Sunday Times Mum wins case to stop Gender GP

[Cismyfatarse]

Mother wins landmark court ruling to stop child having private trans treatment

www.thetimes.co.uk/article/20276262-7016-11ee-8275-e4bad3604bca?shareToken=590d845315b0d71da77c347639fb0da7

Hopefully the share token works and the mother knows the support she would get on here. Sending her a massive cheer and a hug.

Well there's very little information on this case in the public domain so we have no idea of the competence of the child involved. But the information that there is says that the mother is seeking to prevent the child having treatment outside the NHS NOT seeking to prevent them from having treatment at all. The law on minors' treatment is predicated on the assumption that the child is having treatment in a regulated, professional environment with clinicians taking decisions on the best available evidence. It seems to me that the problem with the treatment of transgender children is not the law but that the usual assumptions about medical practice haven't applied (see Cass etc).

If there was ever a good time to interfere with the medical profession...

When doctors are giving experimental drugs to children with irreversible consequences; when this area of medicine is being distorted by political ideology, and when the children in question even if they had some level of intellectual maturity are going to be, many would think, biased by the mental health issues that they suffer from.

An anorexic child may be able to consent to various medical treatments, but we wouldn't necessarily trust that when it comes to their anorexia that they can make sensible decisions.

If you need some extra regulation, it's maybe about the perfect situation for it right?

@PlanetJanette You introduced Gillick to this thread. Please could you explain its relevance in this case?

It looks like deflection or derailment to me.

Puberty blockers are medically approved and prescribed for the treatment of gender dysphoria in some cases.

I'm not sure this is entirely true?

The relevance is obvious.

This is a case about denying a 16 year old (as she will be when the interim injunction expires) and prima facie Gillick competent individual the right to make medical decisions for themselves.

If the mother wins here, it could only be if:

(a) the minor is not Gillick competent - but no one seems to be claiming that to be the case and the presumption is that they are Gillick competent at 16;

(b) Gillick competence is set aside for puberty blockers - but the Court of Appeal rejected that approach; or

(c) The power of the courts to override a minor patients wishes should apply in this case despite having previously only been used in extremis to prevent death or serious harm.

So whichever way you cut it this is relevant to Gillick.

Of course it is. We know that doctors prescribe puberty blockers in some cases for gender dysphoria.

They do not, by contrast, prescribe gastric band surgery for anorexia.

In that case why are tattoos banned for under 18s?

Look, if it’s illegal to have a tattoo under 18, then it is right it’s illegal to take like altering drugs which inevitably lead to cutting off body parts,

They do not, by contrast, prescribe gastric band surgery for anorexia.

OK, but if someone is intellectually competent, we normally let them decline treatment. They can refuse consent.

We don't do that with children with anorexia, and maybe not even adults.

Why? Because their thinking is distorted by a mental health condition.

So I think that's an extra reason to doubt that children can be competent to make their own decisions when it comes to experimental treatments for gender dysphoria.

@PlanetJanette

Puberty blockers are medically approved and prescribed for the treatment of gender dysphoria in some cases.

Um where and by who? That they are being used off label does not give that impression to me. Who has medically approved puberty blockers for the treatment of gender dysphoria? The NHS clamping down on, disbarring rogue doctors, and refusing to prescribe them outside of a research study does not sound like the approval you speak of.

I disagree. This is a case about a disagreement between parents over the treatment of their child. Whether the child is Gillick competent or not is completely irrelevant as they will be 16 when the current injunction expires.

I know a family where there was disagreement between the child, and both parents with regard to the best course of action to be taken for their permanently disabling medical condition. There was no question of the child's competence but no doctor involved in the case wanted to proceed without everyone being more on board with each other's thoughts etc. There were big multi disciplinary meetings involving specialists from more than one hospital and both the parents, child and even siblings were involved in counselling.

Not one of those doctors advocated just cracking on while there was a lack of consensus in the family, because they recognised the significance of the potential complications of the surgery and the life changing impacts of what was proposed.

You have to ask yourself who these doctors are that would push ahead with unlicensed, poorly researched, irreversible treatments for minors where there is a range of opinions amongst those with parental responsibility. Good, competent and wise doctors take time, offer therapy and seek expert opinions before proceeding. I would therefore have concerns about the doctors involved here.

Gillick competent young people don't get to choose their treatment and insist it is provided. Refusing to do what they want does not deny their competence - it reflects the lack of consensus around them.

It's not really primarily about Gillick (possibly not at all). Once the child is 16 the relevant law will be s8 Family Law Reform Act 1969 and in the meantime we've no idea about this child's comptenence.

What it's really about is your point c - how should the court exercise the inherent jurisdiction in this fairly novel situation. The court clearly has the power to stop the child going for this treatment (over or under 16, competent or not) the question is only whether they should use it. Clearly they have used it for the interim order so there's a plausible argument here. I think just focusing on the 'in extremis' previous use misses the context. The key point here is that the mother is trying to confine treatment to the NHS pathway. It's not an argument to stop the treatment at all but to keep it within a regulated, domestic environment.

