NHS wins right to appeal cruel High Court puberty blockers ruling that restricts healthcare for trans kids

NHS wins legal appeal against puberty blockers ruling.

The NHS has been granted permission to appeal a High Court ruling that said transgender under-16s cannot give informed consent to puberty blockers.

The Tavistock and Portman NHS Trust, which runs GIDS, the only gender clinic for trans youth in England and Wales, said it would appeal the ruling when it lost the judicial review in December 2020.

The Tavistock’s appeal has now been granted, it was confirmed Monday (18 January), and will be heard before 22 March, 2022. A spokesperson for the Trust said they “welcome” the court’s decision to allow their appeal against the ruling.

“Our priority is to work together with our partners to support our patients and their families while legal proceedings are ongoing,” the spokesperson said. The judges ruled in December that the judgment will not be implemented until the outcome of the appeal is determined.

The High Court’s verdict sent shockwaves through the LGBT+ community, as it meant young trans people’s access to healthcare in England and Wales was further restricted.

The case was brought by Keira Bell, 23, who took puberty blockers at 16 and had top surgery at 20 but has since detransitioned, and Mrs A, who is trying to prevent her 16-year-old child taking puberty blockers.

It hinged on whether under-16s can give informed consent to puberty blockers, which are currently the only medication available to trans under-16s experiencing gender dysphoria. Seventeen and 18-year-olds who have been taking puberty blockers for at least a year are eligible for hormone replacement therapy (HRT).

Puberty blockers are widely deemed safe, reversible and medically necessary, lawyers for the Tavistock maintained. Lawyers for Bell and Mrs A argued that trans teens should have to go before a court before being able to access the medication.

The High Court agreed, with the judges saying in their ruling that it is “doubtful” children aged 14 to 15 could understand “the long-term risks and consequences” of taking puberty blockers and then HRT, and “highly unlikely” that children under 13 would be competent to give consent.

As a result, the court said clinicians may “regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment”. The judges ruled that informed consent for puberty blockers should be tied to an understanding of the long-term implications of taking HRT or having gender-affirming surgery later in life.

At the hearing in October, the court heard that in 2019-2020, 161 under-18s were referred by GIDS to be assessed for puberty blockers by endocrinology specialists. Half of the trans youth referred were aged 16 or older – even though puberty starts, on average, at age 11 for those assigned female at birth and at 12 for those assigned male.

Years-long waiting lists for GIDS mean trans young people referred to the service wait several years for their first appointment, and must be assessed over at least 10 appointments before being considered for referral on to an endocrinology service to be assessed for puberty blockers.

As a result, many trans teenagers in England and Wales age out of the youth gender clinic system before receiving any healthcare at all.