Jolyon Maugham, GLP and scary stuff re parental consent

The Tavistock procedure of requiring informed consent from the child themselves is highly unusual.

Indeed, but so's the "treatment", as the judges noted. All the usual Gillick etc examples are actual concrete treatments for real serious medical conditions.

This could be viewed as an extreme body alteration justified on psychological/societal/cosmetic grounds. It is a very long way away from a physically life-saving treatment like a blood transfusion.

I think the Tavistock knows that mere "assent" doesn't cut it for something like this. They don't want to be facing that ethics panel.

We wouldn't allow mere "assent" rather than "consent" from children in many instances.

I am not a lawyer and I'm not a medical professional, so my knowledge of this is not expert. However, as far as I understand, parental consent with child assent is the normal procedure for medical treatment in children.

So Jolyon's wish to make this treatment available with only informed consent from the parents and assent from the child (who is deemed unable to give fully informed consent) would be in line with current arrangements for a child who does not have the maturity to give fully informed consent for other treatments.

If this treatment is viewed as a 'normal' or 'standard' medical treatment, is there a possibility that Jolyon's case could succeed?

The Tavistock procedure of requiring informed consent from the child themselves is highly unusual. I can help wondering whether this is because a surprisingly high number of parents disagree with the proposed treatment.

I thought they required informed consent from both the child and the parent(s). The Tavistock might have been trying to keep the Munchausen by proxy sufferers, homophobes and paedophiles at bay with the requirement of informed consent from the child.

With children now deemed unable to consent, we would need more vigilance from the medical professionals to prevent such parents from inflicting irreversible damage on their children.

The Tavistock procedure of requiring informed consent from the child themselves is highly unusual. I can help wondering whether this is because a surprisingly high number of parents disagree with the proposed treatment

Or have concerns about the competency or motives of the parents.

The child in this case had been refered to the Tavistock www.bailii.org/ew/cases/EWHC/Fam/2016/2430.html.

While whistle-blowers have raised concerns about the motives of other parents, homophobia etc

[quote InvisibleDragon]Gillick competent to refuse a heart transplant. Autocorrect gubbins alert.

Here's a link as penance. There's a happy ending - she changed her mind:
www.bbc.com/news/av/uk-43110989[/quote]
That is a lovely clip.

"The child isn't mature enough to consent and therefore we will seek the parents' consent to treatment that will stop the child maturing"'

Oh hold on. I can comment on this, going back decades though.

I had high risk multiple surgeries as a child at children's specialist hosps. Not risk of death but risk if it went wrong would be permanent and life altering.

They discussed with us. They definitely asked my assent. Which I gave as the docs and my parents said for the best. But yes they asked.

I was the same sort of age, 11+

The other thing though is that it seems to serve mtf better? By preventing growing in height, voice breaking, beard etc. Which are not really mitigated through cross sex hormones.

The age seems more for m2f as well. Talk of 11 or 13.

My girls started puberty 8.5. Girls do start earlier. So the ages mentioned are too late for female children

Also. If you block female puberty and then give male hormones does that result in a lot of height growth? I have no idea. I know the voice deepens and beard comes in. Not if you growth upwards has been stopped at 9 for eg you're going to be a very short adult man.

I think there is bias here as well in looking primarily at outcomes for mtf.

Gillick competent to refuse a heart transplant. Autocorrect gubbins alert.

Here's a link as penance. There's a happy ending - she changed her mind:
www.bbc.com/news/av/uk-43110989

I am not a lawyer and I'm not a medical professional, so my knowledge of this is not expert. However, as far as I understand, parental consent with child assent is the normal procedure for medical treatment in children.

The best outcome is when everyone is in agreement: the doctors recommend a treatment, the parents consent to it and the child assents (agrees to have the treatment, but does not need to demonstrate Gillick competence). Parental consent would also be sufficient if the child was too young or otherwise unable to take part in any decision making (eg operation on a baby).

Gillick competence only comes into play either when the child disagrees with the parents over treatment, or when the parents and child together disagree with the medical team. For example, Jehovah's witnesses and blood transfusions. The was also a case of a 12(?) year old who was found to be Gillick competence too refuse a heart transplant. Courts get involved when it's complicated to determine Gillick competence, or when there is a disagreement about what is in the best interests of the child (eg Charlie Gard).

The Tavistock procedure of requiring informed consent from the child themselves is highly unusual. I can help wondering whether this is because a surprisingly high number of parents disagree with the proposed treatment.

I guess this is what puberty blockers represent to many - the mythical True Sex Change treatment. It is a wish fulfilment to them. For trans-identifying adults who wish they could have had such a treatment, Munchausen Mermaids Mums, and an increasing number of children.

