Heartbroken trans teen in ‘unbearable pain’ after ‘devastating’ High Court puberty blockers ruling

Trans girl denied puberty blockers on 'devastating' effect of Keira Bell ruling

A 17-year-old girl who’s been trying to access puberty blockers for two long years has described the “unbearable pain” of the High Court ruling last week.

On 1 December, judges decided that to give informed consent to puberty blocking medication, transgender under 16’s would have to be able to understand the nature of not just puberty blockers, but also hormone replacement therapy (HRT) and gender-affirming surgery.

The verdict made clear that the judges think trans under youth are unlikely to be able to give informed consent and that clinicians should therefore seek a court’s approval before prescribing puberty blockers. The outcome of this ruling is that the only NHS gender clinic for under 18’s in England and Wales, GIDS, has immediately halted referrals for puberty blockers.

The judicial review was brought by Keira Bell, 23, who took puberty blockers aged 16 and now regrets that decision, and Mrs A, a mother who wants to prevent her trans teenager taking puberty blockers.

This has left hundreds of young trans people – most of whom will have spent several years on the GIDS waiting list before even being able to speak to a doctor – in a limbo that they cannot see a way out of. Four parents of trans children, all of whom were on the brink of being referred for puberty blockers, last week described the judge’s decision as “devastating, discriminatory and cruel”.

Last year, 161 trans youth were referred by GIDS to an endocrinology service to be considered for puberty blockers. Each young patient had spent years on the GIDs waiting list before being assessed for the treatment over a course of 10 or more appointments, before being referred to the endocrinology service.

One GIDS patient, Amber, 17, told PinkNews that she is one of “those cancelled people” whose wait for puberty blockers is now over – with the High Court ruling denying her the healthcare she has waited two long years to access.

Puberty blockers could have prevented irreversible effects of male puberty

Amber was first referred to GIDS at the age of 15 by CAMHS, the child and adolescent mental health service, and her social worker. She socially transitioned with the support of her social worker at the same time, wearing similar clothes to other girls her age and presenting as a girl.

During her two year wait to be seen by a doctor at GIDS, Amber said she received no support – only “radio silence”.

“I slowly became more suicidal, anxious and depressed,” she says. “The feelings of helplessness and dread set in as days turned to weeks, and weeks turned to months, and months turned to years, knowing that nothing I can do can save me from my own body. 

“My body was progressing with a puberty I did not want. I despised the fact that when I walked with my friends, I could not help but think about how I am different than them. About how I feel as if I am a fake woman with testosterone in her body.”

Amber said she watched as male puberty changed her voice, skeletal structure and body hair – changes that are now irreversible, except with expensive and hard-to-access surgery.

“GIDS’s complete inability to provide me with the adequate care I needed during that time did not help,” she says. “My own puberty has traumatised me and devastated my mental health.”

My own puberty has traumatised me.

When she finally got a date for her first appointment at GIDS, after two years of waiting, she had to travel alone, as her mum struggles to travel and her grandad was busy. The 17-year-old made the 50-mile journey to the youth gender clinic by herself, and then spent an hour talking to a specialist about how she felt about her gender.

“I finally felt like I could voice everything. How I felt, my concerns, my fears, my hopes. You talk at GIDS for one hour maximum, and though it felt short, I was glad I could finally speak to someone who understood me on a higher level,” Amber remembers.

After that first appointment, she was given a date for her second one, in a month’s time. Despite having known she was a girl since she was 10, and despite having socially transitioned at 15 and then spent two years on the GIDS waiting list, GIDS would spend a year assessing Amber at monthly appointments before considering her for puberty blockers.

After that first appointment at GIDS, Amber remembers: “A new wave of sadness swept over me as I realised that they still do not think I am ready to even be considered for blockers.

