Parents of trans children 'can consent to puberty blocker use without court approval'

26 March 2021, 16:28

The parents of transgender children can consent to their treatment with puberty blockers on their child’s behalf without approval from a court, a judge has ruled.

The decision follows a separate, landmark High Court case which could have blocked the treatment of a 15-year-old who was born a boy but lives as a girl.

The girl, identified as XY, was on puberty blockers and the court was asked to rule that she and her father can consent to her treatment amid "uncertainty on the lawfulness of parental consent".

She had been treated with her own consent, but the separate, landmark ruling "cast (that view) into doubt".

There was concern her GP might not prescribe the treatment anymore.

Mrs Justice Lieven said the use of the blockers for children "raises unique and highly controversial ethical issues" and acknowledged views on it had become "highly polarised".

The previous case was brought by Keira Bell, who took puberty blockers aged 16 before "detransitioning".

Ms Bell later took legal action against an NHS trust which runs the UK’s only gender identity development service that provides treatment to transgender children, arguing children cannot properly consent to taking puberty blockers.

Judges ruled in Ms Bell’s favour in December and said children under 16 need to understand the consequences of treatment to be able to consent to using them.

The ruling is being challenged.

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In a statement before the court at the hearing earlier in March, XY said: "The visible and irreversible onset of male puberty was very and most distressing for me.

"It also meant that my life wouldn't be my life any more and normal, where everyone knew and accepted me as female."

On Friday, Mrs Justice Lieven, who was one of the judges that gave the ruling in the Bell case, said she still agrees with that case.

However, she said parental consent was not considered by the court and in XY’s case there was agreement between the teenager, her parents and treating clinicians that her use of puberty blockers should continue.

She concluded: "In my view, the factors identified in (Ms Bell's case), which I fully agree with, do not justify removing the parental right to consent.

"The gravity of the decision to consent to puberty blockers is very great, but it is no more enormous than consenting to a child being allowed to die."

The judge said that in cases where there was disagreement between clinicians, or concern that parents were being "pressured" by their children to consent, then those cases should be brought to court.