Court verdict on puberty blockers won't affect Scottish children

[theskyispink]

The only clinic in Scotland that can prescribe puberty blockers to children who are gender dysphoric will not change its protocols in the wake of a landmark court judgement in England that ruled children under 16 were not mature enough to give informed consent.

www.scotsman.com/news/politics/court-verdict-puberty-blockers-wont-affect-scottish-children-3056057

They have two people who write on this topic in The National, ItsAll, Shona Craven and Stephen/Steph (non-binary) Paton.

The former is a very sharp, smart and engaged young woman who really does her research. The latter is an angry transactivist.

This piece was written by Shona, unsurprisingly!

That was a very good piece.

Sinead Watson spoke movingly on her treatment by the Sandyford:

www.bbc.co.uk/news/uk-scotland-51445579

Great article very disturbing that Sandyford’s data collection seems to be as poor as the Tavistock
Sexism and homophobia are at the heart of the stereotypes that comprise “gender” – the societal expectations a culture places on girls and boys, men and women. We cannot, as a society, claim to be working to root out either of these problems while failing to challenge policies that uphold them.

Appeal denied!!!

Lady Justice 👩‍⚖️ (@RadFemLawyer) Tweeted:
Permission to appeal to the Court of Appeal in the Bell v Tavistock case has been refused. 10 grounds of appeal were advanced. None succeeded, including an attempt at an Article 14 (discrimination) point which had not been suggested previously by the Defendant. twitter.com/RadFemLawyer/status/1335926918223433734?s=20

Interesting too see that the paper linked by ItsAllGoingToBeFine refers to the adolescent giving their "informed consent / assent" to blocker treatment.

Assent refers to getting agreement from a patient when they are not able to give informed consent, when their parent/guardian had given their informed consent. (I think this is the more standard procedure when treating children. Gillick usually only comes into play when there is a conflict between what the parents and the child want, or when the child needs to make a decision in the absence of their parents.)

I wonder if this is why Scotland is still prescribing?

The Tavistock made a big deal of only going ahead with blockers if the patient themselves could provide informed consent. This was somewhat undermined by the lawyer for the endocrinology service, who implied that responsibility in the case of regret lay with the child's parents.

Perhaps Scotland has always allowed parental consent + child assent for the prescribing blockers and has therefore sidestepped the issue of Gillick competence entirely.

Piece in Scotsman: www.scotsman.com/news/opinion/columnists/gender-dysphoria-keira-bell-court-ruling-should-lead-changes-scotland-murdo-fraser-msp-3061328

Also, apparently there will be a question asked in FMQs tomorrow.

Murdo Fraser has been great on this issue. He attended the seminar at the Scottish Parliament earlier this year about gender dysphoria in children/adolescents and wrote a column about it:

www.scotsman.com/health/are-unscientific-ideas-about-gender-causing-irreparable-harm-childrens-lives-murdo-fraser-2446013

Just wanted to say that there is a question on this in Parliament today. FMQs is on now, and looks like it will be the last question.

NS: Not a matter for government. Robust psychological assessment before prescription.

JM: interesting that FM thinks courts can't overrule medical opinion. Case specifically about capacity to consent. Does NS think children can consent,

NS: English ruling not relevant to Scotland. Sandyford works within guidelines. Decisions for clinician.

Good comments in today’s Times article:

www.thetimes.co.uk/article/ba127fbe-3b3b-11eb-9017-abc630b6062b?shareToken=9c98e4e817bb9ed6d56f078dc9538875

@PaleBlueMoonlight

Its interesting that they don't say why they think Scottish children can consent, ie. where they think the court's reasoning is incorrect.

They don't need to. Scots law applies here. There's no more need to say the English court's decision is wrong than if the decision were from a French court. It simply doesn't apply.

I wonder if there’s any other area in the NHS where there’s such a controversial division between Scotland and England. I know there will be smaller differences- e.g. even within Scotland how to get your gallbladder removed can vary greatly just from LHA to LHA let alone country, but is there any area of division on quite this scale?

I defend the separateness of Scottish law, but on this issue want it to change.

Sunday Times today- Sandyford took down their pamphlet for young people from their website 6 months because of out of date info re puberty blockers and still haven’t updated it:

www.thetimes.co.uk/article/0889d1de-3cc1-11eb-838a-941b63872fa8?shareToken=2b64ae352c8064688eec8db782c82878

Good - thanks for the share.

What really gets me is that they say:

“ We want to reassure the public the leaflet was never intended to be used in isolation. The Young People’s Gender Service and endocrine teams are reviewing this leaflet, taking into account limited available research into the long-term effects of hormone blockers.”

Except this is the ONLY information adolescents get from Sandyford while on their 2+ year waiting list. That information influences and forms thinking, so to say it is not supposed to be used in isolation is appalling when it is the only information out there until seen by Sandyford.

And if they are taking into account the limited available research (and this is the reason for the delay in updating) why on earth aren’t they following the lead of the Tavi and suspending treatment?

Utterly appalling and irresponsible.

Pamphlet normally sits here: www.sandyford.scot/sexual-health-services/gender-identity-service/

@nosswith

I defend the separateness of Scottish law, but on this issue want it to change.

There are very few democracies that do not use precedence. The US & UK, Canada, Australia etc etc. Support for independence doesn't mean real independence in law . Laws are tested all the time and if they weren't, we would still be living totally under common law, semi feudal.

The responsibility lies directly with the Sandford. They must ensure they have thoroughly investigated competence before referring to endocrinology. The Endocrinology departments will have to ensure they agree with that competence. Even if Scotland were independent, the citizens would have the right to state their case before the law using precedence.

So if they took down the leaflets, because the outcomes of blockers are unknown, how can they justify informed consent now?

If you want to see the pamphlet, it is here: www.sandyford.scot/media/3744/304280_1_1-yp-gender-service-information.pdf

They can't Datum. Another fine paradox you've gotten me into Stanley

Highame, I think the issue is that only rulings made in Scottish courts set precedent in scotland.

@highame

They can't Datum. Another fine paradox you've gotten me into Stanley

😁

That pamphlet is worth archiving:

<a class="break-all" href="https://web.archive.org/web/20201213104927/www.sandyford.scot/media/3744/304280_1_1-yp-gender-service-information.pdf" rel="nofollow" target="_blank">web.archive.org/web/20201213104927/www.sandyford.scot/media/3744/304280_1_1-yp-gender-service-information.pdf

There is a comment by Alex Massie in the Times today:

www.thetimes.co.uk/article/27f50800-3e28-11eb-87aa-2b872fbc5d91?shareToken=a929f9433749f8cdd66e0a52864c5458