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The GIDS clinicians failed to reassure the court that under 16s were able to be able to give informed consent for blockers, which led to GIDS shutting up shop in a knee-jerk response, discontinuing treatment to under 16s and putting new referrals on hold.

 

GenderGP wholeheartedly disagrees with the outcome of the determination and in response two affirmative steps were taken:

  1. An emergency fund was set up for adolescents let down by GIDS.
  2. A letter was written to the World Professional Association for Transgender Health (WPATH) in which our position in support of trans youth was clearly outlined. It is important to note that WPATH has previously supported clinicians providing gender affirming care to under 18s threatened with legal action in several states in the US.

 

On December 17th, 2020, The European Professional Association for Transgender Health (EPATH) supported by all the major International players (WPATH, USPATH, AsiaPATH, AusPATH and PATHA) issued a joint statement.

In it they stated that: ‘all strongly disagree with the recent judgment of the London High Court in Bell v. Tavistock. We believe this decision will result in significant harm to the affected children and their families. We oppose this ruling and urge that this ruling be appealed and overturned’.

They then went on to say that: ‘although treatment for young transgender adolescents involves uncertainties, as is the case in many fields involving young people, several studies demonstrate the clear mental health benefit of gender-affirming medical treatment (including puberty blockers). Withholding such treatment is harmful and carries potential life-long social, psychological, and medical consequences’.

The statement goes on to explain that gender affirming care, including the use of blockers, is fundamental to the guidelines of WPATH’s Standards of Care as well as the Endocrine Society’s Clinical Practice Guidelines and that puberty suppression is the most widely accepted and preferred clinical approach in leading centres of excellence for transgender healthcare around the world.

The aim of puberty suppression is to prevent the psychological suffering which stems from the undesired physical changes that occur during puberty, and to allow the adolescent time to carefully consider if and how they want to continue with their transition longer term.

In terms of age of consent they point out that extensive research has demonstrated that many minors possess the cognitive and emotional abilities to understand the consequences of their decisions, including those concerning healthcare.

The determination of the ability of a particular adolescent to give consent should be made by a competent transgender healthcare provider who has evaluated the adolescent, and not exclusively by a court of law. Current guidelines already recommend that this competence is assessed prior to the start of treatment.

The important phrase here is ‘competent transgender healthcare provider’. It is well known that GIDS practitioners have long ignored International guidelines and held onto the flawed view the majority of trans adolescents will change their minds and desist.

For these reasons the UK endocrinologists have refused to prescribe Gender Affirming Hormones (GAH) for under 16s, meaning that for many adolescents, puberty blockers are prescribed for many years, leaving them stuck in a suspended puberty while their peers move forward.

The role of GIDS should be appealed absolutely and International experts, stakeholders, trans charities and expert private providers should be consulted for alternative insight and expertise. At the same time vital education of primary and secondary care physicians must be undertaken so that the NHS can safely resume care.

Out of this devastation there is the potential that we may end up with a much better service, but for that to happen, NHS England needs to make some tough decisions about the future of GIDS and its lead clinicians, as well as being prepared for the approaching tidal wave of anger and dismay from a litigious transgender community which has been severely let down.

Letter to James Palmer

 

Photo by Brett Zeck on Unsplash