Heartbroken parents of trans kids slam High Court puberty blockers ruling as ‘devastating, discriminatory and cruel’
This week, a British court ruled that transgender under 16s are “unlikely” to be able to give their informed consent to puberty blockers.
The case was brought by Keira Bell, 23, who began taking blockers aged 16 and now regrets that decision, and Mrs A, who wants to prevent her trans teenager from accessing the medication.
The judges said in their ruling that it is “doubtful” children aged 14 to 15 could understand “the long-term risks and consequences” of taking puberty blockers and then hormone replacement therapy (HRT), and “highly unlikely” that children under 13 would be competent to give consent.
As a result, the court said clinicians may “regard these as cases where the authorisation of the court should be sought prior to commencing the clinical treatment”.
The only NHS gender clinic for under 18s in England and Wales, GIDS, immediately paused referrals for puberty blockers. Last year, 161 trans young people were referred to an endocrinology service to be considered for puberty blockers. Half of the trans youth referred were aged 16 or older.
Because the ruling applies to puberty blockers as a treatment, rather than to an individual clinic, GIDS has confirmed on its website that this “means that all providers, public and private, are bound by it. This includes where providers are based overseas, but treatment is administered in the England and Wales.”
In effect, puberty blockers are now unavailable to trans teens in England and Wales. The Tavistock and Portman NHS Trust, which runs GIDS, has already said it will appeal the ruling. Work has begun, led by lawyers and charities, on how to get trans youth access to the healthcare.
In the meantime, PinkNews spoke to four parents whose trans teenagers were on the brink of taking puberty blockers.
‘I haven’t told my trans daughter about the judgment yet. I don’t know how to break her heart’
“My daughter is almost 13 and has been under the care of the Tavistock for ore five years. She was due, after years of assessment, to have blood tests next week in order to commence puberty blockers. The process to get to this stage can be measured in years, the clinicians and experts multiple, the cost extensive, travelling in from the south east to the only clinic in a position to help my child.
“We borrow money from my parents for the train fare as we live in social housing and earn minimum wage.
“At every appointment we have had our daughter has been questioned intensively, at times it bordered on interrogation. If she mentioned liking anything seen as non-stereotypically female, such as climbing trees or Star Wars, or if she had a hair cut, the clinicians questioned her extensively. In her words: ‘I feel like I have to prove that I’m a girl, but my friends all play Star Wars too, girls and boys.’
“When referred to endocrine services, agreed by the Tavistock’s multidisciplinary team, she had to endure an intimate genital inspection to check her pubertal stage. At that point the endocrinologist assessed her as being in early Tanner stage two and not ready for blockers. This process was repeated six months later, and then after another six months, we were due to be seen next week to commence tests ready for treatment.
“She is in year eight at secondary school and all around her watches her peers develop as they enter puberty – the girls moving on without her, and the boys presenting clear and detailed information as to what lies ahead for her.
“When she returned to school in September, one boy in her class had grown facial hair over the summer and she came home sobbing in terror at the idea that might happen imminently. She didn’t sleep for a week. Every day she examines her face in the mirror, looking for telltale signs of facial bone structure changes or Adams Apple that come with male puberty.
“When she’s particularly dysphoric she can’t leave the house, so school attendance has been patchy. On good days, her best days, she’s like any other almost teen. But these days are rare and getting rarer as puberty encroaches.
“‘High school is hell’ goes the old saying – with the pressure of tests and friendships, looming exams and the horror of the school changing room.
“For a trans child this is multiplied tenfold. For the first year of high school she managed two lessons. This year, thanks to the changes due to COVID and attending school in PE kit on PE days, she’s managed five (the sports kit is tight and revealing and we’ve had to fight to get permission for looser fitting items to ease her dysphoria).
“At her worst times, the only comfort I am able to offer, as she sobs and claws at her body, crying that she wished she were dead, that death would be better than living with a male body, is that blockers are coming, that she won’t have to endure the torture of her body ‘betraying’ her (her words) for much longer. Hang in there, I say. The cavalry is coming.
“Yesterday’s judgement has torn that hope from her, and from us as parents. How do we protect our child from her own body’s betrayal? She has lived her life as a girl for six years, she has legal documents saying she is a girl.
“Male puberty will not only be torture, it will immediately out her as trans to everyone she meets, further endangering her in a society where trans hate crimes are only increasing.
“I haven’t told her about the judgement yet. I don’t know how to break her heart and shatter her world.”
‘My trans daughter was just about to be referred for puberty blockers’
“My daughter Emily is 12. She has been under the Tavistock for three years, her assessment was very detailed and gruelling and we were just about to be referred to endocrinology for blockers as recommended by her clinician.
