NHS England’s only gender identity clinic for children has defended prescribing hormone blockers to children as young as ten.
Fenella Morris QC, representing the Tavistock and Portman NHS Trust, told the High Court this week that several ten-year-olds had already received the drugs at their clinic.
Detransitioner Keira Bell is taking action against the Trust to make it illegal for children to be prescribed hormone treatments.
Speaking on behalf of the Trust in London, Morris claimed that some young children were able to decide to take the blockers, but admitted conversations with them required “imagination” due their “potentially limited” life experience.
She told the judges that the nature of the assessment would vary from child to child, but would involve discussions about sex and “how babies are made”.
The QC admitted to the court that the full long-term impact of hormone blockers were not fully known.
Morris claimed that all children that start on blockers, including those as young as 10, know “that one of the possibilities is cross-sex hormones” – the effects of which are irreversible.
But the counsel for Bell, Jeremy Hyam QC, said: “There is evidence that hormone blockers can have significant side-effects, including loss of fertility and sexual function and decreased bone density.”
Hyam described the idea that a thirteen year old child could give informed consent to treatment as “just not credible” and “simply a fairy tale”.
He added: “Nobody could sensibly think that a child of 13 or under who cannot in law give valid consent to sexual acts could possibly give informed consent to treatment of dubious benefits” and “lifelong consequences”.
In a witness statement Bell said she had been left with “no breasts, a deep voice, body hair, a beard, affected sexual function and who knows what else that has not been discovered”.
She continued: “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.
“Transition was a very temporary, superficial fix for a very complex identity issue.”
The court has deferred judgment to a later date.
Change of guidance
In June the NHS quietly changed its guidance on puberty-blocking drugs to better reflect the growing evidence of the dangers posed to children by hormone suppressors.
Until recently, NHS guidance stated that puberty blockers “are considered to be fully reversible, so treatment can usually be stopped at any time”.
However, the guidance has now been altered to state: “Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria.”