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UK High Court Rules Children Cannot Make Wise Decisions on Treatments to Alter Gender

Children in the United Kingdom under the age of 16 can no longer get puberty-blocking transgender hormones unless they can show an understanding of the risks and costs, says a High Court in the United Kingdom.

In their decision, Dame Victoria Sharp, president of the Queen’s bench division, Lord Justice Lewis and Mrs Justice Lieven, said a child under the age of 16 may only consent to the use of medication intended to suppress puberty “where he or she is competent to understand the nature of the treatment.” Such an understanding must include “the immediate and long-term consequences of the treatment, the limited evidence available as to its efficacy or purpose, the fact that the vast majority of patients proceed to the use of cross-sex hormones, and its potential life changing consequences for a child.

“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers,” the judges wrote. “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.

“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 recognize that clinicians may well regard these as cases where the authorization of the court should be sought prior to commencing the clinical treatment,” the judges wrote.

“At a hearing in October, lawyers for the claimants argued that children going through puberty were “not capable of properly understanding the nature and effects of hormone blockers,’” the Guardian reported.

The Tavistock organization “treats” children who live in England and Wales. In the year 2019-2020, of 161 children referred to GIDS, three were aged 10 or 11 and 95 under the age of 16, the Guardian reported. A spokesman for the Tavistock and Portman NHS trust said the trust would seek permission to appeal.

The case was brought on behalf of Keira Bell, who was given the drugs at age 16 after only three one-hour appointments. Dr. Jennifer Roback Morse, Ph.D., noted in a statement. “At 20, she had a double mastectomy. Now at 23, she’s in the process of de-transitioning.”

At the time, Bell said she believed the treatment would help her “achieve happiness,” but later she regretted the decision and last year began trying to reverse the process.

“It was heartbreaking to realize I’d gone down the wrong path,” Bell said, adding that the drugs had “irreparably damaged” her body and likely left her sterile.

Bell told the Guardian that she is “delighted” with the outcome. “This judgment is not political, it’s about protecting vulnerable children … I’m delighted to see that common sense has prevailed,” Bell said.

In her witness statement, Bell said, “I made a brash decision as a teenager, (as a lot of teenagers do) trying to find confidence and happiness, except now the rest of my life will be negatively affected.”

The Transgender Trend website, which took part in the lawsuit, also reported on the ruling:

Through her court action, Keira Bell has ensured that other troubled teenagers will now be protected from the harmful consequences she has had to face.

Transgender Trend intervened in this case particularly because of the unprecedented rise in the referral rate of teenage girls and the context within which the most vulnerable young people are now suddenly adopting a transgender identity.

"In our intervention, we submitted evidence that the GIDS operates within a core illogicality: a belief that biological sex is irrelevant to being a boy or being a girl, while providing a service that is predicated on the existence of, and ability to define, a ‘boy body’ and a ‘girl body’ that children might move between through medication and subsequent surgery. This is of course an impossibility, but it is an outcome that children are led to believe is possible,” Transgender Trend said.


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