“Emily is extremely uncomfortable in her body and struggles to even have a bath or use the toilet. We have to ensure she eats and drinks enough on a daily basis because of this. She is extremely fearful of her body changing and becoming more male. She doesn’t want to look or sound like a boy, she is scared that if she doesn’t get blockers in time she will have to undergo surgeries to make right the changes that will come with puberty.
“Denying her blockers will not change who she is, so denying her them is cruel.
“Allowing Emily to access blockers was not a decision that we took lightly. We did our research and took advice and guidance from my son, who is a personal trainer on diet and exercise, to help minimise side effects, and my cousin who is a cancer research scientist and creates medication for a living – she researched studies and looked at the medication itself and the likelihood of it causing Emily any harm. She is of the opinion that not only are blockers safe for her but essential.
“Blockers are vital for my daughter because she shouldn’t have to go through the trauma that puberty will cause. I genuinely don’t believe she would make it through puberty without taking her own life even though she is a very strong little girl with an amazingly positive outlook on life and the belief that things will improve for the trans community with each passing generation.
“She is a big believer in making change happen and is often happy to do this herself. But puberty is something that she won’t cope with, she is very openly trans and visible changes to her body will not only traumatise her but will probably cause bullying from her peers.
“In practical terms, this is a devastating blow. I work as a community care assistant on a minimum wage and I just about make ends meet, we don’t have luxuries, holidays and my children get what they need, just about. If Emily needs new clothes I have to work overtime to provide these.
“I told Emily [about the ruling] an hour ago and she is devastated. She has been crying and can’t believe that she got so close to her puberty being paused and now it’s been taken away from her because of the experience of one person. She feels that the decision is cruel and unfair. She doesn’t understand why she is yet again being discriminated against, and she has lost all faith in the establishment.
“I wish that the judge understood that trans kids are trans. They are not mentally ill. And they know better than anyone who they are.”
Puberty blockers ‘stop a young person from going through an unwanted puberty’
PinkNews: How old is your child?
My daughter is 12.5 years old.
Is she waiting to go on puberty blockers?
We have been with Tavistock since she was five – had regular assessments and they supported us through her social transition (to live as a girl) aged seven. She has been referred for blockers – our appointment at the hospital was supposed to be next week.
Why are puberty blockers important?
Blockers are life-saving. They stop a young person from going through an unwanted puberty. For trans girls like my daughter, they would stop her from developing facial hair, a deep voice and a broad jawline – all irreversible and devastating changes.
The thought of this happening to her is terrifying.
What does this ruling mean for your daughter in practical terms?
Her appointment at the hospital next week has been cancelled and the Tavistock has said they cannot currently prescribe blockers. So we currently don’t know how we will get blockers for her. This ruling is absolutely devastating for us and for all the families like us.
How they can decide to change the NHS policy on this just because it didn’t work out for one person, is unbelievable. This will do so much harm to so many young people and their families.
How did you and your daughter react to hearing the verdict?
We were horrified and shocked. I did not sleep last night and have been upset all day. My daughter needs this treatment. She has a medical condition and needs the appropriate treatment to rectify that.
I haven’t told my daughter the full details yet, she will be absolutely devastated.
What do you wish the judges had understood about trans kids?
Being trans is not a choice. It’s a medical condition – a variance of nature. It’s how someone is born. I wish the judges understood this, and understood what being trans means.
Because to make this ruling means denying essential medical treatment to so many young people, and that will have tragic and long-lasting consequences. I wish they would think about how this would feel if it was their own child.
The ruling is ‘a final barrier to already near impossible to access trans healthcare’
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“We are a family who has been in contact with GIDS for more than five years and we are starting to have discussions with our child on her decisions around puberty blockers, to pause a puberty that she desperately doesn’t want.
“We are frightened and dismayed by the judicial ruing and the immediately updated NHS service specification which would require our daughter to go to court to access what for many trans young people is described as life-saving medication. We couldn’t face discussing the impact of the ruling with our daughter yesterday and are hoping we are able to protect her from the worst of the media headlines – COVID may help with this.
“It is deeply unjust that the same medications are available routinely for children with precocious puberty, for children and young people with differences of sexual development (intersex conditions), and for many other treatments. The singling out of transgender adolescents is discriminatory and reveals the systemic transphobia within the judicial system.
“Our heart goes out to the many families I’ve been hearing from overnight who have faced cancelled appointments that have taken years to reach, to those going to pick up prescribed medication from their pharmacist only to be told it is unavailable and under review and especially to all the trans children and young people who do not have family support, and for whom going to court will be a final barrier to already near impossible to access trans healthcare.
“I want families and young people who are impacted by this draconian ruling to know that they have allies who are working to protect their fundamental right to healthcare and freedom of expression and identity.
“Do not lose hope.”