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

[FindTheTruth]

The appeal hearing will be live streamed this Wednesday 23 & Thursday 24 June, 10:30am

Background

1. The High Court decided in Mrs A and Keira Bell’s favour on 1st December 2020 that puberty blockers and cross-sex hormones are experimental treatments which cannot be given to children in most cases without application to the court. Full details of the original case:

www.transgendertrend.com/keira-bell-high-court-historic-judgment-protect-vulnerable-children/

1. The High Court decided in the case of AB on 26 March 2021 thatPARENTScan consent to their children receiving puberty blocking treatment when their children lack the capacity to consent.

1. Court of Appeal 23 & 24 June 2021 Keira Bell and Mrs A’s legal team is dealing with legal submissions from 7 intervenors who want to see the judgement of the Divisional Court overturned. “A significant task in defending the judgement of the Divisional Court. We are facing very well resourced opponents – the Tavistock being funded by the State and the other intervenors”.

"The alternative, is that you are directing these kids to go through a puberty they do not want, and then face painful surgeries in later life to reverse that puberty.

Regret levels are extremely low, and no-one is advocating hormone therapy or surgeries until these kids are 18.

The parents are allowed to make the decisions for their children, as we all do. That is appropriate and I don't question others who would know their children best."

I have been on the other side of this fence. You are looking at a population of which up to 40 percent in some studies are autistic. Autistic people have difficulty socially, specialist, interest led brains, and difficulty in thinking flexibly. It's part of what makes autistic people amazing. It also makes them very vulnerable in this situation.

Socially you don't fit in and you are motivated to search out why. You find puberty anathema as it is in itself a huge changed- base upheaval. You research. You become intellectually fixed on a solution that appears to make sense.

At the moment as a parent of an autistic teen in this situation just about the only thing you have going for you is treatment times and the gradual maturation and acceptance of the changed body of puberty that maturation brings. It is a huge relief to be able to accept your child but say that sadly, there isn't anything we can do about this medically until you are an adult. Change your name, your pronouns, your hair, your dress - all this is reversible and benign. Enabling teens to pressure parents into providing consent puts parents in an impossible position in those situations where the parent does have valid concerns. It could and likely will cause breakdowns in relationships within families, where the parent has reservations that may well be based on a better recollection of early childhood presentation, identification with own gender up to puberty etc

My autistic teen now says that he was suffering with mental ill health, depressed and dysphoric during the three years that he adopted a female identity. Thank goodness I was never put in a position of being asked to gatekeep his access to medications that at the time, he fervently believed were a solution to his issues.

It needs to be recognised that teens who first express discomfort with their gender as they approach puberty or in early puberty are on the whole a different group from the early onset persistent and consistent tiny group of youngsters and may well need a different treatment approach. You can't just treat symptoms as if everyone is the same. It's like giving everyone presenting with breathing issues an asthma inhaler, regardless of whether the cause is a chest infection, asthma, pneumonia, covid, or lung cancer.

The line the BBC are taking, so far, is that the case is about "whether it's safe to delay puberty".

Here's the link for later on today:

In case they do a last minute change, it's this channel:

www.youtube.com/channel/UCFFIKTKW32WJ-xzfesJ4t8w/live

Article on the case

www.bbc.com/news/health-51034461

Is anyone live tweeting?

Diverse I thought it had been shown that social transitioning was not benign as it embeded belief - and not so long ago Tavistock was advising against this until seen by them?

Also I think we need to be careful with those with 'early onset' these days. What might have been true in the past is not necessarily the case in an environment where children in nursery are effectively being told they can chose their sex in the same way you can chose your clothes, that liking particular things means they are actually the opposite sex or that being trans makes you extra special.

@highame

Is anyone live tweeting?

I reckon there will be loads of people live tweeting as it's being live streamed publicly.

Great, thought it might be but wanted to make sure thanks 33feet

I thought it had been shown that social transitioning was not benign as it embeded belief - and not so long ago Tavistock was advising against this until seen by them?

Also the Dutch researchers who pioneered puberty blockers. They certainly didn't suggest "first socially transition, no worries, then come back for treatment later".

@NecessaryScene

Correction to my above - I don't think the Tavistock has said that they would administer blockers on a patient without their consent. I think the Good Law Project was going to try to get them to do so, as a result of the March judgment, which confirms it would be permissible.

I'm a bit confused. Bell said no to puberty blockers, for those under 16 because they could not understand the implications. Subsequently this was undermined by the AB case, which said under 16's could have puberty blockers if the parents consented. Are you saying it was for only that AB case or all cases. And later you said the Tavistock/Gids will not give puberty blockers because they would never do so without the child's consent, but because of Bell, no child can consent. Sorry if this sounds confusing. (Who is Foxy?)

