Times article - calls to end transgender 'experiment' on children

@Bowlofbabelfish This is neuremberg levels of awful.
I shouldn't applaud at those words because I am desperately sorry for the children involved, and even for their misguided parents.

But at last. We thought the sports thing would open the can of worms because men love sports so we thought the peak trans would be massive. But it wasn't massive enough.

But when it comes to children and their safeguarding, to Mengele-type experimenting with drugs on kids who cannot give consent, to government complicity in such dealings -- it's so massive it can no longer be ignored.
Child abuse trumps sports. Every time.
Perhaps, somehow, it can at least be slowed down and maybe soon, stopped.

Empress

Feel free to share!

Empress you're on a roll with that one!

I'm in a small village in Northern Ireland right now housesitting for my daughter and family. The local grocery store doesn't carry many UK newspapers, mostly Irish Times and the like. This morning there was one copy of The Times and I thought it would soon go. However it was still there an hour ago. Most of the other papers have gone. So I went out and bought is before it is thrown out. Maybe my daughter and SiL can pass it around locally when they return.
This area is very unwoke and very uninterested in UK news so I guess people didn't even look at the headlines/don't care much.

I came out on Facebook by posting two of the articles, the first GC posts I've ever made. I usually get a few likes -- today, not a single one. I'm a little disappointed. But not much. I'm so glad the emperor has definitely been identified as naked, and I won't stop pointing it out now.

There's a fabulous history book by Barbara Tuchman called the March of Folly:
www.amazon.co.uk/March-Folly-Troy-Vietnam/dp/0349106746?tag=mumsnetforu03-21#reader_B00SXNYBNI

What she's interested in here is historical stuff-ups (repeated "great powers" invading Russia in winter, the Vietnam war, etc...) where it could be clearly seen at the time that what was being proposed was a stuff up of gargantuan proportions.

In future years, people will look at this scandal of (as Bowl's husband just put it) "Nuremberg proportions", and look at the Times' coverage of it at the time, and the Spectator's, and the tireless work of GC feminists in having political campaigns, managing to get debates in parliament, and look at the response or lack of it (Layla Moran's ability to see into souls, for instance, aired in parliament), and say "They knew. The bastards knew. But they chose to do nothing."

Wrong side of history my arse, OJ!

What about the adult Gender Identity Clinics? Treating 18 year olds, many of whom will still in fact be adolescents. Where is the evidence base for their treatment? What is the pressure from lobby groups doing to the clinicians practising there?

Is it appropriate to provide, no doubt with good intentions, support to a young person who is on the GID waiting list in the form of a telephone call from a transgender employee telling them how to change their passport etc so that they have better leverage to request hormones when they get to the top of the list? This is before any clinical input at all.

I can imagine that there are other clinical areas where lobbying by patient groups happens and causes tensions, - but hopefully not many others where the influence can lead to such potentially serious harm.

I've been thinking about why this has cheered me up so much. It's not because it means that everyone is now going to go "oh, I see" and things are going to be sorted out. It's because The Times has taken such a strong a public position that it will take a great deal to make them recant. It would wreck their credibility too much. Which means that unless someone can come out with evidence to undermine what The Times is saying, we should be finding them firmly on the gender critical side for the foreseeable future.

One claimed young people were unable to give “informed consent” because it was regarded as taboo to discuss the impact of medical intervention on later sexual function in such a young cohort

If this is true, its huge.

I’ve just read all four articles to dh (clinical professional) over dinner. His reply? ‘This is neuremberg levels of awful.’

Amazing reportage from the Times. I’m impressed. Now keep going. explore the funding links. Explore the vested interests. Explore the very unpleasant proclivities some of the people pushing this through have. This is just the start. A fantastic start, but it’s the tip of the iceberg.

Isn't it just?

Dont they understand what everyone else is seeing?!

It is abundantly clear that most of the critics have not actually read any of the material published.

Popychyk they don't have any.

The lawyers will have been through that article with a fine tooth comb given the sheer scale and scope of the GMC guideline breeches.

