GIDS granted permission to appeal

Does Gender GP allow parental consent?

This is what GenderGP say on their website

We can look to ask someone else to make that decision for them. In this instance we would look at whether there is a legal power of attorney in place, or someone with parental responsibility. In some cases we might need to ask the courts to help with the decision.

www.gendergp.com/a-question-of-consent-gillick-competency-transgender-kids-puberty-blockers/

As an aside, why do they mention 'legal power of attorney'? Please correct me if I am wrong but isn't it only adults that can have a POA?

Is the only remaining aim in using puberty blockers just to achieve a change in appearance?

I think so garden For boys. The focus always seems to be on boys and getting them to 'pass' better when they're older.

Irreversible changes that come with puberty is the excuse activists use to justify the use of PB's. But, as mentioned on another thread a while ago, female puberty causes no irreversible changes. Transmen who didn't take PB's 'pass' extremely well, because there's no ''damage to undo''.

That study (was it Tavi's own, I get muddled) showed that girls mental health becomes worse after PB's.

So why the hell are they even an option for girls in the first place?

After reading about these issues for years, I've come to the conclusion that one significant purpose of puberty blockers is to permanently embed gender dysphoria into some children, including those children having a temporary period of suffering something that presents like gender dysphoria.

The data released by GIDS the day after the judgement only reinforces the courts decision because it shows no positive effect on MN, let alone efficacy.

So the drugs are used to attempt to address a mental health issue, of which there is no evidence of success. Their current use also prevents the addressing of other underlying mh issues.

So what improvement IS being achieved for these children?

Is the only remaining aim in using puberty blockers just to achieve a change in appearance?

I think Tavi didn't have a strong enough case (safeguarding seemed to have been thrown in the bin) as has often been said and it seems Stonewall & Mermaids have a lose grip on reality and on legal proceedings.

We're back to it appearing to seem that some activists, including Stonewall and Mermaid, feel ownership of the Tavi and feel that they should have taken the case on their behalf and been able to be the lead people in it. Which would suggest that they see the Tavi less as the experts, than as those who do what they are told to do by those who know better, and who failed to make the case they were sent to make. Which would tie up rather with what many of the whistleblowers were saying.

Lets do it. Facts create reality, not emotion. The only outcome I am attached to is a logical, thorough set of facts that stand up and objectively prove the required outcome to required legal standard. Children deserve nothing less.

Sorry, my post was during page 1 and hadn't realised there was more info. coffee hand't kicked in. Just ignore.

Does Gender GP allow parental consent? If so wee may see this tested in court before too long (if GGP aren't prosecuted for other dodgy practices first like -allegedly - pretending to practice in Spain while being in the UK really. This is just a rumour but if true I would hope they can be hauled before a court for it).

An additional question would be whether the Tavi were providing patients with accurate information on benefits and harms to enable them to give informed consent, and I suspect the answer to that may be No.

I don't think they will. IIRC the Tavistock were criticised by the judges for acting as if informed consent was just a matter of giving the children enough information and them understanding it.

The court disagreed that the children could give informed consent because of the experimental nature of the drugs, because of the lack of evidence underpinning their use and because they're too young to understand the long term risks and consequences. So, no amount of information, or improved quality of information, could ever get them to a point at which they could give informed consent.

I've had a look through and wonder if they're hoping to get something going on parental consent and arguing about stonewall & mermaids not giving evidence. In regards to parental consent, the case was about child consent. I think Tavistock itself had concerns about parental consent (this might have been in their subsequent report). There is of course the argument that parental consent over the courts is questionable in cases where the drugs and treatment are experimental. If they were to succeed on this ground, the Tavi would have to change its procedures to a much longer wait and see period and a lot more talking therapy in order to re-assure the courts as well as the public.

As for Stonewall and Mermaids, it looks like a non-starter.

I think Tavi didn't have a strong enough case (safeguarding seemed to have been thrown in the bin) as has often been said and it seems Stonewall & Mermaids have a lose grip on reality and on legal proceedings.

I also sense that if they don't appeal they are wide open to claims so someone may have thought it to be worth spending money to try and close that door, even if it is unsuccessful because the alternative is that much worse.

So who exactly is pushing for appeal and who in the NHS would have signed off on pouring more money into this case?

there are several of studies showing puberty blockers don't work, but there are private doctors willing to prescribe them

Think is, there is already law on this. We have a medical profession which is supposed to regulate this. Once this appeal is done they will have little excuse not to act.

It's not clear how they would deal with evidence of lack of efficacy.

In a way they amount to the same thing.

The data released by GIDS the day after the judgement only reinforces the courts decision because it shows no positive effect on MN, let alone efficacy.

This refers to the grounds of appeal that were submitted to the High Court

Very interesting Tired, thanks.

The case was about informed consent, wasn't it

Yep. JM would only need to read the grounds for rejection of the initial appeal to know that what he just said was bobbins.

I suppose the poor thing must find all that legalese hard to follow.

Then I think the answer may be No, as the child/teen is too young to understand the balance of (substantial) harms versus (negligible/uncertain) benefits.

One of the legal commentators I read picked up on this. The judgment actually says:

Ms Morris submitted it is not for this court to determine clinical disagreements between experts about the efficacy of a treatment. We agree. That is a matter for the relevant NHS and regulatory bodies to oversee and to decide. However the degree to which the treatment is experimental and has, as yet, an unknown impact, does go to the critical issue of whether a young person can have sufficient understanding of the risks and benefits to be able lawfully to consent to that treatment.

