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Feminism: Sex and gender discussions

Tavistock Appeal Denied

181 replies

OhHolyJesus · 07/12/2020 13:06

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

Anyone know what happens next?

OP posts:
hoteltango · 08/12/2020 00:19

That's a good point, OldCrone, that PBs eventually lead to CSH: from memory, that was the important point that was in the judgement. The Tavi really don't stand a chance of overturning the judgement on appeal. Either they didn't know that PBs led to CSH, in which case why didn't they know, why didn't they do follow-ups as good clinicians do. Or they did know, in which case they can't hide behind the "it wasn't me, guv" defence.

As you say, Datun: not just connected by chance, but inextricably linked. And the Tavi were derelict in their care of children that they didn't join the dots, and realise what the future health of those children was going to be.

OldCrone · 08/12/2020 00:22

@PrawnofthePatriarchy

Taken from OldCrone's comment:

"From para 22 of the judgment about the lack of published data about the study: The Study recruited children for 3 years, but there was then a period until February 2019 when the last cohort member began the next stage of therapy (cross-sex hormones)."

Maybe I'm dim but doesn't the phrase the next stage of therapy imply that the PB are just part of a larger continuum rather than the independent harmless pause we were being told they were.

I imagine that is the killer point that was being made. But I am very tired.

I think you're right. By saying it's 'the next stage of therapy', and all the study patients appear to have gone on to this next stage, means that the puberty blockers and CSH are two stages of a single treatment programme.

Did GIDS say anywhere in their evidence to the court that any of the study patients didn't go on to CSH?

yourhairiswinterfire · 08/12/2020 00:36

This part of the judgement may be relevant to those points too? (Do excuse me if I'm just talking out of my arse)

137: The defendant argues that PBs give the child “time to think”, that is, to decide whether or not to proceed to cross-sex hormones or to revert to development in the natal sex.

But the use of puberty blockers is not itself a neutral process by which time stands still for the child on PBs, whether physically or psychologically. PBs prevent the child going through puberty in the normal biological process.

As a minimum it seems to us that this means that the child is not undergoing the physical and consequential psychological changes which would contribute to the understanding of a person’s identity

PB's are stopping the mind from maturing as it should. The child's mind will basically be 'frozen' in time, they're not going to become any more insightful, because their brain development is halted. So CSHs are pretty much a guarantee. (I know what I'm trying to say here, I'm just not an eloquent writer Blush )

Datun · 08/12/2020 00:38

I mean, at the very least, you'd have to be telling a ten or eleven year old child that starting puberty blockers will mean a 98.9% chance of CSH - and all the implications of that.

Datun · 08/12/2020 00:41

@yourhairiswinterfire

This part of the judgement may be relevant to those points too? (Do excuse me if I'm just talking out of my arse)

137: The defendant argues that PBs give the child “time to think”, that is, to decide whether or not to proceed to cross-sex hormones or to revert to development in the natal sex.

But the use of puberty blockers is not itself a neutral process by which time stands still for the child on PBs, whether physically or psychologically. PBs prevent the child going through puberty in the normal biological process.

As a minimum it seems to us that this means that the child is not undergoing the physical and consequential psychological changes which would contribute to the understanding of a person’s identity

PB's are stopping the mind from maturing as it should. The child's mind will basically be 'frozen' in time, they're not going to become any more insightful, because their brain development is halted. So CSHs are pretty much a guarantee. (I know what I'm trying to say here, I'm just not an eloquent writer Blush )

That's right. They're no further on, despite the passage of time.
OldCrone · 08/12/2020 00:53

Either they didn't know that PBs led to CSH, in which case why didn't they know, why didn't they do follow-ups as good clinicians do. Or they did know, in which case they can't hide behind the "it wasn't me, guv" defence.

They must have known, from the studies done by the Amsterdam clinic.

In this one from 2011, it says that "No adolescent withdrew from puberty suppression, and all started cross‐sex hormone treatment, the first step of actual gender reassignment."

www.semanticscholar.org/paper/Puberty-suppression-in-adolescents-with-gender-a-Vries-Steensma/96113a2ebd53008744bb3ed275e0738c5c90c1c1

TheCraicDealer · 08/12/2020 00:57

I suppose their position that there is a very low proportion of children (because that's what they are!) desisting has actually hurt their case here- if PB's were a stand alone treatment in their own right you would expect that a much higher proportion would skip the CSH stage and forgoe medical transistion after weighing up the risks, or desist altogether. With 98% moving on to CSH's you're pretty much confirming what we all feared in that you're putting kids on a medicalised merry go round that's very difficult to get off.

ChattyLion · 08/12/2020 06:07

I wonder what the ten arguments that their appeal were, do the arguments get published if the appeal was refused?

Aside from the court process I’ve been wondering about the GMC, with all the staff whistleblowers and concerns over the years and now the court case, will we know if GMC take any kind of action in response? Like going in to the services to audit record keeping around consent or to train or observe the doctors around their consent practice or something? Given that the misunderstanding of legal consent requirements in relation to children seems to have been a generalised working culture problem within these services which the Trusts presumably (I haven’t seen their appeal arguments) effectively would wish to continue with? ..Hence the appeal against the court’s requirements for a complete change to their standard requirements for consent? What do GMC do when it’s a systemic issue like this?

