UK

UK court of appeal overturns landmark ruling on puberty-blocking

Health trust succeeds in arguing that ability to consent is a matter for judgment of doctors

Keira Bell, who had taken the original case, said she was ‘surprised and disappointed’ by the court of appeal decision but that she would be seeking permission to appeal to the supreme court. File photograph: Sam Tobin/PA Wire
Keira Bell, who had taken the original case, said she was ‘surprised and disappointed’ by the court of appeal decision but that she would be seeking permission to appeal to the supreme court. File photograph: Sam Tobin/PA Wire
Fri Sept 17 2021 - 17:35

A British court on Friday overturned a ruling that restricted children’s access to puberty-blocking drugs – a new twist in a global debate over when someone can opt to medically transition genders.

It was the role of doctors, not courts, to decide if a child under 16 was capable of consenting to drugs that pause puberty, the court of appeal for England and Wales said in its ruling.

The case was brought by 24-year-old Keira Bell, who says she regretted taking puberty blockers at 16 and cross-sex hormones at 17, and an unnamed mother.

Their case – a first in Britain – inflamed divisions globally over how best to treat children who are transgender or questioning their gender.

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The Tavistock and Portman NHS Foundation Trust, which runs England’s only youth gender clinic, welcomed the decision.

“It affirms that it is for doctors, not judges, to decide on the capacity of under-16s to consent to medical treatment,” a spokesperson said in an emailed statement.

Bell’s lawyer Paul Conrathe said his clients would be seeking permission to appeal to the supreme court.

“We are both dismayed and surprised at the court of appeal’s decision which appears to us the epitome of the triumph of legal formalism over justice and common sense,” he said by email.

“At a stroke the court’s decision removes a sensible, necessary and proportionate protection for vulnerable young children against the poorly evidenced treatment with lifelong irreversible consequences.”

Rising numbers of adolescents globally are seeking to change gender, dividing those who fear puberty blockers and cross-sex hormones are prescribed too early or with undue haste and those worried about access to medication they deem life-saving.

Tavistock figures show a nearly 30-fold rise in child referrals to its clinic in a decade, to about 2,560 in 2019.

In May, a Swedish hospital stopped giving puberty blockers and cross-sex hormones to children outside of research studies.

In July, a US federal judge suspended a first-in-the-nation state law in Arkansas that would have banned doctors from providing puberty blockers, cross-sex hormones or gender transition surgeries to minors. – Reuters