On Friday, Sept. 17, the Court of Appeal in London overturned a December 2020 ruling that held that children under the age of 16 were not capable of understanding on their own the effects and implications of undergoing ‘sex change’ treatment and thus needed parental approval, the Daily Mail reported.

However, the Court of Appeal ruled that the High Court—responsible for the initial ruling—erred in opining on a procedure that should be left to the judgment of the doctor and the patient, and with that, kids under-16s will once again be able to start the controversial growth hormone-blocking treatments.

Friday’s ruling comes after a lot of back and forth.

In the UK, by a 1985 ruling, children under 16 can make their own medical decisions if they are deemed to fully understand the implications of the treatments they are to receive.

Under this legal argument, children in the UK began receiving ‘sex change’ treatments without the need for their parents to know or approve of the decision.

However, in December 2020, Keira Bell, a woman who underwent hormone treatment to become a man when she was 16 but then ‘reverted’ to her original gender, sued Tavistock and Portman NHS Foundation Trust, the only NHS clinic that provides gender identity development services for children.

The High Court agreed with Ms. Bell and struck down the ‘sex change’ treatments for all children under 16.

The High Court judges ruled that: “It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers. It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.”

However, in June this year, Tavistock and Portman’s clinic appealed, and the Court of Appeal set aside the High Court’s ruling on the grounds that the court should not have opined or given guidance on what amounts to an intimate medical procedure between the doctor and the patient.

Lord Burnett, along with Sir Geoffrey Vos and Lady Justice King of the Court of Appeal, 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.”

Ms. Bell reacted to the court’s ruling by saying, “I am obviously disappointed with the ruling of the court today and especially that it did not grapple with the significant risk of harm that children are exposed to by being given powerful experimental drugs.”

“I am surprised and disappointed that the court is not concerned about the fact that children as young as 10 years old have been put on the path to sterilization,” she added.

But Bell vowed to appeal the decision.

“A global conversation has begun and has been shaped by this case. There is more to be done. It is a fantasy and deeply concerning that any doctor could believe a 10-year-old could consent to the loss of their fertility,” she said.

Bell, now 23, started taking puberty blockers at 16, had testosterone injections at 17, and underwent a mastectomy at 20 before “de-transitioning.”

She claimed she was treated as a “guinea pig” at the clinic and said doctors failed to conduct a proper psychiatric evaluation and should have questioned her more about her decision to change to a man as a teenager.

To ‘sex change,’ hormone blockers—gonadotropin-releasing hormone analogs—are administered, which pause the physical changes of puberty, such as breast development or facial hair.

Typically, following hormone blockers, after the age of 16, the patient is prescribed cross-sex hormones, which some experts say have ‘irreversible’ changes.

Little is known about the long-term side effects of hormone blockers or puberty in children with gender dysphoria. However, some experts claim that the treatment leads to loss of bone density, depression, suicidal thoughts, and infertility.

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