Transgender clinics face puberty-blocker ban to under 17s

Transgender clinics face being banned from giving puberty-blockers to under 17s if ‘detransitioned’ campaigner wins High Court war against NHS Trust that gave her hormone drugs as a teenager

  •  Keira Bell, 23, is taking legal action against Tavistock and Portman NHS Trust
  •  Diagnosed with gender dysphoria, she was given puberty blockers aged 16
  •  She claims gender clinic failed to carry out proper psychiatric assessment
  •  Three High court judges will decide if children can give informed consent 
  •  Bell, now living as a woman, underwent a double mastectomy at the age of 20

Doctors at transgender clinics could be forced to go to court before they can prescribe puberty-blocking drugs to children, if a landmark High Court case is successful this week.

Keira Bell, 23, of Manchester, who was diagnosed with gender dysphoria as a child when she said she wanted to become a boy, is taking legal action against the Tavistock and Portman NHS Trust in London after she was put on puberty blockers as a 16-year-old girl.

The IT worker, who now lives as a woman, claims the gender clinic failed to carry out a proper psychiatric assessment before giving them to her.  

In an interview with BBC Online, Miss Bell related how she was given the treatment – which for girls can pause the development of breasts and periods, or for boys, facial hair and voice breaking after three one-hour-long appointments.

The drugs are prescribed to children with gender dysphoria who feel their sex at birth doess not match up with their gender identity and who need more time to decide their options before going through puberty. 

She said: ‘I should have been challenged on the proposals or the claims that I was making for myself. And I think that would have made a big difference as well. If I was just challenged on the things I was saying.’

Keira Bell, 23, of Manchester, awaits the verdict this week of legal action against the Tavistock and Portman NHS Trust in London regarding prescribing puberty-blocking drugs to children

At the age of 17 she took testosterone, which left her with a deep voice and possibly infertile, and at 20 she had a double mastectomy – only later realising she had ‘gone down the wrong path’.

Miss Bell is now taking the Tavistock, which runs the Gender Identity Development Service (GIDS), to the High Court to stop it ‘rushing’ other teenagers into changing sex.

She is also raising fears over puberty blockers which halt a child’s normal physical development, making sex-change surgery easier when they reach adulthood.

Keira was diagnosed with gender dysphoria as a child and was referred to the Tavistock Centre

The hearing involves a second claimant, known only as Mum A, the mother of a 16-year-old girl with autism, who is awaiting treatment at the clinic. 

She fears her daughter will be fast-tracked for transgender medical treatment once she is seen by clinicians at the GIDS.

The mother says they will simply ‘affirm’ the girl’s belief – mistaken in her mother’s opinion – that she is really a boy. In reality, Mrs A believes her daughter’s desire to be male is driven by having Asperger’s syndrome, a mild form of autism.

‘This is bigger than just my child. The whole narrative is that if your child is confused about their gender, then transition is the only course of action,’ she told The Mail on Sunday last month.

‘There doesn’t seem to be any discussion of other possibilities. And that’s quite frightening.

‘The consequences of them getting it wrong are catastrophic,’ she added.

Three judges at the divisional court are expected to announce their decision on Tuesday as to whether children aged 16 and under are capable of giving informed consent for puberty-blocking drugs or cross-sex hormones.

Bell’s lawyers argue that children do not have enough experience to decide on something that could have long-lasting consequences on their future fertility and sex life. 

The Tavistock, backed by NHS England, argued that medical specialists in this field should be able to make calls based on their assessments.

Fenella Morris QC, who is representing the trust, told the court it was ‘a radical proposal’ to suggest children did not have the capacity to give consent.

Keira spoke on ITV’s This Morning in October and said her transition process felt ‘rushed’

Speaking last month on ITV’s This Morning, Miss Bell said: ‘I grew up very gender non-conforming and so that, along with things like sexuality struggles, kind of led to feelings of alienation.

‘I just became very depressed in my teens and very anxious and definitely very distressed about my body and all of that kind of manifested into gender dysphoria.

‘I was referred on to the CAHM clinic from my GP, which is the child and adolescent mental health service, and very shortly after that I was referred onto the Tavistock. 

‘It was just a process, I wasn’t necessarily happy or felt that I was being listened to. I was very focused on getting on the medical path.’

The Tavistock Centre has referred under 16s for puberty-blocking drugs since 2014

Miss Bell changed her name by deed poll, changed her gender on documents and identified as male, but claimed she did not receive sufficient therapy sessions.

She said: ‘There was no exploration of the feelings that I had, no psychiatric assessment. It was very brief and based on my recent past. There was no in depth discussion.

What is gender dysphoria? 

Gender dysphoria is a condition in which someone becomes distressed because they don’t feel that their biological sex matches the gender they identify as.

For example, someone may feel like a woman and want to live as a woman, but have been born with the anatomy of a man.

Gender dysphoria is a ‘recognised medical condition, for which treatment is sometimes appropriate’ and is ‘not a mental illness’, according to the NHS.

People who live as a gender which is not the same as their biological sex are called transgender.

Some people may choose to have hormone therapy – for example, to make them grow hair or develop breasts – or to have reassignment surgery to give them the genitals of a person of the sex they identify as.

People diagnosed with gender dysphoria are allowed to legally change their gender.

According to the charity Stonewall, as many as 1 per cent of the population may be trans – although accurate numbers are not known.

‘I can see now when I reflect back it was all very rushed, and I wish that there was some psychiatric assessment. At the end of the day I feel like it should have been explored into why I had those feelings and not just accepted for what they were.’ 

At 17 she was injected with testosterone and her body began to change.

She then had a double mastectomy aged 20.

Asked about how she felt about the changes now, Miss Bell said: ‘This is going to affect me for the rest of my life and I have to make do with that and try and accept for how I am now and attempt to move on with that. “

She added: ‘There needs to be explorative therapy. 

‘I don’t think that changing your body is going to help a psychological condition – that doesn’t make sense to me. So I think it’s important for these children to be protected and to be actually listened to in a professional manner.’  

According to legal documents seen by The Sunday Times,  the Tavistock has referred hundreds of patients under 16 – and some as young as 11 – for puberty-blocking drugs since 2014.

The last decade has also seen a significant rise in the number of children being referred for gender treatment in England.

In 2009, 40 girls under 18 were referred to the Tavistock, but by 2017 this figure had soared to 1,806. 

Professor Michael Biggs, a professor of sociology at Oxford, said: ‘If Keira won, this would have an effect all around the English speaking world. It would be a very significant ruling.’ 

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