On 1st December, the UK’s High Court of Justice ruled that Trans children under the age of 18 should obtain permission from a court before being prescribed puberty blockers by the NHS. The judgement, carried out by Dame Victoria Sharp, Lord Justice Lewis and Mrs Justice Lieven, also stated that it is ‘highly unlikely’ a child under 13 could ever give valid consent to treatment, and that it’s ‘very doubtful’ a 14- or 15-year-old is capable of giving valid consent. It also suggests that, in some cases, 16- and 17-year-olds might not be capable of consent and should seek a court order.
This ruling was carried out in response to a case brought forward by Keira Bell, a 23-year-old woman who took puberty blockers in her teen years before “detransitioning’ in her early 20s, and the mother of a 16-year-old girl who is awaiting treatment, against the Tavistock and Portman NHS Foundation Trust, which houses the UK’s only gender identity development service (GIDS) for children.
A number of LGBTIQA+ individuals, organisations and charities, as well as parents of Trans, non-binary and gender non-conforming children, have voiced their concerns around this judgement by the High Court, with Stonewall and Mermaids releasing official statements. In Stonewall’s statement, Nancy Kelley (she/her), the Chief Executive shared the organisation’s worry that this ruling will have a significant restrictive impact on young Trans people’s ability to access timely medical support. She continued, “For decades, hormone blockers have been used to pause puberty for children experiencing precocious puberty. They also play a vital role in helping to alleviate the distress many trans young people experience and offer much-needed time to questioning young people to explore their identity. Denying this vital support is not a neutral act and can be deeply harmful to trans young people.”
Kelley also highlighted the fact puberty blockers are a reversible intervention, which directly challenges a pervasive mentality amongst those who advocate for restricting Trans+ childrens’ access to affirming healthcare. This argument was mirrored by Mermaids, who provide specific support for Trans, nonbinary and gender-diverse children, young people, and their families, who also added that the use of puberty blockers has “been widely researched for three decades and is an internationally-recognised treatment, which has had a hugely positive impact on many young trans people.”
The court today has decided that trans young people should be treated differently. This is concerning in itself because if you start treating minority groups differently, it not only impacts that population of people, but risks opening the floodgates to broader discrimination within the health system and beyond.
Whilst there is no shortage of coverage addressing the lives and rights of Trans people in the UK, whether it be splashed across the pages of a tabloid, argued in prose in the Opinions section of newspapers, debated on sofas on national TV or discussed by the privileged few behind closed doors, there’s one thing that’s often missing – Trans voices. Trans, non-binary and gender non-conforming people are, far too often, excluded from being able to engage with the very conversations that follow them into changing rooms, bathrooms, and even their bedrooms, and have a direct impact on their access to bodily autonomy. Not only does this make Trans people feel even more marginalised and erased, but it feeds into cultural attitudes that paint Trans people as boogeymen lurking in the shadows, waiting for their chance to pounce on unsuspecting children and “turn them Trans”.
In an effort to cut through the tsunami of fear-mongering and uninformed voices, I caught up with four wonderful Trans+ people, who kindly offered to share their lived experiences and thoughts regarding this ruling with me.
“Give the kids their damn pause button. Let them decide what they play next.”
As if there is any way to move back through time. As if there is any way to erase identity exploration from your past. As if someone de-transitioning isn’t in fact ‘re’-transitioning. Just like sexuality or any other aspect of our identity, gender experiences don’t need to be linear. There are as many genders as there are people on Earth, and each of us explores ours throughout life. Some of us barely move; some of us land at a place that’s far from where we started; and some of us end up doing a full 360. Give the kids their damn pause button. Let them decide what they play next.
