The only National Health Service-run gender clinic in the U.K. that serves trans youth announced Wednesday that it is pausing new referrals for endocrinology services indefinitely. The announcement follows a Tuesday ruling from the country’s High Court of Justice, which states that if trans minors are deemed incapable of meaningful consent, they must go through a judicial process before being prescribed puberty blockers.
A spokesperson for the NHS Gender Identity Development Service (GIDS) confirmed this change in policy to U.K.-based LGBTQ+ news outlet PinkNews on Tuesday, adding that current patients will not be affected for the time being since the ruling has been blocked from implementation until at least December 22. Tavistock and Portman, the NHS trust who were sued in the case, are appealing the ruling, according to an NHS statement issued yesterday.
The 38-page decision, which was authored by Dame Victoria Sharp, Lord Justice Lewis and Justice Natalie Lieven, only pertains to children under the age of 16, who the court argues do not have the ability to meaningfully grasp the effects of medically transitioning. This is despite the fact that research has shown that trans children have a sense of their gender identity from very young ages.
“It is the role of the court to protect children and particularly a vulnerable child’s best interests,” it reads. “Apart perhaps from life-saving treatment, there will be no more profound medical decisions for children than whether to start on this treatment pathway.”
Judges further claimed there is a lack of “evidence” for the efficacy of puberty blockers and said long-term effects are not yet known, even though these treatments are generally reversible and safe for trans youth.
The ruling also cites a statistic from the GIDS Service Specification which states that there seems to be a “higher prevalence of autism spectrum disorder conditions in clinically referred, gender dysphoric adolescents than in the general adolescent population.” When GIDS stated that they did not keep track of specific data on the prevalence of patients with autism or other mental health diagnoses, the judges said that they found this “apparent lack of investigation of this issue surprising.”
Despite this unsavory implication about the correlation between gender identity and neurological patterns, the judges admitted that “it is not our role to adjudicate on the reasons for persistence or otherwise” of gender dysphoria. But they added that puberty blockers “may be supporting the persistence of GD in circumstances in which it is at least possible that without that treatment, the GD would resolve itself.”
The case in question, however, tells a different story. Bell v. Tavistock was brought against the NHS trust that runs GIDS by claimants Keira Bell and Mrs. A, with hearings taking place in October. Both claimants argued that young persons under the age of 18 are not capable of giving consent to the administration of puberty blockers, that the quality of information on transition is not adequate enough to form the basis of informed consent, and that gender dysphoria often “resolves itself through adolescence” without puberty blockers.
NHS and Tavistock argued that treatment provided at GIDS, which is currently under review, is compliant with WPATH standards and other international frameworks of treatment and that the information given to young patients is detailed and age-appropriate. The defendants also argued that court intervention in the transition process would be an intrusion into a young person’s autonomy.
The defendants also provided multiple witness statements in which young trans people testified to the benefits of puberty blockers and HRT. Among those who spoke on behalf of gender affirming treatment was N., an 18-year-old trans woman, who stated that her mental health “was spiralling due to my dysphoria” when she was prescribed puberty blockers at the age of 17. She claimed, however, that “the treatment of hormone blockers may very well have saved my life.”