It's all about the lack of evidence of efficacy in the judgment. How can the child understand in that situation? It's not clear how they would deal with evidence of lack of efficacy.

In a potential (and I think likely) future situation "there are several of studies showing puberty blockers don't work, but there are private doctors willing to prescribe them, and children caught up with groups saying they need them", then what?

And also, what about the parental consent thing? The court totally skipped that issue, because the Tavistock said they wouldn't do it, but then that Leeds hospital(?) and another popped up saying, "well we'd like to".

I wonder if maybe the Supreme Court isn't happy with some of the fuzziness here.

Many interesting and informative comments here. Thanks, FWR legal eagles -- I always learn from these threads.

the big positive from this case, or series of cases going up to the Supreme Court, is that the medical establishment will have to put their evidence base in front of a court and commit to it while it is forensically examined. This will mean that the medical practitioners won't be able to say in the future "Oh, we didn't mean that!", "... Medical practitioners are going to have to own what they're doing. To be responsible for what happens and to be accountable for it.

Yes. So much sunlight pouring in. Magnificent work by Keira and Mrs A and all their helpers.

Is the scourge of foxes no longer bothered about gillick & whether the ruling will undermine abortion rights etc? I'm blocked so am wondering what he witters about now, if glp plan to intervene in the appeal I wonder what they will argue.

Lady Justice @readfemlawyer
For those asking about grounds of appeal, that’s still not published. But what we do know is the basis upon which permission was granted by the CoA.

There are two bases on which they can be granted permission; realistic prospect of success or some other compelling reason...

Interestingly, the appeal has been granted on the latter. The Court of Appeal is interested in the Tavistock’s position that the judgement in Gillick has not been properly followed by the Divisional Court

Am i understanding this?

The appeal has been granted on the basis of a legal technicality and not because they think there is merit to it succeeding?

Disappearingirl An additional question would be whether the Tavi were providing patients with accurate information on benefits and harms to enable them to give informed consent, and I suspect the answer to that may be No.
The court looked at the info the children & families were being given. From memory they found that it was reasonable & accurate - they didn't think the fact sheets etc were misrepresenting or withholding info. The issue was that there was no real way for a child of that age to fully comprehend what that actually meant for them, because it related to their potential future life, sex life, & fertility, things that kids can't comprehend.

This article has just popped up on my twitter feed from @radfemlawyer

I think its worth a read:

www.hilldickinson.com/insights/articles/conventional-wisdom-prevails-refusal-consent-medical-treatment-gillick-competent
The conventional wisdom prevails: a refusal to consent to medical treatment by a Gillick competent minor is not determinative

Judgment has today been handed down In the matter of X (A Child) (No 2) [2021] EWHC 65 (Fam) an essential read for the law on consent to medical treatment in relation to those under 16 and those aged 16 and 17.

Its about a minor with sickle cell who is a Jehovah's witness.

It refers to the case Supreme Court of Canada in AC and Others -v- Manitoba (Director of Child and Family Services) 2009 which if memory serves has popped up elsewhere.

Anyway the ruling of the court seems to strengthen the courts hand and that Gillick competence in under 16 and 16 and 17 years only stretches so far and does not apply where death or serious harm may occur...

Sounds a bit of a problem for the Tavi Appeal this one.

Perhaps a side issue, but given that it is known people on steroids are clinically highly vulnerable to Covid, and testosterone is an anabolic steroid, wouldn’t anyone proposing to take “T”, as it is euphemistically called, need to understand that added risk, and any long term outcomes?

Even without Covid, shouldn’t all adolescents taking steroids understand that steroids are supremely dangerous?

Corticosteroids are different from anabolic steroids. Corticosteroids make people highly vulnerable to infection because they suppress the immune system; anabolic steroids don't work in this way. Obviously they have risks of their own, but they're not the same as the kind of steroids that increase vulnerability to infection.

Quote got detached! That reply was to yourhairiswinterfire

No If the court has allowed the appeal in order to obtain clarification of a point of law they probably would not give a toss about either side involved.

All that would matter would be the point of law and the court would not and should not have any bias towards one side or the other.

The original case was about informed consent and Gillick Competence in relation to a particular class of treatment, eg. different to treatment for a condition with reliable diagnosis and prognosis such as cancer that would be terminal if left untreated.

The reason I think this might have been allowed as “an interesting case” is that it might clarify the ruling in Gillick, rather than the court having any interest in puberty blockers per se.

Jolyon Fox-killer was arguing that the original case was dangerous as the outcome might affect access to birth control and abortion. He does not seem to be bothered about that risk now.

Even though there's an appeal, the big positive from this case, or series of cases going up to the Supreme Court, is that the medical establishment will have to put their evidence base in front of a court and commit to it while it is forensically examined. This will mean that the medical practitioners won't be able to say in the future "Oh, we didn't mean that!", "No, we didn't believe that!" or "But of course it wasn't our intention that people would do that!".

These experimental and extremes procedures for children were brought in on the quiet, and by the time concerns were being raised loud enough for the media to take an interest, the medical establishment was able to hide behind "everyone has been doing this for ages, of course it will continue" and "it's very complicated, it's too difficult for you to understand and so we're not going to engage with you over this".

The Bell case means that medical practitioners are going to have to own what they're doing. To be responsible for what happens and to be accountable for it. That in itself is a huge improvement.