Good Law Project files for judicial review of NHS England

[PurgatoryOfPotholes]

The statement from the GLP website is as follows.

Back in October, we told you we were preparing to issue proceedings against NHS England over its long-standing, lengthy and unlawful delays to meeting trans people’s healthcare needs.

Less than two months later, we are now filing our claim for Judicial Review. In that time, the shape of the case has changed slightly, so we wanted to tell you what’s new.

We’re bringing this claim against the NHS alongside two adult claimants, two child claimants and trans-led grassroots charityGendered Intelligence.The claim now focuses on six key problems with NHS trans healthcare provision. We argue:

1. NHS England has failed, under regulation 45(3) of the 2012 Regulations, to ensure that 92 per cent of trans patients who are referred for medical treatment begin that treatment within 18 weeks of referral.

2. NHS England has failed, under section 3B of the National Health Service Act 2006, to provide services for children needing puberty blockers that they can access before starting puberty.

3. NHS England have failed, under the NHS Constitution, to uphold the rights of adult patients with gender dysphoria to begin treatment within 18 weeks of referral.

4. NHS England has unlawfully discriminated against trans people because waiting times for gender identity services are longer than for the vast majority of other healthcare services.

5. NHS England’s decision to introduce and maintain a ‘Multi-Professional Review Group’ as part of puberty-delaying treatment for trans children is unlawfully directly or indirectly discriminatory. We also think the Service Specification unlawfully requires both the child and their parents to consent to treatment, contrary to the principles established in GillickandAB v CD.

6. NHS England has failed to comply with its public sector equality duty to ensure trans people can access acute services by setting up the Multi-Professional Review Group for trans children and in the arrangements it makes with providers.

Eva Echo, one of the adult claimants in this case, explains the impact of waiting so long for treatment. “I would describe being on the waiting list as torture, and there were times when I felt that I may not even be alive long enough to receive my first appointment. Being on the waiting list was no comfort; I desperately needed help.

“My mental health was worse than it had ever been; coming out had allowed me to recognise my gender dysphoria, but I was left completely alone to manage it. I felt, and still feel, completely let down by the system that I thought was there to save me.”

For too long, the NHS has failed to prioritise trans healthcare. We, alongside many affected individuals, medical professionals, families and campaigners for trans rights, believe the current system is not fit for purpose. The available services simply aren’t meeting the needs of the people they should be helping. Too many trans people have died waiting for the treatment they were entitled to. Many more suffer in ways that are entirely preventable. The bottom line is that trans people have a right to access essential care, just like everyone else.

Pandemic and other life threatening illness. You know, those things that don’t respond well to ‘wait and see’.

I just cannot

But it's not an physical or MH condition so why should the NHS be involved at all

Read the room guys. There is a pandemic on. People are missing cancer care and care for other life threatening conditions. I imagine this will go down like a lead balloon.

If it’s a medical issue then it should be treated as such in all ways. Medical definitions, in the DSM, medical review needed for GRA etc etc. And actually, pandemic or not, they are right to ask for NHS standards to be upheld.

I assume they are about to do the same for CAHMS referrals as well for example? If not, why not?

Do donors to the Good Law Project know what their money is being used for? I couldn't work it out from the website. For example if I donated because I supported one of their other cases e.g. climate change, does my money go towards that in particular or just into a big pot that they can then use for this?

If trans identity is not a mental health issue and doesn’t require medical gate keeping then isn’t this essentially elective cosmetic surgery and self prescribed hormones/blockers (since the requirement appears to be health professionals must prescribe on demand and make no clinical judgment). Why should it be funded by the tax payer?

Couldn’t anyone say, I feel depressed, tortured, suicidal because certain aspects of my body don’t match with my self image therefore I must have cosmetic surgery or other treatments within 18 weeks?

I hope this really backfires on them. So many people have suffered delays and cancellations to urgent medical treatment as a result of the unprecedented pressure on the NHS. To do this now is unlikely to attract much sympathy to the fox-beater's cause.

