Britain’s Court of Appeal has overturned a High Court ruling which limited the use of puberty-blocking drugs for children.
The High Court ruled in December 2020 that children under the age of 16 lacked capacity to give informed consent to medical treatment which delays the onset of puberty.
The ruling said it was “highly unlikely” that a child aged 13 or under would be able to consent to the hormone-blocking treatment, and that it was “very doubtful” that a child of 14 or 15 would understand the long-term consequences.
But in a judgment on Friday, the Court of Appeal said that it was “inappropriate” for the High Court to have given the guidance, and that it is up to doctors to “exercise their judgment” about whether their patients can properly consent.
The original case was brought by Keira Bell, a 24-year-old woman who began taking puberty blockers when she was 16 but later regretted doing so, and the mother of a teenager who is on the waiting list for treatment.
“I made a brash decision as a teenager, as a lot of teenagers do, trying to find confidence and happiness, except now the rest of my life will be negatively affected,” Bell told the High Court last year.
Following Friday’s Court of Appeal ruling, Bell said she was “surprised and disappointed” in the decision but said she had no regrets in bringing the case.
“It has shone a light into the dark corners of a medical scandal that is harming children and harmed me,” she said.
Bell said she believes the medical service had become “politicised.” She said she will be seeking permission to appeal to the Supreme Court.
But the judgment was welcomed by the Tavistock and Portman NHS Foundation Trust, which runs the UK’s only gender identity development service for children and brought an appeal against the High Court ruling in June.
A trust spokesperson said the judgment “affirms that it is for doctors, not judges, to decide on the capacity of under-16s to consent to medical treatment.”
In their ruling, the Lord Chief Justice Lord Burnett, sitting with Sir Geoffrey Vos and Lady Justice King, said: “The court was not in a position to generalise about the capability of persons of different ages to understand what is necessary for them to be competent to consent to the administration of puberty blockers.”
The judges also said that gender treatment for children is “controversial” and subject to “intense professional and public debate.”
“Such debate, when it spills into legal proceedings, is apt to obscure the role of the courts in deciding discrete legal issues,” Lord Burnett added.