Heartening comments. The intolerant fuckers one made me LOL

Oliver Burkeman, writer for The Guardian, on Twitter.

twitter.com/oliverburkeman/status/1115253961274068993

"Organisations or commentators who have concrete and specific evidence to cast doubt the veracity of the Times's reporting should make it public; otherwise I think it's fair to assume they don't have any".

GayStarNews are trying to link this to an attack on a transgirl.

www.gaystarnews.com/article/the-times-four-transphobic-articles/

Apparently not wanting children to be medically transitioned is the same thing as wanting children to be attacked

^^But younger children might not be able to understand what their illness or proposed treatment is likely to involve, even when explained in straightforward terms. From no.19 above. This ten times over.

Please do reference points when reading to fuckwit MPs like Steven Doughty.

I think it's very useful if you are thinking if talking to one of the health select committee MPs.

42 Respecting patient confidentiality is an essential part of good care; this applies when the patient is a child or young person as well as when the patient is an adult. Without the trust that confidentiality brings, children and young people might not seek medical care and advice, or they might not tell you all the facts needed to provide good care.

43 The same duties of confidentiality apply when using, sharing or disclosing information about children and young people as about adults. You should:

~ disclose information that identifies the patient only if this is necessary to achieve the purpose of the disclosure – in all other cases you should anonymise the information before disclosing it
~ inform the patient about the possible uses of their information, including how it could be used to provide their care and for clinical audit
~ ask for the patient’s consent before disclosing information that could identify them, if the information is needed for any other purpose, other than in the exceptional circumstances described in this guidance
~ keep disclosures to the minimum necessary.

Sharing information with the consent of a child or young person

44 Sharing information with the right people can help to protect children and young people from harm and ensure that they get the help they need. It can also reduce the number of times they are asked the same questions by different professionals. By asking for their consent to share relevant information, you are showing them respect and involving them in decisions about their care.

45 If children and young people are able to take part in decision-making, you should explain why you need to share information, and ask for their consent. They will usually be happy for you to talk to their parents and others involved in their care or treatment.

Sharing information without consent

46 If a child or young person does not agree to disclosure there are still circumstances in which you should disclose information:

~ when there is an overriding public interest in the disclosure
~ when you judge that the disclosure is in the best interests of a child or young person who does not have the maturity or understanding to make a decision about disclosure
~ when disclosure is required by law.

Public interest
47 You can disclose, without consent, information that identifies the child or young person, in the public interest. A disclosure is in the public interest if the benefits which are likely to arise from the release of information outweigh both the child or young person’s interest in keeping the information confidential and society’s interest in maintaining trust between doctors and patients. You must make this judgement case by case, by weighing up the various interests involved.

48 When considering whether disclosure would be justified you should:

~ tell the child or young person what you propose to disclose and why, unless that would undermine the purpose or place the child or young person at increased risk of harm
~ ask for consent to the disclosure, if you judge the young person to be competent to make the decision, unless it is not practical or appropriate to do so. For example it would be inappropriate to ask for consent if you have already decided that a disclosure is likely to be justified in the public interest.

49 If a child or young person refuses consent, or if it is not practical or appropriate to ask for consent, you should consider the benefits and possible harms that may arise from disclosure. You should consider any views given by the child or young person on why you should not disclose the information. But you should disclose information if this is necessary to protect the child or young person, or someone else, from risk of death or serious harm. Such cases may arise, for example, if:
~ a child or young person is at risk of neglect or sexual, physical or emotional abuse (see paragraphs 56 to 63)
~ the information would help in the prevention, detection or prosecution of serious crime, usually crime against the person
~ a child or young person is involved in behaviour that might put them or others at risk of serious harm, such as serious addiction, self-harm or joy-riding.

50 If you judge that disclosure is justified, you should disclose the information promptly to an appropriate person or authority and record your discussions and reasons. If you judge that disclosure is not justified, you should record your reasons for not disclosing.