NecessaryScene1 · 08/12/2020 06:34

Is anyone aware of anyone who had puberty blockers but didn't go on to cross-sex hormones?

I've never seen anyone public. And not even anonymous person give an account in a case study.

"Desisters" and "detransitioners" are said to be so few as to be not worth acknowledging by TRAs, yet I know of dozens with a public online identity.

Yet all of those I'm aware of either desisted before any physical treatment or detransitioned after cross-sex hormones.

None stopped during the puberty blocker stage. So the percentage really does seem to be extremely small.

It really does seem like the "puberty blockers" are a "pause" on development such that no progress is made in any direction. The only thing that happens on puberty blockers is your calendar age increases until you're legally old enough to take the basically inevitable stage 2 - the hormones. Only when those start is there a chance of dysphoria being resolved (either by the hormones, or by desisting, and I don't know how the stats compares to no treatment in the first place).

On the calendar age point - normal age laws are based on normal development. They're not arbitrary numbers. I can see a reasonable argument that given the effect of puberty blockers, they should also freeze legal ages for such age rules. Legal age for consent should be based on actual years of development, not including these induced "pauses". That legal change would render puberty blockers pointless, as you couldn't make a seamless change to cross-sex hormones, as you wouldn't ever reach the "16 years of development" limit. (And no, Gary, you can't have sex with this 16-year-old-but-still-prepubescent girl).

RealityNotEssentialism · 08/12/2020 07:07

@TheCraicDealer

I suppose their position that there is a very low proportion of children (because that's what they are!) desisting has actually hurt their case here- if PB's were a stand alone treatment in their own right you would expect that a much higher proportion would skip the CSH stage and forgoe medical transistion after weighing up the risks, or desist altogether. With 98% moving on to CSH's you're pretty much confirming what we all feared in that you're putting kids on a medicalised merry go round that's very difficult to get off.
Yes I agree. The data suggests that once you are on the path you will carry on along it. I totally understand the posts that have pointed that out. Therefore the full treatment must be consented to. However, from a legal viewpoint, I still think it is a weakness because there is an argument to be made that only the current treatment has to be consented to and that, even if hardly anyone desists once they are on PBs, CSH is nonetheless a separate treatment where consent should be assessed at the stage when it’s contemplated.

I find the High Court’s reasoning more persuasive than the above (and I think 16 is too young to decide about CSH) and I hope the Court of Appeal upholds it but I am still worried.

merrymouse · 08/12/2020 07:39

even if hardly anyone desists once they are on PBs, CSH is nonetheless a separate treatment where consent should be assessed at the stage when it’s contemplated

I think the relevant question is whether this is a case of correlation or causation.

At the moment, the answer seems to be that nobody knows.

ChakaDakotaRegina · 08/12/2020 07:47

Age seems to be another thought stopping point (like TWAW) where people think of a strapping 16 year old lad with stubble and a changing voice or a lass with breasts and hips who are going through the normal teenage hormonal activities of mood swings, getting the horn and trying to shag about.

They’re not connecting that these teens will still have prepubescent bodies (and you would assume) won’t have had the experience of a hormonal sex drive.

When we think of even the most timid and reticent teens going from school to uni or a workplace, the difference made by a few months of boozing, independence and a first partner is huge. Puberty is worth going through to get to this point.

ThatIsNotMyUsername · 08/12/2020 07:54

I see they are changing the age to buy lottery tickets From 16 to 18. Almost as if children are too young to make some decisions isn’t it?

Floisme · 08/12/2020 07:57

I agree with Reality that the conclusion that puberty blockers act as a pathway to cross sex hormones could well be the point that the lawyers will probe. If only the Tavi had some data for them.....

NewlyGranny · 08/12/2020 07:58

What is worse than using drugs experimentally on children? Using those drugs and not even gathering or collating the data to make a study. It's not even an experiment, is it?

HecatesCatsInXmasHats · 08/12/2020 08:06

Ugh, and pretending that PBs are some kind of benevolent 'pause' and not preparation for the next stages of medical transition.

FannyCann · 08/12/2020 08:11

Slight derail but on the news today it is reported that gambling laws are being tightened to protect vulnerable children. The age limit to buy a lottery ticket will be raised from 16 to 18. Its almost as if the powers that be know that teenagers don't understand risk and odds. Hmm

merrymouse · 08/12/2020 08:34

What is worse than using drugs experimentally on children? Using those drugs and not even gathering or collating the data to make a study. It's not even an experiment, is it?

And thats before you get onto the concerns raised by staff, that presumably are being examined in the separate independent review.

