Puberty blockers: a welcome ruling?
Keira Bell’s story is a distressing one, said Sarah Vine in the Daily Mail. As a troubled teenager, she was referred to the youth genderidentity clinic at the Tavistock Hospital in London, where – at the age of 16 and after just four assessment appointments – she was put on a course of puberty-blocking drugs. A year later, she began injections of testosterone, and at 20, she had a double mastectomy. Now 23, Bell is living as a woman again and bitterly regrets the whole thing. She feels that her earlier gender confusion was simply a symptom of her mental health issues, and that she had been too young to understand the implications of her treatment. Last week, the High Court agreed with her, saying children under 16 were unlikely to be able to give “informed consent” to receiving pubertyblocking drugs. It’s a welcome ruling, but one that, sadly, comes too late for Bell.
Some see this as “a victory for common sense”, said Libby Brooks in The Guardian; others fear it will have a chilling effect on the rights of young trans people. They insist that hormone-blocking drugs provide both relief and more time for reflection for those suffering from gender dysphoria, many of whom find puberty a source of great distress. The Tavistock clinic argues that puberty blockers are safe and reversible, said The Economist, but in practice they do seem to be a one-way street. Of the 2,700 people referred to Tavistock’s youth clinic last year, around 40-50% were put on puberty blockers. Bell’s lawyers produced a study showing that in 97% of cases, they led to further treatments such as cross-sex hormones and surgery.
That children as young as ten have been put on these drugs can’t be right, said The Observer. And many other questions remain about the “gender-affirming” model of treatment for children at Tavistock, which has drawn criticism from several departing clinicians. The clinic was unable to supply basic data to the court. Among the questions it failed to answer was how many children referred to it for puberty-blockers had mental health diagnoses; what their age profile was; and whether the clinic had ever refused a child puberty-blockers because it didn’t deem them capable of consent. There are indeed children “who will find last week’s judgment distressing and it is imperative they receive the professional support they need”. But the situation as it stood was dangerously unsatisfactory. “Bell’s bravery has paved the way” for a system that ensures children get the protection to which they are legally entitled.