High court case on puberty blockers and consent

[bumpertobumper]

This week a case starts in the high court with a mother of a teen and a former gids nurse bringing a case that under 18s can't consent to puberty blockers.
Sorry if there is already a thread on this, had a look and couldn't see one.

https://www.theguardian.com/society/2020/jan/05/high-court-to-decide-if-children-can-consent-to-gender-reassignment?CMP=ShareiOSAppp_Other

How can the Tavi argue the statistic stats when they themselves publicly say they are false/misleading?

Suicide stats!

I think the whole point about Gillick competence is that the child can decide the treatment regardless of what their parents want.

Yes it is, but in virtually all cases of PBs the parents are consenting anyway so I’m not sure where Gillick would come into it.

267 out of how many referrals? Out of how many children? Is it possible that numerator represents approximately the 10 to 20% that would not desist?

To me, it’s as much about educating parents, or having parents start to question the approach, as it is getting a positive court ruling.

Yes fair enough rodgmum that’s a good point. Gids have implied that some parents had pressured them into treatment. Also it might highlight the need for increased mental health resources particularly more intensive psychotherapy to support children without medical intervention.

Fieldofgreycorn

It’s not completely up to date, but these charts might be of interest re numbers of referrals/numbers going onto PB

tavistockandportman.nhs.uk/documents/408/gids-service-statistics.pdf

In the US, healthcare providers have already stated that gender treatment will be provided for minors without parental consent or knowledge. A child could theoretically take their parents to court in the U.K. if their parents were not supportive of PBs

How can the Tavi argue the statistic stats when they themselves publicly say they are false/misleading?

I expect they'll argue (though this is of course all speculation) that they are keeping children safe by offering PBs. It's only the actual rate of suicide that they have said is low AFAIK. The high rate of GD teens who have contemplated suicide is probably correct but the crucial context is that it is no different from any other group of teens with MH issues. Thankfully very few act on the idea.

They can't say those children represent the 20%, because they also say that puberty blockers 'lock in' gender dysphoria.

If they're going to talk about suicide contemplation, then the fact that children who are autistic have a higher rate of suicide contemplation is going to be an interesting addition. Given the number of autistic children who say they are trans.

Isn't this particular child, involved in the case, autistic?

The radio 4 piece was great.

The questions put to her were excellent and she refuted them very succinctly.

I would have liked her to comment more on the politicisation in terms of how this is filtering through to schools, but unlikely to be enough time.

^XXcstatic* The Carmichael report to the GIDS BoD (2015j re the study of children on triptorlin stated: a significant increase was found in the first item ‘I deliberately try to hurt or kill self’”

I’m really not convinced the Tavi will go down the suicide stats route.

With regards to the tavi, alot of staff have left over the past 2 or 3 years.

I do worry that it will end up in a situation where the only people who can stomach working there are those who are themselves deeply invested or have full blown acceptance of the ideology. Are we in.danger of ending up that way do you think?

Aren’t the Tavi on public record saying the suicide stats are misleading? That they’ve only had one in 10 years? So how can they then say they need to block puberty as an imperative to prevent suicide? And as such, why are puberty blockers required?

’m really not convinced the Tavi will go down the suicide stats route.

They may not - obviously I am only guessing how they will argue.

Aren’t the Tavi on public record saying the suicide stats are misleading? That they’ve only had one in 10 years?

Yes. Although I think there has been a second because they amended the website to say "extremely rare". The original page explained that the first had significant mental health comorbidities including hospitalisation.

Is it starting today? Will there be live tweeting?

Here are the suicide stats

I feel that the Tavistock has been calling out for help for a while actually. This court case may finally get them the help they need.

Sarahtancredi That's something I've wondered too. As clinicians resign it leaves only those who are true believers of the ideas underpinning the current trans rights movement, and happy with the politicised environment, influence from lobbying charities etc.

mander

The next question is also, what happens if the ruling goes the way we hope. Theres so much going on at the moment that is dependent on this course of treatment being considered "ok" . Will it spark a complete review of everything?

