Puberty-blocking treatment for children ‘provides time and is reversible’, court hears
Written by on 8 October 2020
Puberty-blocking treatment for children who are considering swapping gender provides time for deliberation and discussion and is reversible, the High Court has been told.
A 23-year-old woman who began taking puberty blockers when she was a teenager before “detransitioning” and the mother of an autistic girl are suing the UK’s only gender identity development service (GIDS) for children.
However lawyers for the Tavistock and Portman NHS Trust, which runs the service, has defended hormone treatment which is given to children as young as 10.
The case has been brought against the country’s only gender identity clinic for children by two claimants – the mother of a 16-year-old on the waiting list for treatment and Keira Bell who transitioned to a boy in her teens but has since stopped taking testosterone.
Lawyers representing the pair argue that children going through puberty are “not capable of properly understanding the nature and effects of hormone blockers”.
They are asking the High Court to rule it is unlawful for children who wish to undergo gender reassignment to be prescribed hormone blockers without an order from the court that such treatment is in their “best interests”.
Fenella Morris QC, representing the Tavistock and Portman NHS Trust which runs the service, said every consent decision involves explaining to each child the consequences of their decision in the future.
She added that it is up to clinicians to make sure they understand and if that child is deemed unable to grasp the consequences, they will not be given the puberty-blockers until that child’s “understanding of themselves and the world grows”.
The court previously heard that referrals to GIDS had risen from 97 in 2009 to 2,590 in 2018, “essentially a 20-fold increase”.
Lawyers for the hospitals which prescribe the treatment told the court how a 10-year-old could begin taking puberty-blockers and go on to “mature and have further life experiences”.
At 14 or 15 they could stop taking the treatment to enable them to have eggs harvested in case they decided to have children later, they added.
They went on to say that a child of 10 can “understand their body and the changes of their body” and can have “gender dysphoria which is causing them distress”.
The court heard there is no alternative treatment to the hormone blockers.
Keira was 16 when she began taking the puberty-blocking drugs and the following year began taking the cross-sex hormone testosterone, before have a double mastectomy at the age of 20.
She told Sky News that once on hormone blockers “it’s hard to get off because you are already on a medical pathway and even at that point you feel that you cannot turn back”.
“I was completely convinced the physical transition and medical transition was what I wanted to do.
“I was so distressed at the time and I fit the criteria… I thought it would change my life for the better.”
She now describes that as a “brash decision”.
On Wednesday, Ms Morris QC told the court the contention that children could not give informed consent to being prescribed hormone blockers was “a radical proposition”.
She argued in written submissions that the claimants sought to “impose a blanket exclusion” on children under the age of 18 to be able to consent to medical treatment.
Ms Morris added the majority of children referred to GIDS between March 2019 and 2020 were over 12, with only 13 of the children referred being under the age of 13.
The hearing before Dame Victoria Sharp, Mr Justice Lewis and Mrs Justice Lieven is in its second and final day.
It is expected that the court will reserve its judgment to a later date.
Lui Asquith, legal and policy director for the charity Mermaids, which supports transgender children, said: “If this case were successful, it would prevent trans young people from being able to take their own medical advice, heralding a new era of minority discrimination in England and Wales.”