Puberty blockers: under-16s 'unlikely to be able to give informed consent'

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 high court has ruled. Even in cases involving teenagers under 18 doctors may need to consult the courts for authorisation for medical intervention, three senior judges have ruled in an action brought against the Tavistock and Portman NHS trust, which runs the UK’s main gender identity development service for children. The claim was brought by Keira Bell, a 23-year-old woman who began taking puberty blockers when she was 16 before detransitioning, and the unnamed mother of a 15-year-old autistic girl who is on the waiting list for treatment.

“It is highly unlikely that a child aged 13 or under, or 14 or 15, would be competent to give consent to the administration of puberty blockers,” the judges added. For those over 16 it is normally presumed that they have the ability to give consent. But where puberty blockers may lead to subsequent surgical operations, the judges said: “Given the long-term consequences of the clinical interventions at issue in this case, and given that the treatment is as yet innovative and experimental, we recognise that clinicians may well regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment.”

At a hearing in October, lawyers for the claimants argued that children going through puberty were “not capable of properly understanding the nature and effects of hormone blockers”.

Lui Asquith, from the trans children’s charity Mermaids, said: “It’s frankly a potential catastrophe for trans young people across the country and it cannot be exaggerated the impact that this might have, not only on the population of trans young people that require hormone blockers, but it may potentially open the floodgates towards other questions around bodily autonomy and who has the right to govern their own body.”