Good Law project have succeeded...

[Wandawomble]

goodlawproject.org/news/tavistock-success/

[Manderleyagain]

@NecessaryScene1

This is moot now though, because the KB case establishes that under-16 patients can't consent to PBs and that presumably also means that if PB are determined to be in their best interests they can't withold consent either. So the legal battle is now to determine who, if anyone, is entitled to make that decision on their behalf.

That was something that I did, and still do, find notable about GIDS' stance.

If they truly believed these puberty blockers are a vital treatment, then they would not be bothered by a lack of consent from the child due to Gillick-incompetence. Isn't that what you'd do for any important medical treatment?

Presumably they're viewing it as not actually being a medically-necessary treatment, but an elective one. And as such the child has to elect.

This is an extremely good point, and I hadn't quite thought of it in that way. There may be other treatments where this is the case, but I am struggling to think of them.

[Akela64]

No adult needs to be "reminded" of the sex of themselves or their children.

[Manderleyagain]

The fact that JM isn't giving an interview to a main broadsheet about this suggests he doesn't think the spin that glp has put on it is really backed up by the substance & context of the judgement.

[NecessaryScene1]

There may be other treatments where this is the case, but I am struggling to think of them.

I can't think of any. This seems to me like Gillick competence being applied to an elective procedure, but GIDS can't bring themselves to say that that's how they see it.

[ListeningQuietly]

The homophobia of denying that some boys are effeminate and some girls are butch is awful

I thought we grew out of that in the 70's

Every child should be free to dress and act as they wish without being forced to conform to parental prejudice

let alone be forced into a medical pathway when they are too young to sign a contract

[Shizuku]

I said all along it would be reversed. This is a partial but hugely important reversal. The rest will follow in time.

Absolutely celebrating this

[nauticant]

That means you haven't understood it. Which is hardly surprising.

[NecessaryScene1]

This is a partial but hugely important reversal.

Actually, I am trying to figure it out. What exactly has been reversed?

GIDS said in Bell that parents can legally consent. This court decision agrees that parents can legally consent.

What's changed?

[R0wantrees]

It is interesting to observe which adults are celebrating such a finding and as such demonstrate some investment in children having their pubertal development disrupted by experimental medical treatments.

[nauticant]

Have a look at the replies under this Maugham tweet:

twitter.com/JolyonMaugham/status/1375406406195683328

It's a gruesome spectacle.

[NecessaryScene1]

What's changed?

I mean, I think this is an important ruling, that future rulings will have to take into account. Bell didn't touch it, and it doesn't contradict Bell.

But I can't spot any immediate consequence, apart from GLP using it as the basis to demand that the Tavistock act on parental consent.

But saying "the doctors have to agree if the parents consent" is not "proceeding if the doctors and parents agree" is it? If the doctors do not want to proceed without child consent - Gillick competence for an elective procedure - then what?

I guess you find non-NHS providers less ethical than GIDS? This opens the door to GenderGP private provision?

[NecessaryScene1]

This opens the door to GenderGP private provision?

Although it was never clear that Bell closed that door, due to the "Tavistock wouldn't do it" limitation.

I'm going to have to re-read this one - in all the stuff about the Cass review - that's an NHS review, right? Are we still assuming NHS here? How much can this or Bell limit GenderGP?

[spacedusting]

@Wandawomble

Being taken into care and then drugged and operated on.

puberty blockers are entirely reversible. nobody under 18 is being operated on. what even are you going on about?

[MondayYogurt]

puberty blockers are entirely reversible


Cool just post your evidence for that with links here>>>>

Because I'm still confused how sterilising a child can be reversed. Thanks!

[NotDavidTennant]

The more I think about the more I think it's inevitable that the Tavistock will pivot to a parental consent model if they lose their appeal of the Bell case. They clearly still support puberty blockers as a treatment and there are parents who are not only willing to conset but are actively pushing for blockers. What would stop them changing the policy?

[gardenbird48]

Really good news for trans children and their families. The arrogant assumptions about 'forcing' could only be made by folk with negligible knowledge of families of trans children.

Families that GIDS have seen have said it in their own words - they would rather a trans child than a gay one. There is one extremely high profile person from a well-known charity who did a TED talk on her child and described her husband's relief that the child wasn't a gay male, but a trans straight girl.

There are many other examples on social media and online of parents clearly guiding their children down a particular track, for whatever reason. There are very clear examples of certain high profile organisations repeatedly telling worried parents that their child is likely to commit suicide if they don't allow them to transition. Parents can suffer coercion from many sources.

I suggest your statement demonstrates that you have little knowledge of the full range of dynamics that occur here.

For the people who weren't listening at the back (me - I was hoovering) - is this a bit of a non-judgement?

The judge is saying that theoretically parents could consent to puberty blockers but because the Keira judge has already said that children can't (or are extremely unlikely to be able to) give informed consent, then the puberty blockers still wouldn't happen because GIDS can't medicate a child without informed consent from the child (even if they are saying that they would like that treatment but because of their age, they are not able to give fully informed consent)?

