Children under-16 in UK CAN take puberty blockers without parents' consent

UK: Children under-16 can now take puberty blockers without their parents' consent as the Court of Appeal overturned landmark ruling against an NHS gender clinic.

In a ruling last December, the High Court ruled that children under 16 with gender dysphoria could only consent to the use of hormone-blocking treatments if they understood the 'immediate and long-term consequences'. 

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. 

But the Tavistock and Portman NHS Foundation Trust, which runs the UK's only gender identity development service for children, brought an appeal against the ruling in June.

In a judgment on Friday, the Court of Appeal said it was inappropriate for the High Court to give the guidance, finding doctors should instead exercise judgment about whether their patients can properly consent.

The original case was brought by Keira Bell - a 24-year-old 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.

Critics had argued that puberty blockers could leave youngsters infertile and have longer-term effects on sexual function and bone density. 

Ms Bell today said she was 'obviously disappointed' with the ruling, and said the case had 'shone a light into the dark corners of a medical scandal that is harming children.'

She added: '[Today's ruling] did not grapple with the significant risk of harm that children are exposed to by being given powerful experimental drugs.

'I am surprised and disappointed that the court was not concerned that children as young as 10 have been put on a pathway to sterilisation.'

A mother of an autistic teenager who is on the waiting list for treatment, only known as Mrs A, supported Ms Bell in the successful legal challenge. 

Hormone, or 'puberty', blockers pause the physical changes of puberty, such as breast development or facial hair.

In Friday's 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.'

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. 

Keira Bell said she was 'surprised and disappointed' in the decision but said she had no regrets in bringing the case.

Adding that she believed the medical service had become 'politicised', Ms Bell said she will be seeking permission to appeal to the Supreme Court.

She said: 'I am obviously disappointed with the ruling of the court today and especially that it did not grapple with the significant risk of harm that children are exposed to by being given powerful experimental drugs. 

'I am surprised and disappointed that the court was not concerned that children as young as 10 have been put on a pathway to sterilisation.' 

'It has shone a light into the dark corners of a medical scandal that is harming children and harmed me,' she continued. 

Ms Bell also said: 'A global conversation has begun and has been shaped by this case. There is more to be done. 

'It is a fantasy and deeply concerning that any doctor could believe a 10-year-old could consent to the loss of their fertility.' 

Adding that she believed the medical service had become 'politicised', Ms Bell said she will be seeking permission to appeal to the Supreme Court.

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