By Laura Miles
Downloading PDF. Please wait... Issue 2734

High Court decision over puberty blockers will put trans young people at risk

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Issue 2734
Access to puberty blockers could save trans childrens lives
Access to puberty blockers could save trans young people’s lives (Pic: Ted Eytan/flickr)

The High Court of Justice has just made a shocking and disastrous decision that reflects the poisonous atmosphere generated against trans people in recent times.

It has reportedly left many young trans people distraught.

The court has ruled this week that trans people under 16 will now need to persuade doctors to apply to court ‘in their best interests’ to access puberty blocker medication (PBs).

It is also possible that those who are aged 17 and 18 may also have to go through the same process.

Such medication, which is reversible, puts on hold the largely irreversible and sometimes distressing physical changes of puberty such as breast development or beard growth.

Recent studies have demonstrated how effective PBs are in reducing suicidal feelings.

Puberty blockers give young trans people the option for breathing room to decide whether to pursue further gender transition interventions like cross-sex hormones once they reach at least 16.

The numbers accessing such medical intervention are small. Last year nationally there were only 95 under 16s referred for such treatment in the UK. This was despite a significant rise in numbers referred to the Gender Identity Development Service (GIDS) in recent years.


The High Court case was brought jointly by someone who de-transitioned and a mother concerned that her child that hasn’t even been referred to a clinic-might access PBs.

They were backed by a number of transphobic groups.

The judges took evidence from Transgender Trend a transphobic groupbut not from pro-trans groups like the trans children’s charity Mermaids.

The ruling is a major retrograde step. Life has suddenly become even more difficult and insecure for young trans people.

And this will enormously increase the already high levels of distress in those dealing with their gender dysphoria.

It will inevitably increase the likelihood of self-harm, depression and suicidality of trans youngsters.

There is also the fact that more young people will be driven to the internet to access medication putting them in considerable danger.

Following the ruling the NHS-run GIDS, which covers the Tavistock and Leeds gender clinics, immediately issued amended treatment specifications for young trans people.

These specifications go beyond even the consequences of the court ruling, despite the ruling not coming into effect for at least another three weeks pending appeals.

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The amended specifications blocks any access to puberty blockers for new patients under 16 unless they have a ‘best interests’ court order.

They also insist on full clinical reviews of all patients under 16 currently receiving puberty blockers. The threat of withdrawal is therefore real and would be devastating.

If the clinicians and the patients currently receiving medication want to continue they will now have to make a court application in each case, which will take time and money.

Mermaids have reported that the Tavistock clinic in London, the main referral clinic for young trans people, is already cancelling long-awaited appointments.

The idea spread by various transphobic groups that young people get ‘fast-tracked’ in GIDS onto a conveyor belt of PBs and then cross-sex hormones is laughable.

The average waiting time for a first appointment after referral is between 22 and 26 months and there is an assessment period of at least six months following that. If puberty has begun to kick in at that point then PBs may be prescribed assuming clinician approval.


The ruling is likely to be appealed. But if it stands it means trans youngsters under 16 have lost the legal right to be considered ‘Gillick competent’ to make an informed decision about accessing PBs.

Gillick competent is a term used to describe whether young people can be emotionally and cognitively mature enough to understand the consequences of their choices

Children certainly mature physically and emotionally at different rates. Some 12 year olds might be considered Gillick competent, some 16 year olds might not.

This is the crux of the matter. There are issues concerning young people and consent. For example the law that says under-16s cannot consent to sex provides some protection against abuse.

But there are other examples to consider. We think under-16s should be able to access contraceptive advice and supplies without a parent’s consent. And they should be able to access a full range of information and make medical decisions.

The same considerations should apply to puberty blocking medication. Treatment should be discussed in the most open way, with all questions and issues raised.

Vulnerable children undeniably need legal protection and safeguarding in many situations.

Gillick competency arose from a landmark case of a mother’s legal challenge to her daughter receiving contraception against her wishes.

This case was a major step forward in balancing children and young people’s vulnerability and safeguarding needs with their right to bodily autonomy. As well as ability for young people to make informed choices about potentially life-changing procedures and treatments.

The High Court ruling effectively abolishes this for trans children and also risks introducing major legal inconsistency in respect to their rights to access PBs.

The court ruling may generate legal challenges from bigots in respect to young people’s access to abortion, contraception and other medical matters where Gillick competency applies.

The transphobes celebrating this decision will no doubt feel encouraged to bring more cases intended to undermine what limited legal and human rights trans people have in Britain.

This latest blow comes on top of the Tory government going back on their original proposal to update the Gender Recognition Act. As well as Boris Johnson’s recent decision during Trans Awareness Week to cut funding for LGBT+ training in schools.

Shame on anyone on the left who supports or condones such right wing attacks on this hugely oppressed group.

They’re not protecting trans children and young people, they’re helping to fuel the oppression they face and putting them at greater risk of harm.

Laura Miles is the author of Transgender Resistance: Socialism And The Fight For Trans Liberation, available at Bookmarks Bookshop,

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