A very quick scan, and I'm no expert but even I could shoot down those arguments. However, looking at the quality of the legal teams the NHS has put forward recently, anything could happen. It's only been the joiners who've brought clarity and sense to proceedings. Cass review on the horizon?

@EndoplasmicReticulum

Do donors to the Good Law Project know what their money is being used for? I couldn't work it out from the website. For example if I donated because I supported one of their other cases e.g. climate change, does my money go towards that in particular or just into a big pot that they can then use for this?

Maugham goes into some detail in his statement to the court here. I am hesitant to quote the whole thing directly, because it would, in my opinion, infringe the Samaritan guidelines.

glplive.org/1412-jm-ws

Given that the NICE review into puberty blockers in children and teens found that the quality of evidence was very low, I would think the Good Law Project is on a sticky wicket. Unless they are actively campaigning for trans identifying individuals to have access to poorer quality healthcare based on people shouting on the internet, rather than gold standard clinical trials?

And yes, there are processes by which very rare diseases can have access to therapies outwith the usual trials process. Hint: you don’t get that by judicial review.

Point 2. Do they want blockers given to children before puberty starts?

Point 2. WTaF?! It's eugenics.

I am absolutely bewildered by this claim. I am certain he was saying we should trust the doctors a while back.

NHS England’s decision to introduce and maintain a ‘Multi-Professional Review Group’ as part of puberty-delaying treatment for trans children is unlawfully directly or indirectly discriminatory

Now that the NHS has decided that you need input from all the relevant specialisms, and that maybe psychologists don't know how inhibiting physical maturation with medication will impact patients' bone density in 10 years' time, he's totally against trusting doctors. Huh?

@oldwomanwhoruns

Message deleted by MNHQ. Here's a link to our Talk guidelines.

And 'elective cosmetic surgery'?

I hope the NHS come back all guns blazing to say that:

1. puberty blockers have not been licensed to treat children with gender dysphoria
2. 80-90% of children with gender dysphoria will resolve without medical intervention - i.e. accept their sex
3. there have been no suicides for children on the Tavistock waiting list for several years
4. a rising number of detransitioners shows the risk of prescribing puberty blockers and mastectomies on request
5. there is no evidence that gender treatment reduces suicide risk. On the contrary, those who have undergone medical transition have a suicide rate 19x that of the general population.

I know two families with teens/young adults at the Tavistock. While making the right noises to keep their children on-side, they are privately relieved that the waiting time is so long. Both are terrified that their children are making a huge mistake.

Anecdotally, the older one has had testosterone, and - in news that should surprise no one - taking cross-sex hormones has not improved their mental health.

@DazzlePaintedBattlePants

"Unless they are actively campaigning for trans identifying individuals to have access to poorer quality healthcare based on people shouting on the internet, rather than gold standard clinical trials?"

PREACH!!!!!!!!

I am SICK TO THE BACK TEETH of campaigners willfully misunderstanding Gillick competence and persisting in spreading misinformation around.

"Too many trans people have died waiting for the treatment they were entitled to"

I am past reading something like the above and just accepting it as fact.

How many trans people have died waiting for treatment? What was the cause of death? If these people were driven to suicide, that is clearly a mental health crisis that needs addressing before anything else can be considered, surely?

Yeah, reading the room isn't really a TRA forte. And asking Maugham to represent you is a prime example.

No media outlet is sympathetic to him. And demanding speshul treatment from an NHS on its knees isn't going to improve the TRA PR.

Still, its useful for Maugham to be so open about 'services for children needing puberty blockers that they can access before starting puberty.'

Always happy to give that as much media spotlight as possible.

RepentBirthingPersonFucker
But it's not an physical or MH condition so why should the NHS be involved at all

I believe that actual gender dysphoria is still listed as a mental health condition and the drive to have it removed is still ongoing?

However if as I understand if the patient is suicidal the clinics would not treat with PB/hormones anyway. So there would be have to be an official diagnosis of GD and an otherwise mentally stable patient who is capable of making a decision.

