The judgment in Keira Bell's case will be given tomorrow

[MaudTheInvincible]

The judgment of the Tavistock's appeal of the case will be given at 2pm.

www.gov.uk/government/publications/royal-courts-of-justice-cause-list/royal-courts-of-justice-daily-cause-list

Brave Keira. You have done so much to protect children from ideologically driven healthcare around the world. Your integrity and courage is inspiring and rare in this ridiculous day and age. 💚🤍💜

@Artichokeleaves

Yeah the whole 'accept this devastating issue for women and girls because if you fight it things will get worse for you' -

no.

Really not swallowing that either.

Neither am I

@MrsKeats

For clarity my was stepdaughter says she's a gay man now. We are expected to go along with this. I don't see how gay men would be attracted to what is essentially a female body pumped full of testosterone. And why should they?

Oh god thats sad. I guess all you can do is be there for them. I do worry about these young people who get so wrapped up in the Tumblr / Fanfic fantasies that can't become reality

Let's not kid ourselves.
This is entirely because young people are being forcefully told their bodies must look a certain way.
It's nothing new.

If they really believed you could be a man who looked like Pamela Anderson or a woman who looks like, I dunno, Bob Geldof, we wouldn't be seeing this desperation to conform.
It's all about appearances. It wouldn't be so bad if they would admit it, but the line seems to be that it's about something in their character that has XX /XY chromosomes.

Nor would I consider a lawyer who defends murderers or sex offenders is pro murder and sex offence.

I’m really saddened by the news today.

I’ve been on Triptorelin, which is the puberty blocker used in the UK. I’ve posted before about the devastating side effects, physical and mental. I can’t honestly believe that people are celebrating these dreadful drugs (as articulated very well by charlieparley above) being given to children. Children who are by definition struggling with complex needs.

Children among whose number are those who would naturally desist at puberty who it seems likely are being actively denied the cure for their struggles.

Children who will never grow up to have full sexual function and fertility.

Children who are being swept into a lifetime of irreversible medicalisation before they’ve even finished their education, had a boy or girlfriend, moved out of home, held down a job.

I can’t see what there is to crow about here what sort of person would be celebrating that?

The lawsuits will be next. This has paved the way for that, in the clearest possible terms.

There is a big difference between puberty blockers / cross sex hormones and contraception / abortions.

One prevents the physical and emotional harms of pregnancy / childbirth / parenting on children / teenagers. Yes there are side-effects but the benefits of these drugs / procedures are known to outweigh the risks.

With puberty blockers / cross sex hormones the the risks are well known and documented, but there seems little robust evidence of difference.

That is why these things are not the same. Saying children shouldn't be given puberty blockers and cross sex hormones is in no way comparable to saying they shouldn't be able to access contraceptives or abortions.

I'm interested to see how the endocrinologists respond, as GIDS have been passing the buck and saying that they (GIDS) don't make the final decision about hormones, endocrinologists do. If I were an endocrinologist I'd be very uncomfortable with this idea. I think endocrinology will have been working on the principle that GIDS assessed the need and appropriateness of hormones, and endocrinology are prescribing and monitoring doses. I wonder how keen they'll be to continue now GIDS are saying that endocrinology make the final decision?

The judgment does say that it is the endocrinologists who obtain consent for the treatment and the Tavistock only claim that they assess a child as 'capable of giving consent'.

If, following assessment, Tavistock is satisfied that it is medically appropriate to do so, the patient is referred to the paediatric endocrinologists at either University College London Hospitals NHS Foundation Trust (“UCH”) or Leeds Teaching Hospitals NHS Trust (“Leeds”) (together the “Trusts”). A referral takes place only if Tavistock assesses that the child would benefit from treatment and is capable of giving consent to puberty blockers (the first step in any such treatment). Referral requires the consent of the child and of the parents. Each Trust thereafter, independently of Tavistock, makes its own clinical assessment and prescribes puberty blockers only after deciding that to be the proper medical course and after obtaining what each considers to be valid consent from the child.

The endocrinologists are putting themselves in danger of future legal action if they take the word of the Tavistock that the child is 'capable of giving consent'. The best course of action for them would be to go through the courts as was required by the original judgment.

@SusannaM

The thing that bothers me is, the idea that blocking puberty gives the child time to think through their options. But puberty isn't just about growing breasts, wet dreams, deepening voices etc. It's also about developing mental, emotional maturity and the development and maturation of the prefrontal cortex. If we block or delay puberty then that won't happen, so of course these children go straight to CSH they haven't developed enough to have the maturity to move on from their dysphoria.

