Under 16 year olds must be able to give informed consent
Court believes it is unlikely they are able to do so
Puberty blockers can be given to under-16’s, it has been ruled by the High Court, however this is only if they can give informed consent, understanding the gravity of the decision and the comprehend the treatment that they will receive.
Keira Bell, 23, a young woman who was given puberty blockers at the age of 16 by the Tavistock and Portman NHS Trust who has now undergone a process of de-transitioning, has won a partial victory in her court case against the NHS trust that gave her the puberty blockers.
The Tavistock and Portman NHS Trust currently runs the only gender identity development service for children named the Gender Identity Development Services (GIDS) clinic and assists numerous young people the opportunity to start the transition process using safe and reversible medical intervention.
The case, that was brought forward by Bell and another, was a landmark judiciary review of whether trans people under-18’s should have the ability to opt for puberty blockers by giving informed consent without parental consent.
The High Court ruled in its judgement that children under 16 must understand “the immediate and long-term consequences” of any decision to take puberty blockers prior to being allowed to commence the treatment. They also identified that they felt it was “doubtful” that children aged 15 could understand “the long-term risks and consequences” of their decisions and added that it was even more “highly unlikely” that children of 13 and 14-year olds would have the ability to comprehend their decision.
As a result of their decision, the court ascertained that any young person under 16 must have the capacity to make a fully realised and informed decision regarding the use of any puberty blockers.
Dame Victoria Sharp, who sat on the judiciary panel with Lord Justice Lewis and Mrs Justice Lieven, said, “There will be enormous difficulties in a child under 16 understanding and weighing up this information and deciding whether to consent to the use of puberty blocking medication.”
“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers.”
“It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.”
“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.”
“Given the long-term consequences of the clinical interventions at issue in this case and given that the treatment is as yet innovative and experimental, we recognise that clinicians may well regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment.”
The announcement comes as a large blow to anti-trans campaigners who were hoping for a judgement to be made that banned the use of puberty blockers in under-16s altogether.
The Tavistock and Portman NHS Trust said of the judgement, “The trust is disappointed by today’s judgment and we understand that the outcome is likely to cause anxiety for patients and their families.”
“Our first duty is to our patients, particularly those currently receiving hormone blocking treatment, and we are working with our partners, University College London Hospitals NHS Foundation Trust and Leeds Teaching Hospitals NHS Trust, to provide support for patients concerned about the impact on their care.”
“The trust is seeking permission to appeal the judgment, and in the meantime, confirms its ongoing support for the review commissioned by NHS England being led by Dr Hilary Cass.”
Although the ruling means that there will not be an all-out ban on puberty blockers for children under-16, it does mean that there will be much stricter procedures in place prior to trans children undergoing the treatment.
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“Puberty blockers can be given to under-16’s if they understand treatment”
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