Doctors can give children drugs that block puberty
They’re free to decide if under-16s are able to give their consent after controversial clinic has court ruling overturned
DOCTORS should be allowed to decide if children under 16 can be given puberty-blocking drugs rather than need a court’s approval, judges said yesterday.
In December the High Court ruled that it was ‘highly unlikely’ under-13s could consent to the monthly hormone injections, which ‘pause’ puberty so doctors can carry out sex change surgery later.
And it said it was ‘very doubtful’ a child of 14 or 15 would understand the potential lifelong consequences of the drugs.
Six months later, the ruling was appealed against by the Tavistock and Portman NHS Foundation Trust, which runs the UK’s only treatment clinic for young people with gender dysphoria.
And yesterday, the Court of Appeal ruled the original judgment was ‘inappropriate’ – finding that it is for doctors to exercise their own expertise on whether young transgender people can consent.
The trust, which does not provide puberty blockers itself, has referred children as young as ten to other hospitals for the drugs. But new referrals were suspended following the court ruling last year.
Following the trust’s appeal, the Lord Chief Justice Lord Burnett, Sir Geoffrey Vos and Lady Justice King issued a ruling which said: ‘The court was not in a position to generalise about the capability of persons of different ages to understand what is necessary for them to be competent to consent to... puberty blockers.’ They added: ‘It placed patients, parents and clinicians in a very difficult position.’
The original challenge to pubertyblockers was brought by Keira Bell, a 24-year-old woman who began taking them when she was 16 before ‘detransitioning’.
A mother of a 15-year-old autistic teenager who is on the waiting list for treatment also supported the case.
But, during the appeal, the trust’s barrister, Fenella Morris, said the court’s decision ‘reset almost half a century of established law’ and caused ‘serious distress to many young people and their families’.
Human rights group Liberty also said the High Court had imposed a serious restriction on the rights of transgender children and young people to ‘essential treatment’.
Puberty-blockers are said to give children ‘breathing space’ to decide if they wish to be a different sex, by preventing changes to their body such as their voice getting deeper or breasts growing.
If they then decide they want to, at 16 they can begin the physical transition, using the sex hormones oestrogen or testosterone. Or they can change their mind and come off the hormone-blockers before reaching a further stage, at which time puberty happens normally.
But the treatment may have irreversible effects – with fears that it could impact girls’ fertility if they do not come off it.
There are also concerns that the drugs may lead to osteoporosis, low mood and long-term effects on the brain and body which are not yet known.
Miss Bell said she was ‘disappointed’ by the ruling and will seek permission to appeal to the Supreme Court.
She added: ‘It did not grapple with the significant risk of harm that children are exposed to by
‘Placed patients in a difficult position’
‘Dark corners of a medical scandal’
being given powerful experimental drugs... It has shone a light into the dark corners of a medical scandal that is harming children and harmed me.’
But Nancy Kelley, chief executive of LGBT charity Stonewall welcomed the ruling, saying: ‘This deeply unsettling case has caused many trans young people and their families enormous distress... leaving young people in limbo without vital healthcare support.’
A spokesman for the trust said the judgment respected its clinicians’ ability ‘to engage actively and thoughtfully’ with its patients.
An NHS spokesman said its independent review on gender identity services would ‘set out wide-ranging recommendations’ including on the use of puberty blockers.