Yep. Puberty isn't just about tits and deep voices. It is an absolutely vital stage of brain development. But I guess the sort of people who are in favour of this don't give a shit about trivial things like brain development, as long as the ideology continues.

@PiglingBlonde

*Very interesting last sentence in the summary:
"Clinicians would be alive to the possibility of regulatory or
civil action which allows the issue of whether consent has been properly obtained to be tested in individual cases."

The next route will be claims against the Tavistock for damages on the basis that they didn't obtain proper consent.*

Just come out of work to see the judgement so I've got some catching up to do, but that sentence does sound like a warning.

For the record, scarpa I am not lamenting this as a loss. Having discussed the particular nature of judicial reviews and judges' attitudes towards them with a lawyer friend, I expected this outcome and I cannot disagree with the Court of Appeal right now. (I want to, but that's a different matter.)

And because I am neither Keira nor Mrs A nor someone personally involved in supporting either, I can look at what they achieved without being weighed down by this judgment:

Uncovered the shoddy practice of the clinic around consent, now in the public record
Uncovered the shoddy practice of the clinic on patient-follow-up, now in the public record

Confirmed the lack of evidence for either efficacy or safety of PBs and cross-sex hormones, now in the public record
Confirmed the fact that PBs are not a pause to think but the first step of a medical transition for most children prescribed PBs, also now in the public record

Raised huge awareness of the existence of detransitioners and how they're being failed. Raised public awareness on the shortcomings of the Affirmative Approach.

Yes this judge overturned the High Court judgement, but this genie isn't going back in the bottle. This is all well and truly out in the open now. And this judge didn't overturn the High Court judgement because they were wrong about PBs. That's significant, too. They overturned it on a technicality (an important one, I agree, scarpa). And I do know that even a Court of Appeal judgement can be overturned, because there may be other issues that may make a difference.

We are only just beginning to understand everything that happens at puberty. We have no idea what this treatment means for these children 20, 30 years down the line.

Yay, experimenting on children. It’s the right side of history.

@Sophoclesthefox

I’m really saddened by the news today.

I’ve been on Triptorelin, which is the puberty blocker used in the UK. I’ve posted before about the devastating side effects, physical and mental. I can’t honestly believe that people are celebrating these dreadful drugs (as articulated very well by charlieparley above) being given to children. Children who are by definition struggling with complex needs.

Children among whose number are those who would naturally desist at puberty who it seems likely are being actively denied the cure for their struggles.

Children who will never grow up to have full sexual function and fertility.

Children who are being swept into a lifetime of irreversible medicalisation before they’ve even finished their education, had a boy or girlfriend, moved out of home, held down a job.

I can’t see what there is to crow about here what sort of person would be celebrating that?

The lawsuits will be next. This has paved the way for that, in the clearest possible terms.

I'm very sorry to hear about your horrible experience @Sophoclesthefox. . I hope you are in a better place now.

I am, thank you abhanmor.

I was given the drug for endometriosis, as a fully grown adult woman. I simply cannot fathom how anyone could give it to a child who is already struggling with complex needs, and bludgeon their vulnerable, developing body with such a blunt instrument.

@scarpa

And there it is.

Keira Bell's lawyer, who has worked on a number of anti-abortion cases (including those where it was argued under-16s should have to tell their parents if they got an abortion, which could amount to blocking access to abortion in some cases, and the campaign against late term abortion for certain medical conditions - i.e., women, you'll give birth if we tell you to and fuck your personal choice), is now saying they'll take this ruling to the Supreme Court and that Gillick competence is no longer fit for purpose.

That's why I'm glad about today's ruling. Blow a hole in Gillick for this, and other things - like abortion - follow, and what a fucking terrifying rollback of women and girls' rights that would be.

yes - and a lot of people have been saying this all along.

That's why I'm glad about today's ruling. Blow a hole in Gillick for this, and other things - like abortion - follow, and what a fucking terrifying rollback of women and girls' rights that would be.

Gillick competence is the principle that minors can consent to medical treatment if they can understand the consequences.

To access an abortion, a 14 year old girl would have to understand that the abortion will revert her back to a non-pregnant state, what the procedure will involve, that she will need time to recover, that there may be some post abortion complications and there is a very small risk of problems in the future. But the abortion is necessary to stop her growing a foetus that she will have to give birth to.

In order to access puberty blockers, a 14 year old would have to understand the statistics of how many children who go onto blockers then go onto cross sex hormones (I believe its close to 100%). They will have to understand the reasons as to why this statistic is as it is. They will have to understand that this will make them irreversibly infertile and that if they want children in the distant future, this will not be possible. They will have to understand that their brain development will be affected by not going through/delaying puberty. That there is a high risk that they will have bone density issues, meaning more drugs to try and stop this. That once their voice breaks that this is irreversible. That a double mastectomy is painful surgery and again, irreversible. They will have to know what vagina atrophy is and that it is very painful. They will have to understand that they may well be sexually dysfunctional and that there is a risk they will never have a healthy sex life, for many different reasons. They will have to understand the risks around taking testosterone when they have a female body, that it can be dangerous. They will have to understand that they will become a lifelong medical patient, and that they will need to take cross sex hormones for the rest of their life in order to keep their body suspended in a state of artificial 'maleness'.

I mean, come on, how can any 14 year old possibly even begin to understand that? It is not even comparable to abortion.

There is no serious, credible, broadly supported push to roll back abortion rights in the UK.

It won’t happen. There would be massive opposition, and such a push would be defeated.

It really is desperate that you have to hide the experimental drug treatment being given to children for unclear benefit behind the “if we don’t do this, contraception and abortion will be next!”

It’s a nonsense, and in fact, the judgement which you’re so happy was just overturned specifically ruled out the possibility of it being used as a wedge to go after Gillick competence in other domains, so again- no idea why this is cause for celebration.

@SusannaM

The thing that bothers me is, the idea that blocking puberty gives the child time to think through their options. But puberty isn't just about growing breasts, wet dreams, deepening voices etc. It's also about developing mental, emotional maturity and the development and maturation of the prefrontal cortex. If we block or delay puberty then that won't happen, so of course these children go straight to CSH they haven't developed enough to have the maturity to move on from their dysphoria.

Yes, and they'll be stuck while their real world friends and schoolmates will be growing up, maturing, leaving them more and more isolated apart from their online 'glitter family' who will then have an even more powerful, unmediated role in their life.

Yes, it really upsets me to think of children whose brains have not been able to mature properly because their growth and development was deliberately stunted, surrounded by peers who have matured and grown up.

Scarpa:

Given that puberty blockers are already used in children experiencing early onset puberty to delay it, I would assume they're safe in the appropriate dose, and I make no claim whatsoever to know more than endocrinologists on this. I don't know why you are, to be honest.

And if the dose is (as one would hope) appropriate for blocking puberty (as these drugs are already used for, so we would assume so), then yes, I am happy for a child who has demonstrated the required level of competence to take them, yeah.

Dosage is always important but the use and intention of puberty blockers for gender dysphoria is entirely different. For precocious puberty PBs put puberty on hold until the appropriate and usual time. For gender dysphoria they're predominantly used to completely suppress natural puberty until cross-sex hormones can be given at age 16. Given the complexity of changes during puberty the full effects of this on a young person are largely unknown, although a lack of growth, bone thinning and genital immaturity (making the construction of opposite-sex analogues via plastic surgery much harder) are common.

As Carl Heneghan, director of the Centre of Evidence-Based Medicine at Oxford, said: “Given paucity of evidence, the off-label use of drugs in gender dysphoria treatment largely means an unregulated live experiment on children.”

@Sophoclesthefox

We are only just beginning to understand everything that happens at puberty. We have no idea what this treatment means for these children 20, 30 years down the line.

Yay, experimenting on children. It’s the right side of history.

Indeed.

Genderists: "we can't just class people as male or female because sex is binary, sex is really really complicated actually, far more than just chromosomes or male and female. Educate yourself about the science. We are still learning how complex sex really is"

Also Genderists : "but we are totally confident that disrupting the development of this super complex thing we don't fully understand with experimental drugs that have unknown outcomes is the right thing to do for any child that expresses confusion or dissatisfaction related to sexed bodies or gender roles"

abortion MAY have longer term consequences. Stuffing developing bodies fully of puberty blockers WILL have long term consequences and absolutely does not provide a thinking space.

It really is desperate that you have to hide the experimental drug treatment being given to children for unclear benefit behind the “if we don’t do this, contraception and abortion will be next!”

Yep, I mean I guess they should also be campaigning for tattoos for 13 year olds as well? Because if a 14 year old can't get a tattoo then surely that logically means they can't gain access to an abortion either...

And yet, Jolyon Maugham's (t)wittering on the challenge centred on parental consent in the stead of the child. And the idea that a child could say no, and the parent's decision trumped the child's. Which sounds rather more like a threat to abortion accesa to me.

So is the argument that no controversial and harmful treatment/policy about minor children and consent can ever be contested because it's thought in some quarters to be a risk to legal abortion?

Whilst I have considered the arguments about abortion and Gillick I also think it's dangerous to be arguing that anything goes re children and consent because of a perceived risk to abortion law.