Disclosures when a child lacks the capacity to consent

51 Children will usually be accompanied by parents or other adults involved in their care, and you can usually tell if a child agrees to information being shared by their behaviour. Occasionally, children who lack the capacity to consent will share information with you on the understanding that their parents are not informed. You should usually try to persuade the child to involve a parent in such circumstances. If they refuse and you consider it is necessary in the child’s best interests for the information to be shared (for example, to enable a parent to make an important decision, or to provide proper care for the child), you can disclose information to parents or appropriate authorities. You should record your discussions and reasons for sharing the information.

Disclosures required by law
52 You must disclose information as required by law. You must also disclose information when directed to do so by a court.

Young people with capacity have the legal right to access their own health records and can allow or prevent access by others, including their parents. In Scotland, anyone aged 12 or over is legally presumed to have such capacity. A child might of course achieve capacity earlier or later. In any event you should usually let children access their own health records. But they should not be given access to information that would cause them serious harm or any information about another person without the other person’s consent.

54 You should let parents access their child’s medical records if the child or young person consents, or lacks capacity, and it does not go against the child’s best interests. If the records contain information given by the child or young person in confidence you should not normally disclose the information without their consent.

55 Divorce or separation does not affect parental responsibility and you should allow both parents reasonable access to their children's health records.

Child Protection
56 Doctors play a crucial role in protecting children from abuse and neglect. Early identification of risks can help children and young people get the care and support they need to be healthy, safe and happy, and to achieve their potential.

Sexual Activity
57 A confidential sexual health service is essential for the welfare of children and young people. Concern about confidentiality is the biggest deterrent to young people asking for sexual health advice. That in turn presents dangers to young people’s own health and to that of the community, particularly other young people.

58 You can disclose relevant information when this is in the public interest (see paragraphs 47 to 50). If a child or young person is involved in abusive or seriously harmful sexual activity, you must protect them by sharing relevant information with appropriate people or agencies, such as the police or social services, quickly and professionally.

59 You should consider each case on its merits and take into account young people’s behaviour, living circumstances, maturity, serious learning disabilities, and any other factors that might make them particularly vulnerable.

60 You should usually share information about sexual activity involving children under 13, who are considered in law to be unable to consent. You should discuss a decision not to disclose with a named or designated doctor for child protection and record your decision and the reasons for it.

61 You should usually share information about abusive or seriously harmful sexual activity involving any child or young person, including that which involves:

~ a young person too immature to understand or consent
~ big differences in age, maturity or power between sexual partners
~ a young person’s sexual partner having a position of trust
~ force or the threat of force, emotional or psychological pressure, bribery or payment, either to engage in sexual activity or to keep it secret
~ ^drugs or alcohol used to influence a young person to engage in sexual activity when they otherwise would not
a person known to the police or child protection agencies as having had abusive relationships with children or young people.^

62×You may not be able to judge if a relationship is abusive without knowing the identity of a young person’s sexual partner, which the young person might not want to reveal. If you are concerned that a relationship is abusive, you should carefully balance the benefits of knowing a sexual partner’s identity against the potential loss of trust in asking for or sharing such information.

63 You can provide contraceptive, abortion and STI advice and treatment, without parental knowledge or consent, to young people under 16 provided that:

~ they understand all aspects of the advice and its implications
~ you cannot persuade the young person to tell their parents or to allow you to tell them
~ in relation to contraception and STIs, the young person is very likely to have sex with or without such treatment
~ their physical or mental health is likely to suffer unless they receive such advice or treatment, and
~ it is in the best interests of the young person to receive the advice and treatment without parental knowledge or consent.

64 You should keep consultations confidential even if you decide not to provide advice or treatment (for example, if your patient does not understand your advice or the implications of treatment), other than in the exceptional circumstances outlined in paragraphs 46 to 52 and paragraphs 57 to 62.

Conscientious objections
65 If carrying out a particular procedure or giving advice about it conflicts with your religious or moral beliefs, and this conflict might affect the treatment or advice you provide, you must explain this to the patient and tell them they have the right to see another doctor. You should make sure that information about alternative services is readily available to all patients. Children and young people in particular may have difficulty in making alternative arrangements themselves, so you must make sure that arrangements are made for another suitably qualified colleague to take over your role as quickly as possible.

