Keira Bell and Mrs A vs. Tavistock - Court of Appeal hearing 23 & 24 June 2021

Again, the use of people when referring to minors.

It is rational. That's why it's in the courts. Can a child give informed consent when it's impossible for a child to know what they are consenting to given that they don't know about sexual pleasure until they go through puberty and this 'treatment' is precisely designed to stop them going through puberty.

From what I understand, the point of law being made that the court cannot decide by judicial review, whether Gillick competence is possible or not, based on age-bands as laid out by the previous court, as every single case has to be assessed on its own merits.

So even with poorly-evidenced medicine, which causes enormous harm, it isn’t up to the courts to designate or limit who might be considered competent. Presumably the judges must make the assumption that the medics are assumed to be responsible and skilled. You can challenge an individual case, but not put a more general stop to the rest.

So even if the judges decide that what’s being done is criminally bad, they might still conclude that legally it’s not up to them to draw up guidelines that doctors and medical bodies should be creating.

Which suggests to me that it may turn out that the only way to challenge this situation is through individuals suing the hospitals and hoping that enough damage is done that the medical pathways are changed.

Hope I’m wrong, but it sounds like it may be an important point of law: that judicial review is the wrong way to challenge this.

And it says a lot about someone who describes child safeguarding, and the sterilising of children, many with autism, as ''frivolous''

I invoke Bunbury's

No yeahbutnaw. This is not frivolous. I could've been in Keira's shoes. Luckily I didn't get a whole load of adults encouraging me down a pathway where my breasts got lopped off and I never got to experience orgasms.

Isn't that the same as all frivolous GC cases? e.g., Ann Sinnot's recent failure.

Nope. That was just one. Plenty have been very successful :)

Seems to me that the judges are saying that children can have Gillick competence and it's not up to them to decide whether or not whatever the Tavistock is doing is good for them or not.

Sounds like someone needs to judicially review the use of puberty blockers in children for gender dysphoria.

Judge: Perhaps you might want to reflect on this overnight Mr Hyam and try again tomorrow?

The question being examined here seems to be: can a child consent vs were there cases where the Tavistock did not obtain consent because their guidelines weren't followed properly or were not thorough enough.

Bell's lawyer currently sounds like a student getting a grilling in supervision and not really having done his homework.

I think one of the difficulties is that this isn't a review of the use of PBs. It's a review of whether the Tavi's approach to prescribing them is lawful. The pros and cons of PBs are only being considered to the extent that they are relevant to the assessment of the Tavi's approach.

This does not sound good to me.

Uh-oh, one of the judges is saying that Tavistock's approach appears to be wholly lawful and the issue is incorrect application in some cases. Again, a suggestion that this case isn't appropriate for judicial review.

I really wish the original judgment had listed ‘none of this treatment changes sex’ as a matter to be understood. I understand from several UK transsexuals on Twitter that this was a key point made to them before undergoing treatment as adults - their consent was informed and realistic. I am really not sure why it was not specifically listed.

Clear from service specification that consent of the child was a necessary pre-requisite for treatment this should mean that the child must be Gillick competent in the case of PB's and therefore the inclusion of parents is neither here nor there - my understanding

We're now hearing from Jeremy Hyam QC acting for Keira Bell.

The use of puberty blockers therefore relies 100% on “trans (identifying) children” being different from “children with gender dysphoria” and doctors being able to diagnose the difference reliably.

Which is where it appears the Tavistock case is weak to non-existent.

I hope you’re wrong and the judges recognize the difference. My suspicion is that at some point, transition as a “cure” for feeling as if you are/having a strong desire to be the opposite sex will come to be viewed as at least as scandalous as lobotomy. And the worst cases will be those where children were sterilised and suffered appalling side effects, without being successfully helped with the original problem they were suffering.

'leap of logic' I love that, isn't that what has been happening at the Tavi?

twitter.com/SVPhillimore/status/1407697422365642757 great

We're now onto whether the treatment is experimental.

The sound is so terrible making it very difficult to understand what is being argued, sub titles would have been a good idea!