@Diverze

"The alternative, is that you are directing these kids to go through a puberty they do not want, and then face painful surgeries in later life to reverse that puberty.

Regret levels are extremely low, and no-one is advocating hormone therapy or surgeries until these kids are 18.

The parents are allowed to make the decisions for their children, as we all do. That is appropriate and I don't question others who would know their children best."

I have been on the other side of this fence. You are looking at a population of which up to 40 percent in some studies are autistic. Autistic people have difficulty socially, specialist, interest led brains, and difficulty in thinking flexibly. It's part of what makes autistic people amazing. It also makes them very vulnerable in this situation.

Socially you don't fit in and you are motivated to search out why. You find puberty anathema as it is in itself a huge changed- base upheaval. You research. You become intellectually fixed on a solution that appears to make sense.

At the moment as a parent of an autistic teen in this situation just about the only thing you have going for you is treatment times and the gradual maturation and acceptance of the changed body of puberty that maturation brings. It is a huge relief to be able to accept your child but say that sadly, there isn't anything we can do about this medically until you are an adult. Change your name, your pronouns, your hair, your dress - all this is reversible and benign. Enabling teens to pressure parents into providing consent puts parents in an impossible position in those situations where the parent does have valid concerns. It could and likely will cause breakdowns in relationships within families, where the parent has reservations that may well be based on a better recollection of early childhood presentation, identification with own gender up to puberty etc

My autistic teen now says that he was suffering with mental ill health, depressed and dysphoric during the three years that he adopted a female identity. Thank goodness I was never put in a position of being asked to gatekeep his access to medications that at the time, he fervently believed were a solution to his issues.

It needs to be recognised that teens who first express discomfort with their gender as they approach puberty or in early puberty are on the whole a different group from the early onset persistent and consistent tiny group of youngsters and may well need a different treatment approach. You can't just treat symptoms as if everyone is the same. It's like giving everyone presenting with breathing issues an asthma inhaler, regardless of whether the cause is a chest infection, asthma, pneumonia, covid, or lung cancer.

Just wanted to respond to this as I was an autistic child who liked to be perceived as a boy from pre-school age but totally grew out of it. So even some people in the early onset group don't persist after puberty. I think discovering my sexual orientation and more masculine presenting women went a long way to resolving everything for me.

I never seek to speak for others’ experiences

Remind me what you do for a living Robin?

Jo Maugham Cailin runs the Good Law Project. After the Bell case they took a case through the Family Court, trying, in effect to side step the Bell case by arguing that parents could consent. Unfortunately the Judge did not give that ruling. He only allowed in that particular case and for specific reasons. In the Bell case ruling, it is for the courts to decide whether someone should receive experimental drugs for Gender Dysphoria.

The Good Law project along with others have been allowed to join the appeal. They cannot submit new evidence but I believe the importance of the case has meant that the Judges need to ensure everyone is heard. Hopefully things will still go in KB's favour. Parents should not be allowed to consent to their children being given experimental drugs (into healthy bodies) without the court hearing the case imho

without the court first hearing the case.

I'm a bit confused.

You're not the only one.

Bell said no to puberty blockers, for those under 16 because they could not understand the implications.

They said that the child could probably not consent. They didn't totally rule it out, but said that courts would have to be involved.

Subsequently this was undermined by the AB case, which said under 16's could have puberty blockers if the parents consented.

In general principle, children can be treated either because they consent, or because parents consent on their behalf.

Bell part 1 only considered the child's consent, because parental consent was never used by GIDS, and they said they'd never rely on it, so the issue did not arise.

Are you saying it was for only that AB case or all cases.

The court specifically approved the treatment for the AB case. And they said that they would not override the general rule that "parents can consent" with a total prohibition on parental consent for PBs.

"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."

There were a whole bunch of provisions though - they wanted the Cass review to deal with this, and they expected service providers with concerns about parents' judgment to bring cases before the court.

And they recognised that there were potential arguments that were not presented (due to the absence of Bell and others in that case).

So it's likely that this will be looked at again in today's appeal.

And later you said the Tavistock/Gids will not give puberty blockers because they would never do so without the child's consent, but because of Bell, no child can consent.

That's what they said in Bell pt 1. In the AB case they said they now wanted to continue treatment for XY on parental consent alone, as they'd already started it.

It's not clear what their current position is for new treatment. I believe they want to not be relying solely on parental consent, so are now appealing to say that children can consent.

Sorry if this sounds confusing. (Who is Foxy?)

Jolyon Maugham, head of the "Good Law Project", renowned for clubbing a fox to death on Boxing Day 2019 in his wife's kimono and posting about it on Twitter.

Don’t know if this is right place. But it is about detransisting

www.tandfonline.com/doi/full/10.1080/00918369.2021.1919479

Checking in on this thread. I'm another one wondering what new evidence/ on what grounds the appeal is being heard. I'm on the go today so reading from my phone whereas normally I'd prefer to be at a computer reading ask the relevant docs.