Suitability to work with children and young people
Children are not miniature adults. Good clinical care for children relies on specially trained clinical staff together with equipment, facilities and an environment appropriate to children’s needs. If you have children and young people as patients, you should make sure you have the appropriate training and experience in the clinical care of children in your speciality. You should take steps to make sure that, wherever possible, you and members of your team have access to the appropriate premises, equipment and other resources necessary to provide good care. If you also have adults as patients, you should audit separately the care you provide to children and young people.

67 If you are responsible for recruiting or employing people, or if you otherwise control who can work with children or young people in your care, you should make sure that their suitability is checked. NHS Employers (part of the NHS Confederation) issues advice on good employment practice, including pre- and post-employment, Criminal Records Bureau, alert notice, vetting and barring scheme and other checks.

68 You should follow the GMC’s guidance on raising concerns about patient safety if you have concerns that children or young people are, or may be, at risk of harm because of a colleague’s conduct, performance or health.

69 You should always take children and young people’s complaints seriously. You should help them to complain if their rights or interests have been denied or abused, or if they are unhappy with the care they have received or because they have been denied care.

70 If you prescribe medicines for children, you should be familiar with the current guidance published in the British National Formulary for Children.

22 You can provide medical treatment to a child or young person with their consent if they are competent, or with the consent of a parent or the court. You can provide emergency treatment without consent to save the life of, or prevent serious deterioration in the health of, a child or young person.

23 You should involve children and young people as much as possible in decisions about their care, even when they are not able to make decisions on their own.

Assessing the capacity to consent
24 You must decide whether a young person is able to understand the nature, purpose and possible consequences of investigations or treatments you propose, as well as the consequences of not having treatment. Only if they are able to understand, retain, use and weigh this information, and communicate their decision to others can they consent to that investigation or treatment. That means you must make sure that all relevant information has been provided and thoroughly discussed before deciding whether or not a child or young person has the capacity to consent.

25 The capacity to consent depends more on young people’s ability to understand and weigh up options than on age. When assessing a young person’s capacity to consent, you should bear in mind that:

~ at 16 a young person can be presumed to have the capacity to consent (see paragraphs 30 to 33)
~ a young person under 16 may have the capacity to consent, depending on their maturity and ability to understand what is involved.

26 It is important that you assess maturity and understanding on an individual basis and with regard to the complexity and importance of the decision to be made. You should remember that a young person who has the capacity to consent to straightforward, relatively risk-free treatment may not necessarily have the capacity to consent to complex treatment involving high risks or serious consequences. The capacity to consent can also be affected by their physical and emotional development and by changes in their health and treatment.

Children and young people who lack the capacity to consent

27 If a child lacks the capacity to consent, you should ask for their parent’s consent. It is usually sufficient to have consent from one parent. If parents cannot agree and disputes cannot be resolved informally, you should seek legal advice about whether you should apply to the court.

28 The legal framework for the treatment of 16 and 17-year-olds who lack the capacity to consent differs across the UK:

~ In England, Wales and Northern Ireland, parents can consent to investigations and treatment that are in the young person’s best interests
~ In England and Wales, treatment can also be provided in the young person’s best interests without parental consent, although the views of parents may be important in assessing the young person’s best interests (see paragraphs 12 and 13)
~ In Northern Ireland, treatment can be provided in the young person’s best interests if a parent cannot be contacted, although you should seek legal advice about applying for court approval for significant (other than emergency) interventions
~ In Scotland, 16 and 17-year-olds who do not have the capacity to consent are treated as adults who lack capacity and treatment may be given to safeguard or promote their health.

Young people who have the capacity to consent

29 You should encourage young people to involve their parents in making important decisions, but you should usually abide by any decision they have the capacity to make themselves (see paragraphs 30 to 33 and 46 - 52). You should also consider involving other members of the multi-disciplinary team, an independent advocate or a named or designated doctor for child protection if their involvement would help young people in making decisions.