Unfortunately, it's a real-world drug having real-world effects on real children. But they so want to believe. That's why they're not acting rationally.

I was just re-reading the Biggs Tavi PB review and this passage seems relevant, regarding the lack of detail on the patient information sheet provided to the children in the study:
"All these omissions might be explained by the input of parents who saw GnRHa as an
elixir that would enable their child to change sex. “The wording … was agreed with a number
of families with whom the draft had been discussed” (Di Ceglie 2019: 149). Whatever the
cause, GIDS and UCL gave children and parents incomplete and misleading information,
which contradicted the research proposal. Whether they could provide informed consent, in
such circumstances, is open to serious question"

The child isn't mature enough to consent and therefore we will seek the parents' consent to treatment that will stop the child maturing

Bang on the money.

I* would dearly love to know exactly what his stake in this is.*

Despite the kimono-wearing I don't think it's a closet for JM but more something he is building for someone else...

This tweet seen is to the point

"The child isn't mature enough to consent and therefore we will seek the parents' consent to treatment that will stop the child maturing"

I've wondered if the Tavistock staff would actually like this way around the judgement but can't say so, and are quietly hoping things go the GLP's way, or if this really would be about seeking to legally compel doctors to act in a way contrary to their judgement.

@teawamutu

The increasingly inaccurately named 'Good' Law Project

I would dearly love to know exactly what his stake in this is.

It's very concerning.

I like the fact that other lawyers feel able to call this out for the legal nonsense that it evidently is. That wouldn't have happened last year but as ever, it's the outrageous excess and overreach every time.

The increasingly inaccurately named 'Good' Law Project

I would dearly love to know exactly what his stake in this is.

Another vote for Michell's summary & conclusion:

"However things go this is useful; bring it on. Do in full sunlight."

The clear lack of objectivity, expertise, or coherence in the stated views of so many on that list is likely to ring alarm bells even before the case is considered. Ideology before safeguarding over and over again.

So if a parent asks for a second opinion their child can be removed (as in Australia recently) or cut out of the process (as some schools have been doing) but if they affirm, they’re so knowledgeable they can override Gillick?

More logic brought to you from the team that brought you because clownfish be kind.

Parental consent wasn't relevant to the case because of Tavistock's own policy, so won't it be irrelevant in an appeal too?

The Tavistock in evidence in the Bell case just explained their position- they dont accept parental consent if the child can't consent themselves. It wasnt part of the case itself. So I don't think it can form part of the appeal.

If the GLP can't 'compel' the Tavistock to change their position, I wonder if they will lodge a separate JR to challenge?

It could put the Tavistock in a difficult position where they will need to decide if lobby groups can continue to dictate the terms.

No-one should be so naive as to believe that all this public money is being harnessed for the benefit of the public. This is entirely personal or I’ll eat my hat.

• ah, gardenbird, I left the window open and went off and did something and missed your post!!

Dr Kamilla Kamaruddin, who is listed as 'female' on the website of the practise where Kamaruddin works:

'The new patients did not ask any questions at all because they either thought I was a female GP or it did not bother them at all that I was a transgender doctor...

...A lot of my patients were quite conservative — many female patients wore long clothes, or the hijab — but they allowed me to examine them despite my change. In fact, after my transition, they even allowed me to perform more intimate examinations that they did not let me to do when I was a male GP'

bjgp.org/content/67/660/313

www.bailii.org/ew/cases/EWHC/Fam/2016/2430.html

This is the case of the mother who was convinced her very young child was trans. The Good Law Projects position undermines gillick but will enable parents like this.

Simon Myerson QC thinks it's deranged i agree completely

Parental consent wasn't relevant to the case because of Tavistock's own policy, so won't it be irrelevant in an appeal too?
An appeal is a review of the previous decision to ensure it was made correctly. NOT a retrial with new evidence included.

I've just twigged who the other name on the list is - one of those without a bio. I wonder if he will be adding a bio at some point? (I can't double check this as the document isn't loading for some reason)

This GP was listed on their practice website as female and was quite pleased when their patients refused a chaperone for intimate examinations they wouldn't have let them do when they were known as a male GP . Apparently even some colleagues mistook them for a locum.

Apparently some of them got confused and thought Dr K was the wife of their male GP Dr K. and some thought that it was a new GP. There clearly was not much open communication with the female patients that it was their formerly male GP treating them.

As with Mridul, I wonder what relevant qualifications or experience this GP has to help administer this fund for taking legal action re. puberty blockers??

bjgp.org/content/67/660/313