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Court of Appeal hears appeal concerning puberty-blocking drugs

The Court of Appeal has heard an appeal against a judgment in the Divisional Court that children under the age of 16 considering gender reassignment are unlikely to be mature enough to give informed consent to be prescribed puberty-blocking drugs.

The case of R (Bell and another) v. Tavistock and Portman NHS Foundation Trust [2020] EWHC 3274 (Admin) was brought by two claimants: Keira Bell, a young woman who underwent gender reassignment, including puberty blockers as a teenager, and has subsequently regretted this and reverted to living as a woman; and Mrs A, the mother of a 15-year-old autistic girl experiencing gender dysphoria.

The claimants challenged the provision of puberty blockers to children and young people suffering from gender dysphoria by the Tavistock NHS Trust's Gender Identity Development Service (GIDS), on the grounds that informed consent could not properly be obtained from these patients given that this use of blockers was experimental, with limited evidence of benefit, and had life-changing and life-long consequences. The claimants argued that such treatment should only be given after a court order had been obtained.

After considering a large volume of evidence about the nature of puberty blockers and the consent-taking process at GIDS, the Divisional Court found that it was "highly unlikely" children aged 13 or under could give lawful consent and "very doubtful" that a 14 or 15-year-old could do so, and so the protective role of the Court may well be appropriate. It also held that even for 16 or 17-year-olds, due to the unusual and experimental nature of the treatment, clinicians may consider it advisable to seek the Court's authorisation if there was any doubt about whether it was in the patient's best interests.

For an article in the Guardian about the Court of Appeal hearing, click here. For an article on Family Law Week by Bianca Jackson of Coram Chambers concerning the judgment in the Divisional Court, click here. For a subsequent article, Bianca Jackson, considering the subsequent judgment in AB v CD and others [2021] EWHC 741, click here.