An NHS trust has won a Court of Appeal bid to overturn a landmark High Court ruling over the use of puberty-blocking treatments for children with gender dysphoria.
Last year the High Court ruled that children under 16 with gender dysphoria can only consent to the use of hormone-blocking treatments if they can understand the “immediate and long-term consequences”.
However, the judges said it was “highly unlikely” that a child aged 13 or under would be able to consent to the treatment, and that it was “doubtful” that a child of 14 or 15 would understand the consequences.
The original case was brought by Keira Bell – a woman who began taking puberty blockers when she was 16 before later “detransitioning” – against the Tavistock and Portman NHS Foundation Trust, which runs the UK’s only gender identity development service for children.
A mother of an autistic teenager who is on the waiting list for treatment, only known as Mrs A, supported Ms Bell in their successful legal case.
The NHS trust based in north London challenged the ruling in June and the Court of Appeal is due to rule on its appeal on Friday.
During the appeal, the trust’s barrister, Fenella Morris QC, said the decision “reset almost half a century of established law” and caused “serious distress to many young people and their families”.
Ms Morris told the court that reversible puberty blockers are used “to reduce distress” for children with gender dysphoria, allowing them to make decisions about their bodies in the future.
She continued: “Having reduced that distress, it creates the possibility to take time to consider options… it allows the child to make the choice.”
Human rights group Liberty, which intervened in the appeal, argued that the ruling imposed a serious restriction on the rights of transgender children and young people to “essential treatment”.
However, Jeremy Hyam QC, representing Ms Bell and Mrs A, told the court that the appeal should fail as it did not find any “material errors” in the original ruling.
He said that policies and procedures at the Tavistock “as a whole failed to ensure, or were insufficient to ensure, proper consent was being given by children who commenced on puberty blockers”.
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.
John McKendrick QC, for the other trusts, told the court the median age for consenting to puberty blockers is 14.6 for UCL and 15.9 for Leeds.
Published: by Radio NewsHub