Tavistock, a gender identity and mental health clinic located in North London, argued in their successful appeal that puberty blockers "[allow the] young person time to consider their options and to continue to explore their developing gender identity before making decisions about irreversible forms of treatment."
Court of Appeal judges said they saw "the difficulties and complexities" of the issue, but that "it is for the clinicians to exercise their judgement knowing how important it is that consent is properly obtained according to the particular individual circumstances."
But in December of 2020, the High Court ruled under-13s were "highly unlikely" to be able to give informed consent to what it described as "experimental" treatment and it was "very doubtful" children aged 14 and 15 would be able to sufficiently understand the long-term consequences.
The initial case had been sparked by Keira Bell, a young woman who had started puberty blockers at age 16 as she sought to transition to male, and soon after regretted the decision. Bell, now 24, said she hadn't been "challenged" nearly enough to have been allowed to go ahead with the body-altering drugs.
"I feel I could say anything to my 16-year-old self and I might not necessarily listen at that time. And that's the point of this case, when you are that young you don't really want to listen." Bell is quoted as saying in 2020, "So I think it's up to these institutions, like the Tavistock, to step in and make children reconsider what they are saying, because it is a life-altering path."
In mid-2020, the NHS' website removed references to puberty blockers as being "reversible," instead changing the guidance to noting that the "long term side effects of hormones or puberty blockers is unknown." This was after a review of studies related to the effects of puberty blockers by the National Institute of Health and Care Excellence were found to be "subject to bias and confounding." The research was also found to be of "very low" quality.
Tavistock Trust has a long history of controversies. In 2019, former gender identity specialists at Tavistock reported they felt like the Trust was enabling "gay conversion therapy" for youth unable to come to terms with, or even explore, their sexuality.
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