We find the court ruling in the Judgment in the case of Keira Bell and Mrs A against The Tavistock Clinic and Portman NHS Trust highly troubling, as it puts young people's healthcare in the hands of unqualified judges instead of being informed by doctors, the trans individual, and their parents/carers. Adding yet more unnecessary barriers to the service, which already has a waiting list approaching four years long, will mean many more will go without the care that they vitally need.
Denying young trans people treatment from the onset of puberty is not a neutral act, as they will develop characteristics incongruent with their gender, that are difficult or impossible to reverse, or in other words irreversible.
It is very well documented that puberty blockers act as a pause button, and that their use very effectively allows young people time to think while they explore their gender identity; this is the guidance of the World Professional Association for Transgender Health and every other international leading organisation for trans healthcare. Even before the ruling, the NHS Gender Identity Development Service (GIDS) deviated from this guidance in practice by making puberty blockers more restrictive than almost anywhere else they are used in the world.
We are extremely concerned that the court did not wish to hear from any LGBT+ or transgender charities, nor from the international medical community, regarding the evidence for puberty blockers. Accordingly, we believe that this judgement was likely not based on a full and complete evidence base, and that this is grounds for a review of the judgement via appeal.
We agree with Amnesty International UK and Liberty; as well as LGBT+ charities such as Stonewall; this ruling sets a dangerous precedent that could see the rollback of the rights of people under 16. This is gender and age based discrimination, and we oppose any rollback of Gillick competence, which allows young people who have sufficient understanding to give consent for medical treatments, like abortion and contraception.
We are particularly concerned that GIDS appear to be referring every single case to the courts now, as this appears not to be the intent of the ruling, is likely to cause substantial delays to an already overwhelmed system, and is likely to cause major disruption and much anguish to the lives of those currently receiving care or about to receive care after years of waiting and/or assessment appointments.
While we welcome the news that NHS England and GIDS are appealing the order, we are troubled that they have implemented the outcome of the ruling already, this isn’t required by the courts until after the appeal. We are concerned for the wellbeing of every young trans person now unable to start treatment and those that are possibly facing their treatment being halted.
We are launching a petition calling for:
- NHS England and GIDS to delay any implementation, and interpretation of the ruling based on the said ruling being subject to judicial review. In view of the fact that NHS England and GIDS are appealing the order and as such implementation isn’t required by the courts until after the appeal.
- A more balanced and holistic review in the appeal. This could be achieved in the following ways:
- The appeal to involve consultation of LGBT+ and transgender charities, and the international medical community, as this was not the case with the original ruling.
- The Tavistock to do a review of their case files to provide to the court.
- The appeal to fully consider the mental and physical effects of both prescribing, as well as not prescribing, PBs and CSH.
- The appeal to fully consider the consequences when trans children & young people are left unsupported by their parents/carers.
- The appeal to fully consider the differences in the working practices of The Tavistock in comparison with health care providers who follow common international guidance, such as WPATH, in terms of their treatment of trans youth.
(Statement by LGBTIQA+ Greens. This isn’t formal Green Party policy but is a petition to raise awareness on this issue.)