If a young person refuses treatment
30 Respect for young people’s views is important in making decisions about their care. If they refuse treatment, particularly treatment that could save their life or prevent serious deterioration in their health, this presents a challenge that you need to consider carefully.

31 Parents cannot override the competent consent of a young person to treatment that you consider is in their best interests. But you can rely on parental consent when a child lacks the capacity to consent. In Scotland parents cannot authorise treatment a competent young person has refused. In England, Wales and Northern Ireland, the law on parents overriding young people’s competent refusal is complex. You should seek legal advice if you think treatment is in the best interests of a competent young person who refuses.

32 You must carefully weigh up the harm to the rights of children and young people of overriding their refusal against the benefits of treatment, so that decisions can be taken in their best interests. In these circumstances, you should consider involving other members of the multi-disciplinary team, an independent advocate, or a named or designated doctor for child protection. Legal advice may be helpful in deciding whether you should apply to the court to resolve disputes about best interests that cannot be resolved informally.

33 You should also consider involving these same colleagues before seeking legal advice if parents refuse treatment that is clearly in the best interests of a child or young person who lacks capacity, or if both a young person with capacity and their parents refuse such treatment. For further guidance on these issues see GMC guidance on consent and treatment and care towards the end of life.

Procedures undertaken mainly for religious, cultural, social or emotional reasons

34 Both the GMC and the law permit doctors to undertake procedures that do not offer immediate or obvious therapeutic benefits for children or young people, so long as they are in their best interests (see paragraphs 12 and 13) and performed with consent (see paragraph 27).

35 To assess their best interests you should consider the religious and cultural beliefs and values of the child or young person and their parents as well as any social, psychological and emotional benefits. This may be relevant in circumcision of male children for religious or cultural reasons, or surgical correction of physical characteristics that do not endanger the child’s life or health.

Research
36×Research involving children and young people can benefit all children; but they may be vulnerable because they cannot always recognise their best interests, express their needs or defend their rights.

37 Children or young people should be involved in research only when research on adults cannot provide the same benefits. They can be involved in research that has either:

~ potential benefits for children or young people generally, as long as the research does not go against their best interests or involves only minimal or low risk of harm (this would be research that involves, for example, asking questions or taking blood samples, the assessment of the risk depending on the view of the child or young person), or
~ potential therapeutic benefits for them that outweigh any foreseeable risks, which should be kept as low as possible.

38 Children and young people should not usually be involved in research if they object or appear to object in either words or actions, even if their parents consent. If they are able to consent for themselves, you should still consider involving their parents, depending on the nature of the research.

39 You must not put pressure on children, young people or their parents to consent to research in the expectation of therapeutic, financial or any other benefit.

40 Before involving children or young people in research you should seek advice and get the necessary approval from a relevant research ethics committee, the Medical Research Council or a medical royal college.

Donation, transplantation, organ and tissue storage and use

41×The Human Tissue Act 2004 and Human Tissue (Scotland) Act 2006 were passed following inquiries into the storage of children’s organs and tissue without the proper consent. The Acts make consent central to the lawful storage and use of children and young people’s organs and tissue, and to the removal of such material after death. The Human Tissue Authority regulates and issues codes of practice on activities covered by the Act in England, Wales and Northern Ireland. Scottish ministers have those powers in Scotland.

And here is the specific guidance for children

It's interesting to read. The lawyers will have been through the times article when you consider the sheer scale of how many potential breeches of the GMC guidance there appear to be.

Until you read through this I don't think it's truly apparent.

0–18 years: guidance for all doctors
Guidance for all doctors

1 This guidance is for all doctors, but it may also be useful for children, young people1, those with an interest in their care, and anyone else who wants to know what guidance doctors are given.

2 The guidance is for all doctors, whether or not they routinely see children and young people as patients. Doctors should also be aware of the needs and welfare of children and young people when they see patients:

~ who are parents or carers
~ who are cared for by children or young people, or
~ who may represent a danger to children or young people.