As Trans people, we have a strange relationship with time. We can experience it in a different order or speed. We can wait a lifetime for a surgery. We can experience puberty in our 40s. We can be born at any age, an infinite amount of times. Our time-transgressing qualities certainly are magical. But some cis people fear our relationship to time. They especially fear lost time. Transphobic narratives against children fear and pre-empt their regret, their wasted adolescence. (Which, seeing that most of my Trans friends had an uncomfortable ‘cis’ adolescence, seems quite ironic…) This equates gender exploration of any kind with shame – a shame that they put onto us, but one they also claim to want to prevent. The weaponised ‘de-transition’ rate is miniscule. But even if the rate was sky-high, any teenager should be allowed access to hormone blockers. If we were to remove the idea that ‘failed’ gender exploration should be a regret, transphobes’ point evaporates.
Azekel Axelle (they/them)
“I am heartbroken, I am devastated, but most importantly I am angry.”
The recent High Court ruling confirms what I already knew: that the UK is a transphobic country. The only non-medical intervenor in the case that was allowed was a transphobic hate group called Transgender Trend. No groups that helped Trans children were allowed to submit evidence. From the beginning, the case was going to be one that was skewed by the perception of Trans rights through a powerful and privileged cisgender lens.
Keira Bell was 16 when she started transitioning and transitioned for 8 years, having a double masectomy at age 20. She was old enough to consent to and understand the decisions that she was making about her body, as was her right. Puberty blockers being targeted makes little sense as they actually offer the child more time to explore and think about their gender identity in a way that isn’t detrimental to their wellbeing. They are reversible. Puberty is not. Forcing a child to go through the irreversible trauma of an unwanted puberty is as far as possible from protecting the child, instead subjecting them to more turmoil in an already complex existence. Trans children’s mental health will plummet even more and we WILL see more suicides as the Tavistock clinic has now stopped all referrals.
The waiting time to access a Gender Identity Clinic (GIC) is 2-4 years, and there are assessments and regulations put in place by trained medical professionals. It’s not a case of walking into the clinic and being offered treatment. Hormone replacement therapy (HRT) cannot be started below the age of 16, so it makes little sense as to why the risks of HRT were included in this decision. It is important to mention that the lawyer for the claimants, Paul Conrathe, is anti-abortion. He has used similar arguments about the age of consent in many abortion cases. Trans children have a right to bodily autonomy and this has been taken away. I am scared as to the possible questions that could arise for other medical treatments including abortion and contraception.
I am heartbroken, I am devastated, but most importantly I am angry. I will continue to support the Trans community, especially the Black Trans community in any way that I can, as it is clear that this Government and institution has no intention of doing so.
Wednesday Holmes (they/them)
“Anyone who knows what gender dysphoria feels like, would never restrict access to safety like this.”
Supporting Trans children through transition is suicide prevention. We are toying with the health of vulnerable children when we remove their options at having a comfortable life. In all of this, we need to remember that the safety of Trans children is at risk here. Anyone who knows what gender dysphoria feels like, would never restrict access to safety like this.
“When the media amplifies and celebrates cases like Kiera Bell’s, they do more damage than the actual court decision.”
When I heard about the case against the NHS from a de-transitioner, I was immediately worried. Not only because it threatened access to healthcare for Trans children, but because it was blatantly going to be a very public case, saturated in media coverage and just a small part of the wider effort to demonise Trans people in the eyes of the British public. Every time Trans people are in the media, there is an deliberate overtone of distrust: any discussion of bathrooms rests on the idea that Trans women aren’t women, that they’re lying; the GRA Consultation and Response concluded that the “checks and balances” needed to be maintained, suggesting that Trans people might be lying and doctors need to double check; and now this latest attack says Trans children couldn’t possibly be sure enough to consent to reversible medication.
When the media amplifies and celebrates cases like Kiera Bell’s, they do more damage than the actual court decision. Legislation is far easier to change than cultural attitudes. The real trauma that Trans people face – harassment, violence, assault – that all comes from cultural attitudes informed by the media. It’s deliberately vile, it puts our lives at risk, and we need to hold them accountable for the long-term damage they are doing.
If you or a loved one is struggling with this recent development on puberty blockers, support is available at the following places:
Enjoyed this story? Help keep independent queer-led publishing alive by becoming a BRICKS community member for early bird access to our cover stories and exclusive content for as little as £2.50 per month.