“I kept asking as to why I still had not received any sort of treatment, and they said I was still ‘being assessed’,” she says. “I then spent the last year talking with them, expressing each time about my need to access blockers, and how sure I am that I wanted to transition, and that I wanted to stop the development of my male body I am trying so desperately to hide and run away from.

“They said they took my pleas into account, but still did not let me access blockers.”

Suicidal 17-year-old girl describes ‘devastation’ of Keira Bell ruling

Amber’s mental health had been suffering throughout this process. She became “more suicidal” and began carrying a knife with her, sleeping with it in her bed.

“I started being restless and unable to sleep every night knowing my body is proceeding with developing my unwanted characteristics, and it stopped me from functioning in day to day life, and GIDS still did not intervene,” she says.

Her first hospital appointment in Leeds this summer – for a blood test, one of the first steps towards being referred to an endocrinology service to be considered for puberty blockers – gave her hope, briefly, but she was sent home without the bone scan she needed.

I spent the next two months of October and November losing my desire to live, and I felt I had nobody to turn to,” Amber says.

I felt I had nobody to turn to.

“I ended up coping by talking with many of my friends, in which I constantly reiterated that I wanted to end my life, and that I am going to end my life. That I am unsaveable.”

Amber tried to talk to her GP about her suicidal feelings, but the doctor didn’t think that she needed anti-depressants. 

And then came the High Court ruling. GIDS has stopped referring patients for puberty blockers, but Amber can’t access hormone replacement therapy (HRT) until she turns 18 – in the UK, the rules are that trans youth aged between 16 and 18 must have been on puberty blockers for at least a year to be considered for HRT. Without blockers, Amber has to wait another year to be put on another waiting list to be considered for HRT.

“Years have passed,” she says, “and my body has well developed my primary and secondary characteristics. I deal with [this] every day.

“It makes me feel ill knowing I still must endure another year until I am able to access HRT now that my body’s testosterone has made itself feel at home in my body. Feeling like a woman feels like it is getting more and more difficult, and I feel like I want to end my life any day.”

It makes me feel ill knowing I still must endure another year.

“It is incredibly unnecessary, distressing and dehumanising to subject me to wait another year because they do not think I am ‘trans’ enough,” Amber says.

She continues: “Simply saying ‘I am trans, I have felt dysphoria for seven years’ should have been enough. Suffering through the wait list queue should have been enough. Waiting a year while they diagnosed me with monthly appointments including calls on the telephone should have been enough.

I now must wait another year and suffer because of a guideline they have, despite having waited triple that amount. I feel trapped in my own body, unable to escape, languishing treading water thanks to GIDS, a component of the NHS which has failed me, among many other trans people to provide adequate care, many of which have took their own lives.

“It is currently as it stands faster and easier to go on the grey market and inject yourself with imported drugs, or go with a third party out to gain a profit by exploiting the current NHS systems’ waiting times, than it is to wait for GIDS to provide you with sufficient care.

It is faster and easier to go on the grey market and inject yourself with imported drugs than wait for GIDS.

“GIDS is a complete failure of a service which has failed to provide me, as well as many other trans teens and children the care they sorely needed.”

Young British trans person now crowdfunding to access healthcare

Amber, like so many other trans people, is now crowdfunding to access HRT privately with GenderGP. Her family is on a low income, receives benefits, and has no other way of paying for private healthcare.

The ruling last Tuesday (1 December) was “devastating”, she says.

Amber thinks that Keira Bell’s legal fight has resulted in “denying thousands of trans teens and kids access to vital treatment by cancelling all referrals to puberty blockers only to add an extra gatekeeping measure”.

“I was one of those cancelled people, despite being 17 and a year away from being a fully grown adult. Words cannot describe how utterly devastated I was to hear that I must wait even longer than I have already to access treatment.

Words cannot describe how utterly devastated I was.

“I cried for what felt like hours, the pain is unbearable.”

The NHS Tavistock and Portman Trust, which runs GIDs, has said it will appeal the High Court’s ruling. No date has yet been set.