3 Good medical practice states that doctors must safeguard and protect the health and well-being of children and young people. Well-being includes treating children and young people as individuals and respecting their views, as well as considering their physical and emotional welfare.

4 When treating children and young people, doctors must also consider parents and others close to them; but their patient must be the doctor’s first concern.

5 When treating adults who care for, or pose risks to, children and young people, the adult patient must be the doctor’s first concern; but doctors must also consider and act in the best interests of children and young people.

6 Children and young people may be particularly vulnerable and need to be protected from harm; they can often find it difficult accessing services or defending their rights; and they often rely on others for their well-being. They may have particular communication needs and may need help to make decisions.

7 Children and young people are individuals with rights that should be respected. This means listening to them and taking into account what they have to say about things that affect them. It also means respecting their decisions and confidentiality.

8 Doctors should always act in the best interests of children and young people. This should be the guiding principle in all decisions which may affect them. But identifying their best interests is not always easy. This is particularly the case in relation to treatment that does not have proven health benefits or when competent young people refuse treatment that is clearly in their medical interests. There can also be a conflict between child protection and confidentiality, both of which are vitally important to the welfare of children and young people.

9 Reaching satisfactory answers to these challenging questions may mean considering a number of difficult ethical and legal issues. The purpose of this guidance is to help doctors balance competing interests and make decisions that are ethical, lawful and for the good of children and young people.

10 The law relating to children and young people is complex and differs across the UK. Doctors who have children and young people as patients will need some understanding of the law as it applies where they practise. Summaries of the law contained in this guidance cannot be a substitute for up-to-date legal advice in individual cases.

11 When in doubt as to their responsibilities, doctors should seek the advice of experienced colleagues, named or designated doctors for child protection, or professional or regulatory bodies.

12 An assessment of best interests will include what is clinically indicated in a particular case. You should also consider:

~ the views of the child or young person, so far as they can express them, including any previously expressed preferences
~ the views of parents
~ the views of others close to the child or young person
~ the cultural, religious or other beliefs and values of the child or parents
~ the views of other healthcare professionals involved in providing care to the child or young person, and of any other professionals who have an interest in their welfare
~ which choice, if there is more than one, will least restrict the child or young person’s future options.

13 This list is not exhaustive. The weight you attach to each point will depend on the circumstances, and you should consider any other relevant information. You should not make unjustified assumptions about a child or young person’s best interests based on irrelevant or discriminatory factors, such as their behaviour, appearance or disability.

14 Effective communication between doctors and children and young people is essential to the provision of good care. You should find out what children, young people and their parents want and need to know, what issues are important to them, and what opinions or fears they have about their health or treatment. In particular you should:

~ involve children and young people in discussions about their care
~ ^be honest and open with them and their parents, while respecting confidentiality
listen to and respect their views about their health, and respond to their concerns and preferences^
~ explain things using language or other forms of communication they can understand
~ ^consider how you and they use non-verbal communication, and the surroundings in which you meet them
give them opportunities to ask questions, and answer these honestly and to the best of your ability^
~ do all you can to make open and truthful discussion possible, taking into account that this can be helped or hindered by the involvement of parents or other people
~ give them the same time and respect that you would give to adult patients.

15 You should make it clear that you are available to see children and young people on their own if that is what they want. You should avoid giving the impression (whether directly, through reception staff or in any other way) that they cannot access services without a parent. You should think carefully about the effect the presence of a chaperone can have. Their presence can deter young people from being frank and from asking for help.

16 You should take children and young people’s views seriously and not dismiss or appear to dismiss their concerns or contributions. Disabled children and young people can feel particularly disadvantaged in this respect.

17 Children and young people usually want or need to know about their illnesses and what is likely to happen to them in the future. You should provide information that is easy to understand and appropriate to their age and maturity about:

~ their conditions
~ the purpose of investigations and treatments you propose and what that involves, including pain, anaesthetics and stays in hospital
~ the chances of success and the risks of different treatment options, including not having treatment
~ who will be mainly responsible for and involved in their care
~ their right to change their minds or to ask for a second opinion.