After all we are still waiting for the review penny mordant promised regarding the 4400 percent increase in girls wishing to transition .

The Montgomery Case is interesting
The BMA states
Assessing risk
When assessing risks, doctors cannot rely on percentages. The significance of a risk cannot be reduced to its likelihood.

Important factors will include:

the nature of the risk, the effect which its occurrence would have upon the life of the patient
the importance to the patient of the benefits sought to be achieved by the treatment
the alternatives available and the risks involved in those alternatives.

Seems to me using the term 'pause' is deliberately minimising the risks. If the child is not informed of the impact on brain development, etc
If they haven't been given access to alternative treatment etc. Then they are not in a position to consent.
The idea that any child under 16 can meaningfully consent to such drastic intervention when it's experimental not proven treatment for a clearly diagnosable condition is ridiculous. Either children or children or they're not.

The onus should be on the doctors to take the case to court if they truly believe it's necessary and lifesaving for the child.

From Susan Evans' Twitter:

'I just need to clarify - we are not in court this week. Press info is slightly misleading - But we are hoping to lodge the papers in court very very soon- just awaiting some expert witness statements from abroad- then we will launch so will be back soon with news!'

twitter.com/sueevansprotect

Ah ok, I thought it was rather soon.

XXcstatic
Thanks for the reply. Of course i appreciate that a 15 year old is legally allowed to consent for an appendicectomy if assessed as Gillick competent to do so. My point was generally that I think (and again may be different in secondary vs primary care) that Mrs A et al should be able to cite examples where we don’t routinely expect a child under 16 to have capacity to consent and demonstrate that as PBs are equally if not more serious it should be expected that children will not routinely be able to consent to taking PBs.
I agree I think the likely outcome of this will not be the judge deciding that no child under 16 could ever consent to PBs because consent as a general principle tends to avoid those sorts of blanket rulings I think. Given that, the best I can hope for is that the outcome will be that these cases should be referred to the Court of Protection to look at the evidence in each case and to see if using PBs is in the best interests of the child, much in the way we do with others who cannot give or refuse consent so that there is at least some oversight external to the clinicians and families involved.

It's good, really, gives them a bit more time to raise necessary funds. cough.

My point was generally that I think (and again may be different in secondary vs primary care) that Mrs A et al should be able to cite examples where we don’t routinely expect a child under 16 to have capacity to consent and demonstrate that as PBs are equally if not more serious it should be expected that children will not routinely be able to consent to taking PBs

I definitely agree that that would be very helpful. The sterilisation analogy made by PPs would be a good one - would the court expect a child under 16 to be able to consent to an elective treatment that causes sterilisation? - perhaps chemo could be used as the analogous situation? If the court feels that a child can't consent to chemo that may sterilise her under Gillick, even though the chemo could be life-saving, it would surely follow that she can't consent to PBs?

However I am not sure in what detail the court will examine the medical evidence on PBs. Will it be a fairly cursory overview - which would be easier for the Tavi to defend, I would think, or will the hearing examine the case for and against PBs in detail, in order to determine whether or not Gillick competence is applicable? As I said upthread, I am not a lawyer, but my understanding of requests for judicial review is that they are usually based on whether a proper process has been followed on reaching a policy decision, rather than questioning the policy itself. If there are any lawyers reading this thread, it would be interesting to know their views.

I think it is also important to that these children are not making these decisions in isolation: the information presented by the clinic is not the only information they receive or even the most significant. These children are being groomed by people on the internet. They are getting most of their information from biased sources telling them what to say in order to move onto the next level. If we are to consider the issue of consent on the basis of information given then we should consider the totality of that information, how it is presented, who is presenting it, and what outcomes are promised. They are being told if they don’t take it they will commit suicide (we see this even in mainstream media). They also know they will be excommunicated if the do complete the sacraments.