Marci Bowers, a transgender surgeon who specialises in transgender surgery, has stated that children who are on puberty blockers and then cross-sex hormones never experience orgasm.

"An observation that I had, every single child who was, or adolescent, who was truly blocked at Tanner stage 2, has never experienced orgasm. I mean, it's really about zero."

Bowers said, there were two major problems with children undergoing medical "gender affirmation" prior to experiencing natural puberty. The biggest issue, according to Bowers, is one that no amount of surgery can ever fix, and it is the issue of having no sexual function and no ability to achieve sexual pleasure.

https://thepostmillennial.com/gender-affirming-surgeon-admits-children-who-undergo-transition-before-puberty-never-attain-sexual-satisfaction

This case is not about Gillick competence. The mother is seeking to ensure that any medical treatment the child receives is based on fully informed consent, as required for Gillick competence. It is effectively about whether one parent can give a child treatment prescribed from abroad - so equivalent to the parent taking a child abroad for treatment without the consent of the other parent.

So can we agree that Gillick was a red herring?

I heard a lawtuber proffer an old saying that exists within the US legal community about how to win in court.

If the law is on your side, bang on the law.
If the facts are on your side, bang on the facts.
If neither the law nor the facts are on your side, bang on the table.

It feels like that is what we are seeing.

Can I suggest that you all read about the experiences of Sinead Watson. She has spoken out about the pain , trauma & depression that she suffers every day since having surgery. She has been failed, and many more children & young people will be failed if this “ trans” contagion & harm isn’t stopped now.

Let's not forget what a diagnosis of gender dysphoria actually is.

https://www.mumsnet.com/talk/womens_rights/4096882-Surely-this-list-of-behaviours-that-challenge-social-convention-are-not-THE-list-used-by-medical-professionals-to-diagnos-gender-dysphoria

Diagnosis of gender dysphoria involves children demonstrating at least six of a series of behavioural traits as well as an “associated significant distress or impairment in function, lasting at least six months”.

Those patterns of behaviour include:

• A strong desire to be of the other gender or an insistence that one is the other gender.

• A strong preference for wearing clothes typical of the other gender.

• A strong preference for cross-gender roles in make-believe play or fantasy play.

• A strong preference for toys, games or activities stereotypically used or engaged in by the other gender.

• A strong preference for playmates of the other gender.

• A strong rejection of toys, games and activities typical of one’s assigned gender.

• A strong dislike of one’s sexual anatomy.

• A strong desire for the physical sex characteristics that match one’s experienced gender.

--
These are the things they wish to "cure" by drastic surgery. Wearing clothes and playing with toys that others have said are wrong, and not liking your body.

Also, let's try not to conflate "being trans" with "has gender dysphoria". Many of the T community have rejected this as it medicalises their identities, and many trans people realise that physical sex and gender are different.

Gillick is not entirely a red herring for the interim decision by the court - the child's wishes have less impact when under 16.

Personally I think the court of appeal was wrong to say puberty blockers are not significantly different to contraception- they are.

I don't think Gillick is a red herring as such (if the child is competent then those wishes will carry extra weight) but the idea that the mother's case requires a challenge to the existing law on Gillick is a red herring.

Well said. This is how this needs to be viewed. 16 year olds have no understanding of the gravity of what they are considering- how on earth could they understand how their bodies will be impacted for decades to come? This is nothing like going on the pill or not.

So my experience of consent at this age was of a close family member having a breast reduction at 17. Her breasts weren’t causing pain but she was horribly self conscious as a dancer. Not the right shape apparently and didn’t look right in a leotard.
She had the op privately abroad and it went fine luckily. 10 years on she still dances. However her breasts have grown back completely and she’s gone up a good few sizes. Now she advocates for body positivity in dancers. So she risked the operation for nothing and basically sorted her issue by well, just growing up.

I can’t imagine the argument for corrupting puberty. You can’t come back from that.

I would really like to know how many people who blithely advocate the use of "puberty blockers" and "cross-sex hormones" have ever taken them, or seen someone they love on them. I was treated with a gnrh agonist, and with drugs that block oestrogen, as part of my treatment for breast cancer and for the adenomyosis. The experience was not pleasant, and was only bearable for me because I was a fully grown adult (37 - way out of the confused woods of my teens and twenties) who knew that otherwise I would almost certainly be dead quite soon. I wouldn't recommend them to my worst enemy in any other circumstances.

@pontefractals I hope all is well with you now.
SIL had similar treatment to shrink fibroids before removal. The medication made her feel very very ill.

Puberty blockers are NOT licensed for the gender dysphoria. So they are NOT ‘medically approved’.

The NHS must now only prescribe them in a strictly controlled medical trial because there is insufficient evidence to approve them.

The drugs themselves are licensed for treatment of endometriosis in women but on the strict condition that they must not be given for more than six months and only for one episode in a lifetime due to their adverse effects. And they are contraindicated where there is depression or suicidality.