[nauticant]

Does anyone really think that after being on puberty blockers for the whole of their puberty, a child can stop taking them and return completely to the developmental pathway they would have been on had they not taken them, and arrive at the same outcome?

"Reversible" is another of those terms that people have allowed to acquire a meaning that is in opposition to its true meaning. It's another mantra term that's used to close down debate without needing to wonder what the term actually means.

[LisaStansfield]

@MondayYogurt

puberty blockers are entirely reversible

Cool just post your evidence for that with links here>>>>

Because I'm still confused how sterilising a child can be reversed. Thanks!

it's cross sex hormones that can cause sterility, not puberty blockers.

[NecessaryScene1]

What would stop them changing the policy?

Legally, nothing. They could do that whenever, and they could have already.

I suspect what's stopping them is ethics.

They're having enough trouble retaining staff and dealing with whistleblowers and lawsuits as it is.

How many ex-staff or current staff are suing them, testifying against them in court, or appearing on Channel 4 denouncing them already? With them being possibly one of the more cautious gender clinics in the world?

They're not a private operation cowboy outfit like you see in the US, or GenderGP. They are the National Health Service, getting taxpayer money, and using NHS-trained professionals. It's really not in their culture to just go for "informed parent consent" and wash their hands of the consequences.

We may think GIDS actions have been "surprising" as the judge put it, but as many like Helen Joyce have pointed out, they're one of the best. Because they are the NHS. They're caught at the intersection point between real healthcare and ideological lunacy, and do not appear to have been fully captured by the ideologues.

[NecessaryScene1]

"Reversible" is another of those terms that people have allowed to acquire a meaning that is in opposition to its true meaning

How were they ever "reversible", even for precocious puberty use? Sure, when you stop taking them, they stop blocking your puberty. It's not a permanent block. But you don't get to reverse time.

I think "reversible" is a technical term here:

A reversible inhibitor is one that, once removed, allows the enzyme it was inhibiting to begin working again. It has no permanent effects on the enzyme

It is technically reversible in that sense, yes - the bits of the body it stopped working will start working again.

It's just may be too late for them to do their job.

So "reversible" is extremely misleading, or even a lie, if describing the entire course of treatment.

[SunsetBeetch]

@R0wantrees

The arrogant assumptions about 'forcing' not being a serious concern which should be considered could only be made by folk with negligible knowledge of family dynamics and Child Protection.

Indeed.

"Homophobia in families attending GIDS is mentioned in all the transcripts Newsnight has seen.

As well as seeing young people struggling with their sexuality, staff say some parents appeared to prefer their children to be transgender and straight, rather than gay.

In one example, a GIDS clinician describes a young person who had come out as a lesbian and faced homophobic bullying, "within the family and quite openly in school".

"Suddenly the young person changed their mind and they started identifying as trans."

In some of these cases, clinicians thought that it wouldn't be appropriate for the patient to be referred for puberty blockers, with one child apparently saying: "My mum wants the hormone more than I do." "

www.google.com/amp/s/www.bbc.co.uk/news/amp/health-51806962

[Datun]

@NecessaryScene1

"Reversible" is another of those terms that people have allowed to acquire a meaning that is in opposition to its true meaning

How were they ever "reversible", even for precocious puberty use? Sure, when you stop taking them, they stop blocking your puberty. It's not a permanent block. But you don't get to reverse time.

I think "reversible" is a technical term here:

A reversible inhibitor is one that, once removed, allows the enzyme it was inhibiting to begin working again. It has no permanent effects on the enzyme

It is technically reversible in that sense, yes - the bits of the body it stopped working will start working again.

It's just may be too late for them to do their job.

So "reversible" is extremely misleading, or even a lie, if describing the entire course of treatment.

Plus several side-effects like not laying down adequate bone density, and a potential drop in IQ don't appear to be at all reversible.

Not to mention that statistically, there is no significant reversal in the treatment. I don't believe they had any studies on actually reversing it, because hardly anyone does.

[WarriorN]

This is a legal place holder, no 'win' for either side.

As far as I can tell the judge couldn't legally stop parents consenting given other rare treatments or allowing a child to die via stopping treatment.

There's a lot on all professionals agreeing including an endocrinologist.

The Cass review will make the final decision on how appropriate or dangerous PBs are, which will affect this judgment.

twitter.com/threadreaderapp/status/1375460477069824004?s=21

[WarriorN]

It's not brilliant but it's not the final answer:

121. In my view, the factors identified in Bell, which I fully agree with, do not justify removing the parental right to consent. The gravity of the decision to consent to PBs is very great, but it is no more enormous than consenting to a child being allowed to die. Equally, the essentially experimental nature of PBs should give any parent pause for thought, but parents can and do routinely consent on their child’s behalf to experimental treatment, sometimes with considerable, including life-changing, potential side-effects. It is apparent from Bell that PBs raise unique ethical issues. However, adopting Lady Black in NHS v Y, I am wary of the Court becoming too involved in highly complex moral and ethical issues on a generalised, rather than case specific, basis.

[WarriorN]

So it's purely a legal working out.

Tbe cass review will trump all of the above