Cygne · 08/12/2020 09:18

@WeeBisom

Just a word of caution that Maugham being fairly certain there will be an appeal doesn't mean much considering that he seems to utterly fail to understand what the judgment itself is saying. It's also worth noting that in an appeal no new evidence or arguments can be put forward. You can only appeal if the original judgment was wrong on a point of law or procedure.
It would be very optimistic indeed to think that a group of lawyers with a track record in this field doesn't understand the judgment.
JustLikeStitch · 08/12/2020 09:20

Sorry haven’t read the entire thread, but there’s a point sticking for me. I actually thought it was illegal to experiment on people? Especially children? If the drugs they’re giving to children are experimental with no long term research and safe guarding measures attributed to them, why the hell were they ever approved for use on humans? We go through massively strict testing regimes to make sure all the drugs available to us are safe for us to use, did someone have a complete brain fart the day they decided it was perfectly safe and legal to medicate children with experimental drugs?

nickymanchester · 08/12/2020 09:37

@ChattyLion

I wonder what the ten arguments that their appeal were, do the arguments get published if the appeal was refused?

You can sort of work it out from the replies that were made. I would guess that it was probably something like this (and these really are just guesses):-

  1. The court made a material error of fact talking about the use of PBs and consent in relation to precocious puberty which undermines its decision with regard to GD.
  1. The court improperly sought to resolve disputes between experts in an area that is rapidly evolving and where there are genuine and valid differences of opinion between different experts.
  1. The court improperly conflated the two different consent processes for PBs and CSH whereas it should just have considered the effects of PBs and what level of consent was required for PBs only.
  1. This judgment is a withdrawal from Gillick (Gillick v West Norfolk and Wisbech AHA (1985) UKHL 7) and it improperly restricts the areas where children are able to consent to treatment.
  1. This judgment is incompatible with Section 8, Family Law Reform Act 1969 in that it places restrictions on people over 16 being able to consent to medical treatment.
  1. They may be talking about either the European Convention on Human Rights or the UN Convention on the Rights of the Child. So, it would one of the following:-
  2. This judgment is not compatible with the UNCRC. Article 14 (right to freedom of thought) when read together with Article 8 (right to preserve their identity) means that the court should not restrict a child's right to take PBs if they believe they are in the wrong body.
  3. This judgment is not compatible with the ECHR. Article 14 (no discrimination) when read together with Article 8 (respect for privacy and family life) means that the court should not interfere in a discriminatory way in a private matter of an individual.
  1. The Court has placed flawed reliance on another case involving a 16 year old girl, Re W (Re W (a Minor) (Medical Treatment: Court’s Jurisdiction) (1993) Fam 64) that is not relevant to the current case for the following reasons (insert whatever reasons here).
  1. The Claimants have wrongly contended that a child needs to have an "adult" understanding in order to be competent whereas we contend that it should be an appropriate level of child's knowledge. The court erred in that it did not resolve this issue and should only consider a child's understanding.
  1. There was a procedural error in that the Court did not explicitly rule on evidence supplied by the Claimants. There were other procedural errors in that Stonewall and Mermaids were barred from giving evidence as was any child actually affected by this, eg "S"
  1. The Court failed to rule on the effectiveness or role of parental consent in this context which, as parents can give conse4nt for treatment on their otherwise non-competent children means that this issue has not been properly considered.

Just to emphasise that the above are just my guesses based on the responses given by the court

ChattyLion · 08/12/2020 09:44

What is worse than using drugs experimentally on children? Using those drugs and not even gathering or collating the data to make a study. It's not even an experiment, is it?

That’s awful not to research medical practice on children and in combination with institutional capture can get really dangerous.
Concerns have long been raised around consent by parents and whistleblowing clinicians, that children and young people are being left without adequate professional emotional support, while they are at risk of being groomed by an affirmative online culture and lobby organisations.

The Trusts should have raised the alarm themselves, long ago, that the growing authoritarian culture was pushing their clinicians towards either treating in fear of criticism by outside organisations or towards treating kids politically-based on political views not evidence.
The trusts should have ensured they were gathering evidence properly, to satisfy themselves that the clinicians were not deviating from norms of their role. They left themselves vulnerable to accusations of poor practice and let down patients by not insisting on basic follow up.

The culture surrounding this is dangerous because partly as a result of lack of public funding for CAMHS, the specialty team potentially underserves psychological need at the same time as it is in favour of offering permanently-affecting physical interventions to help, allegedly also deviating from proper safeguarding practice (see Sonia Appleby case), while it offers experimental care with a cosmetic aim.

Good medical practice treats each individual individually according to their needs, and takes account of the culture around the patient let alone around the staff, and takes proper account of the patients’ age or drug-induced immaturity while operating a service for children who are asked to make decisions that would affect them permanently with no concrete evidence to weigh up.

SirVixofVixHall · 08/12/2020 09:49

@Siameasy

Goodness me fancy using an ideology as a basis for experimental procedures on children! And then getting upset when a court says no.
Indeed.
FannyCann · 08/12/2020 10:15

Excellent Twitter thread

twitter.com/barbararich_law/status/1335956880414347265?s=21

Tavistock Appeal Denied
ChattyLion · 08/12/2020 10:16

Thanks Nicky I xposted with you.

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