@CardinalLolzy

Checking in on this thread. I'm another one wondering what new evidence/ on what grounds the appeal is being heard. I'm on the go today so reading from my phone whereas normally I'd prefer to be at a computer reading ask the relevant docs.

They're not actually allowed to produce new evidence, I don't think. They have to argue that the 3 judges in the original case got it wrong somewhere, using the (absolutely shit) evidence they used the first time.

IIRC, the reason the appeal was also allowed was for ''some other compelling reason'', rather than the other reason which was it ''has a reasonable chance of success'' (something like that).

I was gobsmacked that they decided to appeal a safeguarding decision, but then I've been reading the Sonia Appleby thread and I'm not so surprised

I am hoping it is being heard as a means to draw a line under it all. This way there can't be any foot stamping about how they weren't listened too. (We will just gloss over the lack of evidence presented last time.)

Just had a thought, Liz Truss said 'no' to puberty blockers under 16, so how does that feed into the Bell case. I assume extreme circumstances could be used, but then one would expect the court to have the last word on that one. One always has to take account of 'healthy bodies' and the Good Law Project and others, still argue that parents do give consent to experimental drugs - but this is pretty disingenuous

I'm copying the court's description of the case from their page with the live link, as it will presumably disappear tomorrow and this is a good summing up of the case:

Wednesday 23rd – Thursday 24th June 2021

Bell & anr (claimant/resp) –v- The Tavistock and Portman NHS Trust (def/appellant)

This is an application for permission to appeal the Order of the President of Queen’s Bench Division, Lewis LJ and Lieven J (1/12/20).

The claim for judicial review was of the practice of the Tavistock and Portman NHS Foundation Trust, through its Gender Identity Development Service of prescribing puberty-suppressing drugs to persons under the age of 18 who experience gender dysphoria.

The Court declared that the relevant information that a child under the age of 16 would have to understand, retain and weigh up in order to have competence to consent to the administration of puberty blocking (PB) drugs is set out at para. 138 of the judgment:

(i) the immediate consequences of the treatment in physical and psychological terms;

(ii) the fact that the vast majority of patients taking PBs go on to CSH (cross-sex hormones) and therefore that they are on a pathway to much greater medical interventions;

(iii) the relationship between taking CSH and subsequent surgery, with the implications of such surgery;

(iv) the fact that CSH may well lead to a loss of fertility; (v) the impact of CSH on sexual function;

(vi) the impact that taking this step on this treatment pathway may have on future and life-long relationships;

(vii) the unknown physical consequences of taking PBs; and

(viii) the fact that the evidence base for this treatment is as yet highly uncertain.

Lower Court Judgment:

www.bailii.org/ew/cases/EWHC/Admin/2020/3274.html

Thanks Necessary Scene/Highame and others, I had misunderstood the AB case clearly. The reporting at the time was not so clear and the trans activists and articles made me think Bell was overturned as regards consent.

As this is an appeal, where no new evidence can be brought, I wonder why organisations not part of the original case are part of this appeal.

Thanks, 33feet.

I'm interested to see how the 2 different cases will intersect.

In the Bell judgement, they only looked at whether children could consent to blockers, because GIDS said that this was such a special treatment that they would only ever prescribe if the children could consent.

When they lost, the AB case allowed parental consent for blockers - but I think largely for children who already had them prescribed and needed a repeat prescription. I don't think GIDS is currently using this to give new prescriptions.

I'm quite worried that the appeal outcome will be that blockers can be prescribed with parental consent and child assent, because that is in line with standard practice.

That ignores the incredibly weak evidence base for blockers. It is arguable that they are so experimental that they should not be given outside of an experimental trial. It is also arguable that based on the existing evidence base they should not be given at all for gender dysphoria.

But those aren't decisions that a court usually makes - those are the normal ethical standards of science and medicine. It's clear that there is a huge ideological divide between people who think that blockers are basically quackery and those who think they are lifesaving. And if the lifesaving camp are the ones at GIDS talking to parents about blockers, a lot of parents will believe that this is the best option for their child.

This is actually really reminding me of the vaginal mesh scandal - women being prescribed harmful treatments on dodgy evidence, leaving them with chronic pain and disability. Only this time, the patients harmed are even younger and more vulnerable. And the evidence base isn't just weak, the whole ideology it's based on is totally whack.

The bbc today said in the link I posted earlier

"In a separate ruling in March 2021, the Family Division of the High Court ruled parents can consent to the treatment on behalf of their child, although additional safeguards should be considered."

Would I be correct in stating that's incorrect, that in the AB case the consent was only for that child. So it doesn't change the Bell judgement.

It's started! Watch live here: