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. 💚🤍💜

So, If I am asking anything its ... 'What happens to those people? what do we do for them?

But TRAs say that any therapy at all for children with gender dysphoria is' conversion therapy' and that there should be no therapy at all, it should be straight to affirmation and blockers.

Your question is valid, and applies to any psychological disorder, but is not the issue here when we are talking about children being out straight onto puberty blockers.

" www.ncbi.nlm.nih.gov/pmc/articles/PMC7656150/
But prepubescent children all know if they are a boy or girl. Not going through puberty won’t change that."

This is really disturbing to read, surely we can't allow 11 year old to start talking a lifelong drug based of their decisions as a child. Also isn't this a retarding of normal brain development and skeletal maturity. I'm aghast this is allowed. that poor child.

Honestly, this judgement opens up a whole can of worms over who's ultimately culpable. GIDS clinicians are not experts in endocrinology and the Endocrinologists are not experts in gender or psychology/psychiatry.

As people have already said this really isn't the 'win' it looks like. It should give pause to any decent clinician on either side.

@OvaHere

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.

I see your point here.

But between something being deemed medically necessary (or at least potentially medically necessary) by doctors - i.e. in the case of trans affirming healthcare - and parents actually dissenting, I imagine this is so rare it's unnecessary. No teens are trying to get arm amputations for no reason, for example, and doctors would simply refuse on the grounds that it was unnecessary so their consent would be irrelevant.

So I imagine there's a relatively small pool of treatments or procedures that routinely fall under the need to assess Gillick competence in light of a parents' lack of consent (as opposed to generally involving a child in their medical care and asking for consent, even though parents have already consented, as part of general respect for their autonomy once they're capable of understanding what's happening).

No parent (I'd imagine) would, for example, refuse their child a plaster being put on their leg if they'd broken it. And in the tragic cases where e.g. certain treatments like chemo are no longer performed on terminally ill children without their express consent I'd imagine the children are either too young to be able to understand and therefore request it with informed consent, or it's medically inadvisable to continue and would have no benefit.

So largely you're looking at: contraception, vaccination, abortion, perhaps some forms of cosmetic surgery, treatment of trans children, and then maybe a handful of cases where there are various treatment options (I'm thinking of a friend who chose surgery over chemotherapy for a rare bone cancer at 14, even though her parents initially wanted her to try chemo first - she eventually convinced them that's what she wanted, but if she hadn't convinced them and it got taken further/to court I assume that her capacity to consent would have been properly assessed).

So the treatments falling under 'no parental consent so need to specifically and accurately assess child's capacity to consent' are probably relatively limited and those with controversial treatments even more limited still - and controversial will broadly mean morally (i.e. in cases of contraception and abortion it's usually moral controversy that leads the child to seek help without parental consent, not 'I don't want my child taking the pill because of the effect on their body'), although of course anti-vaccination efforts mean there are also times a parent might have medical concerns.
So that's mostly it, unless there were drug trials etc a child wanted to take part in for a condition, but I imagine the cases where that is relevant AND the parents don't want it to happen are just vanishingly few and far between, if they exist at all.

In a long winded way I'm saying - I see your point, but I just can't really imagine there are many cases where it could be a concern that aren't already reasonably well-covered by precedent.

Droite

But also, potentially, the other way round: could a parent consent to an abortion for a child who does not want it?

JM's proclamations on (what he saw as) the path forward would have certainly permitted that, were they law. His starting point very much was "the parent always knows best" and I can see little difference on this point between him and the famous Mrs Gillick.

He seemed genuinely taken aback when the child protection professionals, family courts lawyers and child abuse survivors express their horror. I assume he then blocked them all.

I think they should be free to be themselves as they are.

Is a gross misunderstanding of what it means to be transsexual or have severe dysphoria. It’s not about clothes and make up or blue or pink. It’s about looking in the mirror and knowing that the sex of the person you see is instinctively and consistently wrong. The sex that other people see you as just feels wrong. That’s true for m2fs and f2ms. Call it sex or gender, or male, man or female, woman; they mean the same thing in the end.

You seem to be saying that it's a delusion: It’s about looking in the mirror and knowing that the sex of the person you see is instinctively and consistently wrong.

Isn't that the very definition of a delusion? Seeing what is and 'knowing' that it is 'wrong'? To be clear, it's not me that's saying it's a delusion, it's your description which says that. 'Knowing' that your perfectly healthy body is 'wrong' is not a healthy state of mind.

For those who 'know' that their perfectly healthy bodies are 'wrong', surely the best sort of treatment is that which helps them to understand that their bodies are not 'wrong' and to come to terms with the way they are, isn't it? Altering the body to fit the mind's idea of how it should be can't possibly be the best course of action. And remember that it is children who are being discussed here, not adults.

No one refused Keira.

Her whole case is that she was helped to do something permanent to her body that she now regrets and will have to live with all her life, because more questions were not asked about why she felt as she did. Because too much weight was given to decisions and beliefs she held in a state of high distress, without wider consideration of her best interests.

What happens to the Keiras? What protections are built into the system for them? Are we just going to accept that there's going to be some deeply unhappy, deeply distressed adults with lifetime challenges caused to their previously perfectly healthy bodies and life prospects and this is the price of many other adults being happy with those changes and medical challenges?

Or should the system work better than this and take more care?

It's rather like 'shall we stick a rapist in a female prison because that's what he feels he needs and ignore that the female prisoners now live in terror and a couple have been assaulted?' or 'shall we think of a better way to do this, that may involve saying 'no' to some things and considering all parts of the needs instead of just the wants of one vulnerable person in the equation'?

I do feel like at least this has shone a massive spotlight on the Tavistock. And that from now on, hopefully clinicians will be aware that they will be under a lot more pressure to prove that their patients who are put into blockers do fully understand the consequences of that pathway (although how you would do that I still don't know tbh?)

@Fieldofgreycorn

I’m not sure that puberty blockers are that useful here. The initial stages of puberty are both the treatment and the filter. 80% of those with gender dysphoria will desist with puberty. Those that don’t can go for medical transition. This has been the safe model in the past. It’s what psychiatrists and psychologists have done for decades.

PBs only suspend the decision without any new information and without the right brain development. Sex hormones are critical for brain development and maturation. A more useful approach would be not to use PBs but examine and research at what age should cross sex hormones begin? 16? 18? 20? There is certainly no rush with f2ms.

But this:
I think they should be free to be themselves as they are.

Is a gross misunderstanding of what it means to be transsexual or have severe dysphoria. It’s not about clothes and make up or blue or pink. It’s about looking in the mirror and knowing that the sex of the person you see is instinctively and consistently wrong. The sex that other people see you as just feels wrong. That’s true for m2fs and f2ms. Call it sex or gender, or male, man or female, woman; they mean the same thing in the end.

So gender/gender identity is directly about physical appearance? It's related to the sexed body?

(Note I didn't specify "transsexual" or ppl with severe dysphoria - you don't need to be/ have these to be trans, as I understand it).

Just read the other day that Jazz Jennings, one of the oldest transitioners, has gained 100 lb which s/he blames on 'emotional eating' and the 'side effects of her medication'.

That's a staggering weight gain for a twenty year old.

None of this is reassuring, is it?

Artichokeleaves as i understand it they are saying Kiera should sue because they didn't do their job to make sure it was appropriate to prescribe rather than they shouldn't be able to prescribe?

I don't think I said in that post that they shouldn't be able to prescribe, but that the system should take more care.

Considerably more care.

And yet this entire thread exists because a person who asked for and received treatment now realises she didn't want what she thought she wanted, and wants to make sure others don't make the same permanent mistake that she did.
It comes down to the fact she was a child.

A child asked for a drastic treatment and then regretted it. Whose fault is it the child got what she asked for?

The High Court said the doctors failed to keep records and failed to prove the drastic treatment even works. They told doctors to stop providing this drastic treatment to children, who couldn't be expected to understand how drastic it actually is.

This Court of Appeal has said that the High Court answered the wrong question. That decisions about drastic treatments shouldn't have to go to court. But that if those drastic treatments aren't given with consent, then those doctors could be sued.

Gillick was about consent to receiving contraception.

Am I being really thick or are we still undecided on whether children can legally consent to something unproven, undocumented and irreversible? This ruling doesn't address that does it?

So whose fault is it that a child was given drastic treatment on her own say-so? Is anyone going to take responsibility?

Contraceptives are not unproven, undocumented and irreversible, they're not experimental, they're widespread and unlike triptorelin/goserelin etc they don't cause such a high percentage of recipients to have permanent physical damage.

This should be unlinked from Gillick, surely. Its not in the same realm at all.

Plus there is no evidence whatsoever that denying children this particular type of medication causes a worse medical outcome. There's a lot of talk of suicide, not backed up by any statistics.

If this treatment was banned by law, would a legal challenge be successful? Would a family have to prove that a suicide was down to a lack of blockers? How could that case be successful when there is no proof they work? When there is evidence they increase suicidal ideation? How would the reverse of this case play out?

No teens are trying to get arm amputations for no reason, for example, and doctors would simply refuse on the grounds that it was unnecessary so their consent would be irrelevant.

Amputating an arm = bad, unnecessary
Amputating breasts or a penis = good, necessary

Is that what you're saying?

So its out in the open now at least, they're going straight for Gillick now. The Bell counsel, who has strong links with the Heritage Foundation and has acted a number of times on anti-abortion cases, is going to go and try and have Gillick competence struck out.

... they all said this wasn't the plan .....

I can see there's a game plan of repeating this Gillick nonsense sufficient times that hopefully someone might start to think it's true.

Looking at Twitter it’s pretty revolting to watch males/transwomen in late middle age (many of whom had children prior to transitioning) celebrating this judgment as a way to stuff yet more dysphoric children with blockers. They know the evidence for them is shaky. They know that most non conforming kids if left alone will become gay or lesbian.
They are celebrating the use of a drug on children. Why on earth would you do that?
It feels so narcissistic

@DisgustedofManchester

So its out in the open now at least, they're going straight for Gillick now. The Bell counsel, who has strong links with the Heritage Foundation and has acted a number of times on anti-abortion cases, is going to go and try and have Gillick competence struck out.

... they all said this wasn't the plan .....

No they are not going 'straight for Gillick'.

He said 'The Gillick competency test is no longer fit for purpose'.

He is basically saying that if you are conclude that it is in any way possible for an under 16 year old child to be able to fully understand a the full consequences of a medical pathway which starts with off label puberty blockers, then the Gillick competence principle is pretty much redundant because what is the point of it if it is just going to be ignored?

No mention of abortion, no mention of contraception.

Stop weaponising women's reproductive rights to try and force people to your way of thinking.

@DisgustedofManchester

So its out in the open now at least, they're going straight for Gillick now. The Bell counsel, who has strong links with the Heritage Foundation and has acted a number of times on anti-abortion cases, is going to go and try and have Gillick competence struck out.

... they all said this wasn't the plan .....

Are you sure you've got that the right way round? It's Jolyon Maugham who is arguing that parents should be allowed to consent on behalf of the child. As a PP said, this sounds very much like what Mrs Gillick wanted - parents can consent (or not) but children can't.

@MinervaBoudicca

Looking at Twitter it’s pretty revolting to watch males/transwomen in late middle age (many of whom had children prior to transitioning) celebrating this judgment as a way to stuff yet more dysphoric children with blockers. They know the evidence for them is shaky. They know that most non conforming kids if left alone will become gay or lesbian. They are celebrating the use of a drug on children. Why on earth would you do that? It feels so narcissistic

It's their way of saying it's not a fetish. If children are just like them, it's an innate state and they've always been that way.

Miranda Yardley has written a lot about this.

To understand why the focus has moved onto children, look to the [now deleted] YouTube discussion between TransYouth Family Allies executive director Kim Pearson and transgender activist Autumn Sandeen, who states:

“I’ve always said there are two groups that are going to make change in transgender legislation and the “gender identity and expression” related language in legislation. It’s going to be trans youth because … they demystify it and take the sex right out of the trans experience.”

mirandayardley.com/en/this-is-an-all-out-political-war-the-gender-recognition-act-and-beyond/

A lot of transgender activism is focussed on children, ‘transkids’, and much of this activism is carried out by late-transitioning non-homosexual transgender males, men who have lived a life as a man, benefitted from this and often leave a wife and children behind as they move out and pursue their midlife crisis. I asked Blanchard whether these cheerleaders, who are generating a powerful vector to normalise the social and medical transition of children, are the same type of transsexuals as those children who would ordinarily be regarded as being ‘transkids’.

“I think that in some cases where you have a male to female transsexuals of the non-homosexual type, which is to say they were previously married. They had children. They were fathers. They were this and that and then became women. That type of transsexual who are very well represented to say the least among trans activists, when they involve themselves in treatment of children, they are really colonizing a clinical population to which they don’t belong. They are claiming the boyhoods of pre-gay males for themselves and saying: ‘I was this kind of boy.’ They weren’t.”

mirandayardley.com/en/the-colonisation-of-the-boyhood-of-pre-gay-children-by-heterosexual-transgender-activists-interview-with-blanchardphd/

I feel Jolyon Maugham's line decrying the existence of the family courts and their role of intervening for children was a moral event horizon for trans activists.

Nothing he said would have been out of place from a Victorian patriarch saying an Englishman's house was his castle and if he wanted to physically discipline his daughter or son for "sexual immorality", he jolly well would.

@OldCrone

No teens are trying to get arm amputations for no reason, for example, and doctors would simply refuse on the grounds that it was unnecessary so their consent would be irrelevant.

Amputating an arm = bad, unnecessary
Amputating breasts or a penis = good, necessary

Is that what you're saying?

No, it's not.

I said 'medically necessary or deemed to be' - i.e. many trans people deem these surgeries to be medically necessary for their mental health, and the prevailing medical guidance certainly makes room for mastectomy etc as part of the treatment, so they are evidently willing to treat these surgeries as having a medical justification, too.

I didn't make a pronouncement either way.

It's very disappointing, even more so because the Tavistock has its roots in psychotherapy and their clinicians should understand the value of therapeutic help before other treatments are recommended.

Keira Bell clearly said that while depression came up briefly in her therapy, it was thought transitioning would be the cure, no one really wanted to explore it further. Now she regrets the decision because she realises she wasn't in a good frame of mind to make that decision at all.

many trans people deem these surgeries to be medically necessary for their mental health

Which brings us back to Kiera Bell and the fact that she at one point in her life believed this surgery was medically necessary for her mental health and was enabled by the medical profession, and now realises she made a mistake.

So even if it is true that in some cases the best treatment for an issue of the mind/identity is to modify an otherwise healthy and functional body into a state that will require lifetime medical support, the simple fact that the treatment is so life-changing and so irreversible means that all non-permanent alternatives should be thoroughly explored first.

TRAs trying cynically (or maybe naively) to appropriate the entirely different circumstances and experiences of gay, lesbian and bisexual people would call that “conversion.” I think it’s more accurate to call it Confirmation - confirming that applying a drastic, physically costly and non-reversible surgical intervention is really the best option for the individual based on their own needs rather than to comply with an ideological belief about trans people.

I said 'medically necessary or deemed to be' - i.e. many trans people deem these surgeries to be medically necessary for their mental health, and the prevailing medical guidance certainly makes room for mastectomy etc as part of the treatment, so they are evidently willing to treat these surgeries as having a medical justification, too.

Surely it's not just up to the patients to 'deem these surgeries to be medically necessary for their mental health', there must also be some medical diagnosis by a professional who decides that this is the best way to proceed.

But there have also been cases of doctors amputating healthy limbs because patients decided they wanted this.

In January of this year British newspapers began running articles about Robert Smith, a surgeon at Falkirk and District Royal Infirmary, in Scotland. Smith had amputated the legs of two patients at their request, and he was planning to carry out a third amputation when the trust that runs his hospital stopped him. These patients were not physically sick. Their legs did not need to be amputated for any medical reason. Nor were they incompetent, according to the psychiatrists who examined them. They simply wanted to have their legs cut off. In fact, both the men whose limbs Smith amputated have declared in public interviews how much happier they are, now that they have finally had their legs removed.

www.theatlantic.com/magazine/archive/2000/12/a-new-way-to-be-mad/304671/

There was also the case of a woman who persuaded a psychologist to blind her by pouring drain cleaner in her eyes.

www.bioethics.net/2015/11/can-clinicians-maim-healthy-organs-the-case-of-jewel-shuping/

These people also 'deemed these surgeries to be medically necessary for their mental health', just like the trans people you talk about. What is the difference? Is there a difference?