Under-16s win right to take puberty blockers

Trust behind gender identity development service successfully appeals ruling by High Court

CHILDREN under 16 will be allowed to take puberty blockers without parental consent, the Court of Appeal has ruled.

The High Court previously concluded it was “highly unlikely” that a child aged 13 or under would be able to consent to the hormone-blocking treatment used to treat children with gender dysphoria, and that it was “very doubtful” a child of 14 or 15 would understand the long-term consequences.

The Tavistock and Portman NHS Foundation Trust, which runs the UK’S only gender identity development service (GIDS) for children, brought an appeal against the ruling in June.

In a judgment yesterday, the Court of Appeal said it was inappropriate for the High Court to give the guidance, which will affect thousands of children with gender dysphoria. Instead, it found that it is for doctors to exercise their judgment about whether their patients can properly consent.

In their ruling, the Lord Chief Justice Lord Burnett, with Sir Geoffrey Vos and Lady Justice King, 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 the administration of puberty blockers.”

They added: “It placed patients, parents and clinicians in a very difficult position.” The decision reverses a 2020 landmark ruling that under-16s lacked capacity to give informed consent to the drugs, which delay the onset of puberty.

The trust is now liaising with NHS England to consider how this ruling will affect its practice.

The Court of Appeal heard the Tavistock does not provide puberty blockers itself but instead makes referrals to two other NHS trusts – University College London Hospitals and Leeds Teaching Hospitals – who then prescribe the treatments. The court heard that the median age for consenting to puberty blockers is 14.6 for UCL and 15.9 for Leeds. Following the ruling, a Tavistock and Portman spokesman said: “We welcome the judgment on behalf of the young people who require the GIDS and our dedicated staff. The judgment upholds established legal principles which respect the ability of our clinicians to engage actively and thoughtfully with our patients in decisions about their care and futures.

“It affirms that it is for doctors, not judges, to decide on the capacity of under-16s to consent to medical treatment. We recognise the work we do is complex and, working with our partners, we are committed to continue to improve the quality of care and decision-making for our patients and to strengthen the evidence base in this developing area of care.”

Bayswater Support Group, which represents 350 families advocating for evidence-based care for trans-identified adolescents and young people, said it did not share the Appeal Court’s “confidence in GIDS clinicians”.

Nancy Kelley, chief executive of LGBT charity Stonewall, welcomed the ruling, describing it as “a huge relief for trans young people and their families, as well as the wider trans community”.