Puberty blocker ruling: suppression of transgender rights or victory of common sense? | Transgender

The groundbreaking High Court ruling highlights the work of the Gender Identity Development Service (GIDS) for children and adolescents at Tavistock Clinic and Portman. NHS Trust in London.

The long-awaited ruling on Tuesday was about the legal action taken by 23-year-old Keira Bell on the service. This is the only one in England and Wales.

Former patient Bell claimed that he was too young to agree to the treatment supervised by GIDS, who began the transition from female to male as a teenager.

In a decision on page 36, the court found that children under the age of 16 who are considering gender reassignment are likely not mature enough to give informed consent to prescribing adolescent inhibitors, effectively gender identity. We concluded that we would reduce medical interventions under the age of 16 with gender identity. ..

“It is very difficult for children under the age of 16 to understand and evaluate this information and decide whether to agree to the use of puberty suppressants,” the ruling said.

“It is very unlikely that children under the age of 13 will be able to consent to the administration of puberty suppressants. Children 14 or 15 years will see the long-term risks and consequences of taking puberty inhibitors. It is doubtful that we can understand and weigh them. “

This decision was welcomed as a victory of common sense and protection, and some were accused of having a chilling effect on the rights of young transgender people.

The NHS England has stated that future medical interventions under the age of 16 will only be permitted “if the court specifically permits”.

GIDS has faced major scrutiny in recent years, with some ex-staff and activists having significantly increased referrals to girls suspected of having gender identity as a result of “overdiagnosis” of gender dysphoria and early medical intervention. Has expressed concern about.

The only provider of gender services for children and youth in Glasgow in a series of interviews with GIDS and Sandyford Clinic in Glasgow Scotland, Clinicians gave Guardians insight into treatment routes, but former staff shared their own experiences.

The High Court ruling pointed out certain concerns about the use of adolescent inhibitors and stated that it “can be adequately explained as an treatment” with “limited evidence of efficacy or long-term effects.”

Between March 4, 2019 and March 1, 2020, GIDS introduced endocrinology to 171 adolescents. This is the first step before medical intervention. Of these, 60 were male and 111 were female, with an average age of 15 years or older, with an average of 10 appointments before this occurred.

GIDS emphasizes that the entire process is aimed at giving young people time to look back. Some young people arrive with specific medical interventions in mind, while others are said to be far more uncertain, benefiting from exploratory sessions with or without parents.

Next, a care plan is created. This will probably include further evaluation, such as seeking help from local services or schools. Prior to the High Court ruling, a minority who began puberty was recommended a hormone blocker to arrest puberty. This is often a source of great distress for transgender teenagers.

A process of individualized evaluation and consent was required before patients could transition to cross-sex hormones. It aims to more closely match secondary sexual characteristics and gender identity and was available in blockers about 16 years and a year later. GIDS does not offer surgery.

Both GIDS and Sandyford Clinics have seen an increase in referrals to teenage girls over the last decade. This trend is reflected throughout Europe and globally.

GIDS experts say we need to keep an eye on the rise. Only 1 in 10,000 young people are referred to highly specialized services. It is also possible that a girl’s overexpression is a boy’s underexpression other than gender. Conformity tends to be more actively monitored by peers.

For some girls who are more adolescent, more sexual from society, and more aware of the pressure to have a “perfect body”, this service is more embracing the changing body. Helps you find a way to become.

Only a few of the people seen on GIDS receive treatment during service.

However, critics believe that this is essentially a medicalization of a woman’s beginning of puberty.

Those critics say that vulnerable adolescents (many of whom have homophobic parents, are bullied at school, have autism, or are abused in childhood) change gender. I believe there is evidence that I am confident that this will solve the problem. I was afraid of criticism if they challenged this.

The High Court itself was critical of what was characterized as a lack of Tavistock’s “amazing” investigation into increasing referrals to girls and girls with autism spectrum disorders.

Sandyford sources argue that there is no overstatement of lesbian and gay youth, girls who have experienced sexual abuse, or those whose homophobic parents are trying to “correct” their child’s sexuality. I will.

They say there is an overexpression of adolescents in the autism spectrum, but that the proportion of sexuality concerns within their population is already high, caused by very rigorous thinking from a self-defining point of view. be careful.

There are stories of suffering girls trying to escape abuse by identifying them as boys, and parents pushing their children into the transroute because of anxiety or misunderstanding, with the exception of these.

One clinician suggests that referrals to Sandyford often give very confused young people and anxious parents the opportunity to think about different professionals and what really bothers them.

These professionals are often able to “inject reality” into the theories and ideas that patients read online, and appear to be able to solve problems quickly.

One of the former consultant psychiatrists and psychotherapists who worked at Tavistock’s adult services and GIDS said that a “very positive” approach there is a normal need for young people to express away from their parents. He raised concerns about the risks of medical behavior that could be understood as sexual. Their personality, perhaps through subculture membership.

He has expressed similar concerns in his current private work with older teenagers and young adults through exploratory therapies that are neither “positive” nor “corrective” in their gender conflict. Reported that it was possible to help overcome.

Transgender teenager with a guardian mermaid – A charity that provides support to transgender or non-gender-compliant children, including children undergoing medical intervention – Overwhelmingly reports frustration with long waiting times for initial bookings (18 months on average according to GIDS). Some tentatively relied on practitioners.Good low project last month Proceedings Against NHS England over these waiting times.

“I don’t understand who says the process is too fast. Getting medical intervention is like winning the lottery,” added 18-year-old Dylan, who added to Bell’s decision “deeply sad.” It was.

“It’s really important for people to understand that this is not a choice. The media wants young people to be transgender because they are” brainwashed “or” hurried “or because it is a trend. I’m talking. Yes, some children are confused or labeled about their gender, but not if they experience discomfort. “

This is a view shared by Alex, also 18 years old, who fears that this ruling will cause transgender years of puberty and uncontrollable levels of discomfort and distress. “.

Alex was introduced to GIDS six years ago and had regular sessions for 18 months before being prescribed a hormone blocker. He described this wait as the “worst part” of treatment so far, but added: “I admit that this is a thorough process and must be done. They break up what you say, but it’s a good remedy.”

He started taking testosterone two years ago and said: I am satisfied. “

Tavistock is seeking permission to appeal Tuesday’s ruling.