18 You should not overburden children and young people or their parents, but give them information at an appropriate time and pace, and check their understanding of key points.

19 You should talk directly and listen to children and young people who are able to take part in discussions about their care. Young people who are able to understand what is being said and who can speak for themselves resent being spoken about when they are present. But younger children might not be able to understand what their illness or proposed treatment is likely to involve, even when explained in straightforward terms.

20 You should only keep the type of information described in paragraph 17 from children or young people if:

~ it would cause them serious harm (and not just upset them or make them more likely to want to refuse treatment)
~ they ask you to, because they would prefer someone else to make decisions for them.

21 You have the same duty of confidentiality to children and young people as you have to adults. But parents often want and need information about their children’s care so that they can make decisions or provide care and support. Children and young people are usually happy for information to be shared with their parents. This sharing of information is often in the best interests of children and young people, particularly if their health would benefit from special care or ongoing treatment, such as a special diet or regular medication. Parents are usually the best judges of their children’s best interests and should make important decisions up until children are able to make their own decisions. You should share relevant information with parents in accordance with the law and the guidance in paragraphs 27, 28 and 42 to 55.

I bought the Times in my lunch hour in support. Really can’t remember the last time I bought a newspaper and I’m glad it was such a quality edition.

This is parts 1 and part 2 of the GMCs guidance on consent. I've left part 3 out (it can be viewed via the link) which is capacity issues because this is about consent generally about adults over 18. The capacity stuff that is more relevant is contained in a specific guidance for 0 - 18 which I'll also post shortly.

I apologise for its lengthy but I think it's worth sharing the lot because there are so many points that the clinicians raise which if they didn't they would be acting outside the GMC guidance if they practiced without considering them.

Professor Carl Heneghan head of Evidence Based Medicine at Oxford was interviewed on Panorama & as a consequence of his analysis concluded that 'informed consent is not possible'

BMJ EBM Spotlight paper:
'Gender-affirming hormone in children and adolescents – Evidence review'
Posted on 25th February 2019

(extract)
"Gender dysphoria occurs when a person experiences discomfort or distress because of a mismatch between their biological sex and gender identity. Gender dysphoria can arise in childhood and adolescent which raises many questions about how best to handle the condition. This post sets out the current evidence for gender-affirming hormones in adolescents and children to aid decision making. (continues)

"Conclusions

There are significant problems with how the evidence for Gender-affirming cross-sex hormone has been collected and analysed that prevents definitive conclusions to be drawn. Similar to puberty blockers, the evidence is limited by small sample sizes; retrospective methods, loss of considerable numbers of patients in follow-up. The majority of studies also lack a control group (only two studies used controls). Interventions have heterogeneous treatment regimes complicating comparisons between studies. Also adherence to the interventions are either not reported or at best inconsistent. Subjective outcomes, which are highly prevalent in the studies, are also prone to bias due to lack of blinding, and many effects can be explained by regression to the mean.

The development of these interventions should, therefore, occur in the context of research. Treatments for under 18 gender dysphoric children and adolescents remain largely experimental. There are a large number of unanswered questions that include the age at start, reversibility; adverse events, long term effects on mental health, quality of life, bone mineral density, osteoporosis in later life and cognition. We wonder whether off label use is appropriate and justified for drugs such as spironolactone which can cause substantial harms, including death. We are also ignorant of the long-term safety profiles of the different GAH regimens. The current evidence base does not support informed decision making and safe practice."
blogs.bmj.com/bmjebmspotlight/2019/02/25/gender-affirming-hormone-in-children-and-adolescents-evidence-review/

Prof Heneghan:
"The current evidence base does not support informed decision making and safe practice."

www.mumsnet.com/Talk/womens_rights/3518188-BMJ-Prof-Carl-Heneghan-Evidence-Based-Medicine-Oxford-Panorama-Trans-Kids-Gender-affirming-hormone-in-children-and-adolescents-Evidence-review-concludes-There-are-significant-problems