Puberty blockers - The case against Tavistock & Portman NHS trust
The judgment in this case has been highly anticipated and, as expected, three High Court Judges have confirmed that children under 16 with gender dysphoria are unlikely to be able to give informed consent for treatment using puberty-blocking drugs.
The Trust has now immediately suspended all referrals for under 16 year olds.
What is Gender Dysphoria?
Gender dysphoria is a term that describes a sense of unease that a person may have because of a mismatch between their biological sex and their gender identity. This sense of unease or dissatisfaction may be so intense it can lead to depression and anxiety and have a harmful impact on daily life.
What are puberty-blocking drugs?
Puberty blockers, also called puberty inhibitors, are prescriptions used to postpone puberty in children.
The question to be decided by the Court was whether a child had the ability to consent to the use of these drugs.
A child aged 16 would be thought to have capacity, as the Judges confirmed:
“In respect of young persons aged 16 and over, the legal position is that there is a presumption that they have the ability to consent to medical treatment.”
The Judges heard arguments from lawyers that there was a “very high likelihood” that children who start to take the puberty blockers will then, later, begin to take cross-sex hormones and the evidence showed that these drugs will cause “irreversible changes”.
Is it possible that a child under 16 can consent to that? Can a young person 16 or over consent or should these be cases that are always referred to the Court?
The case was brought following Claimants’ undergoing the treatment, having consented to the same under the age of 16 years and then changing their mind. One Claimant is currently going through the de-transitioning process after having undergone hormone therapy for years and then a double mastectomy aged 20.
The judges concluded that a child under 13 us “highly unlikely” to be able to given informed consent and at 14 and 15 it is still “doubtful” if they could fully understand the long term implications of the medication. Even for 16 and 17 year olds’ the judges thought that it may be appropriate to involve the courts in the decision.
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