Parents can consent to children being given puberty blockers, High Court rules

Parents can consent to their child being given puberty blockers without applying for a court’s approval, the High Court has ruled following a case that contested whether under-16s were able to give permission themselves.

The judgement goes some way towards undoing the practical effects of a previous High Court decision regarding children’s ability to access the treatment, according to the Good Law Project, the organisation which funded the case.

Last December, the court ruled that under-16s can only consent to puberty blockers if they can “understand the nature of the treatment” in a case brought by Keira Bell against the Tavistock and Portman NHS Trust, which runs the UK’s only gender identity development service for children.

Ms Bell, who started taking puberty blockers when she was 16 before “detransitioning”, argued children cannot properly consent to the treatment. The court’s December judgement cast doubt over whether even 15-year-olds would be able to consent under the terms it set, and suggested clinicians may have to consult courts before prescribing hormone blockers.

The ruling is being challenged and will be considered by the Court of Appeal in June.

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The High Court’s ruling on Friday morning was in regard to the case of a trans 15-year-old girl, identified only as XY.

XY’s parents sought a declaration to clarify that they can consent to her ongoing treatment amid “uncertainty on the lawfulness of parental consent” and a concern that their daughter’s GP might not continue to prescribe puberty blockers following the previous ruling.

The judge said that, before the ruling in Ms Bell’s case, XY had been treated with puberty blockers on the basis that she was able to consent to the treatment herself – a view that she said had been “cast into doubt” by the landmark ruling in December.

In light of this, the High Court was asked to decide whether XY’s parents “retain the parental right to consent to that treatment”, regardless of questions of whether the teenager herself can consent.

Mrs Justice Lieven, who said she agreed with the December ruling and had contributed to it, concluded that “the factors identified” in that decision “do not justify removing the parental right to consent”.

The judge said the “key difference” from Ms Bell’s case is that parents are generally in a position to judge what is in the best interests of their child.

In a statement before the court at the hearing earlier in March, XY, who has fully transitioned socially and changed her name via deed poll, described the prospect of beginning male puberty as “very distressing”.

She said: “It meant that my life wouldn’t be my life any more and normal, where everyone knew and accepted me as female.”

The 15-year-old said she would have been “devastated” to develop “any additional male characteristics”, explaining that she discussed everything with her parents who have been “hugely supportive and understanding”.

Responding to the ruling, the Good Law Project, which funded the legal challenge, said: “It is not unreasonable to describe this morning’s decision as in large part reversing the practical effects of [Ms Bell’s case].”

The organisation said in a statement that owing to “enormous” existing barriers to access puberty blockers through the NHS trust, “very few children were able to overcome them without parental support”.

However, it said that Friday’s judgement still leaves a number of unresolved problems, adding that “especially vulnerable” trans children lacking parental support “will remain disadvantaged”.