The court is not deciding on the benefits or disbenefits of treating children with GD (gender dysphoria) with PBs, whether in the long or short term.
"The court has been given a great deal of evidence about the nature of GD and the treatments that may or may not be appropriate. That is not a matter for us.
"The sole legal issue in the case is the circumstances in which a child or young person may be competent to give valid consent to treatment in law and the process by which consent to the treatment is obtained."
It adds to an ongoing debate over how accessible treatment should be for those who wish to have gender reassignment surgery.
Trans children's charity Mermaid labeled the ruling a "devastating blow", describing it as "a potential catastrophe for trans young people across the country"
The organisation's solicitor Lui Asquith told reporters: "This morning's judgment has been an absolutely devastating blow for trans young people across the country.
"We believe very strongly that every young person has the right to make their own decisions about their body and that should not differ because somebody is trans.
"The court today has decided to treat trans young people differently to every other child in the country.
"We believe that we're entering a new era of discrimination, frankly."
At a High Court hearing in October, lawyers representing the claimants said there was "a very high likelihood" that children who start taking hormone blockers will later begin taking cross-sex hormones, which they say cause "irreversible changes".
The Tavistock and Portman NHS Trust - as well as University College London Hospitals NHS Foundation Trust and Leeds Teaching Hospital NHS Trust - argued that taking puberty blockers and later cross-sex hormones were entirely separate stages of treatment.
But in its ruling, the High Court said: "It is said therefore the child needs only to understand the implications of taking puberty blockers alone ... in our view this does not reflect the reality.
"The evidence shows that the vast majority of children who take puberty blockers move on to take cross-sex hormones."
The court added that both treatments were "two stages of one clinical pathway and once on that pathway it is extremely rare for a child to get off it".