Hormones (and PB) given to adults is an adult making a decision.

MH provision is dependant on the availability of qualified clinical providers, can the court order the NHS to provide X when X is not available.

If it's a child, have the Courts not agreed that a child has not sufficient understanding around sex and sexual relationships and the important role it plays in the life of a "well rounded" adult to make a long term decision.

If the complainants are 8-16 years old talking about sex they have a child disclosing Child Sex Abuse. If they have a +16 year old talking about their past this is also someone disclosing CSA.

This may not go as planned as the lack of peer review clinical data is asking the State to sanction clinical experiments on children. This is in a uncontrolled setting in an underfunded field of medicine. Add in clinicians have made public statements on how they are actively discouraged to do clinical research.

Cross-disciplinary input is very important. This is an interview with a surgeon (who is also a transwoman) after some years to reflect on how surgery went wrong on a patient who had had their normal puberty halted by medication.

extract

But that new orthodoxy has gone too far, according to two of the most prominent providers in the field of transgender medicine: Dr. Marci Bowers, a world-renowned vaginoplasty specialist who operated on reality-television star Jazz Jennings; and Erica Anderson, a clinical psychologist at the University of California San Francisco’s Child and Adolescent Gender Clinic.

In the course of their careers, both have seen thousands of patients. Both are board members of the World Professional Association for Transgender Health (WPATH), the organization that sets the standards worldwide for transgender medical care. And both are transgender women.

Earlier this month, Anderson told me she submitted a co-authored op-ed to The New York Times warning that many transgender healthcare providers were treating kids recklessly. The Timespassed, explaining it was “outside our coverage priorities right now.”

Over the past few weeks, I have spoken at length to both women about the current direction of their field and where they feel it has gone wrong. On some issues, including their stance on puberty blockers, they raised concerns that appear to question the current health guidelines set by WPATH — which Bowers is slated to lead starting in 2022.

WPATH, for instance, recommends that for many gender dysphoric and gender non-conforming kids, hormonal puberty suppression begin at the early stages of puberty. WPATH has also insisted since 2012 that puberty blockers are “fully reversible interventions.”

When I asked Anderson if she believes that psychological effects of puberty blockers are reversible, she said: “I’m not sure.”When asked whether children in the early stages of puberty should be put on blockers, Bowers said: “I’m not a fan.” [bold mine]

When I asked Bowers if she still thought puberty blockers were a good idea, from a surgical perspective, she said: “This is typical of medicine. We zig and then we zag, and I think maybe we zigged a little too far to the left in some cases.” She added “I think there was naivete on the part of pediatric endocrinologists who were proponents of early [puberty] blockade thinking that just this magic can happen, that surgeons can do anything.” [bold mine]

I asked Bowers whether she believed WPATH had been welcoming to a wide variety of doctors’ viewpoints — including those concerned about risks, skeptical of puberty blockers, and maybe even critical of some of the surgical procedures?

“There are definitely people who are trying to keep out anyone who doesn’t absolutely buy the party line that everything should be affirming, and that there’s no room for dissent,” Bowers said. “I think that’s a mistake.”

www.bariweiss.substack.com/p/top-trans-doctors-blow-the-whistle

FFS. There is a pandemic on. People are dying of cancer and other serious diseases. What should happen is that NHS should receive funding for early cancer screening to catch cancers early and mental healthcare provision should receive funding to provide support to those that need it.
I don’t think surgery or hormone treatment should be provided by the NHS for gender dysphoria treatment. It should be privately funded. Mental health provision by NHS yes, puberty blockers, surgery and hormones no.

I’ve lost three relatives to cancer this past year. There are a couple of others on my husbands side who are seriously ill with it. So it’s a bit raw and I’m really angry that the Fox killer is prepared to waste public funds like this.

Good Law Project files for judicial review of NHS England
Hurrah. Self-inflicted sunlight Although the NHS has got better things to spend its funds on.

Too many cancer patients have seen their illness become terminal while waiting for treatment during the pandemic FFS