UK High Court finally acts to block unsupervised use puberty blockers on children

[innonimatu]

This is a much-needed ruling, given the explosive growth of the use of this "treatment" in recent years. As we know from the past history of interventions justified with "psychiatry" or "psychology", these things tend to go through fads and then recess - leaving plenty of damaged test subjects of the first impact of the fad behind to cope with their resultant personal problems.

Children suffering with gender dysphoria will now need a court order before they are legally allowed to take puberty blockers, the NHS has confirmed.

The new guidelines were announced following a landmark High Court ruling on Tuesday in which judges said trans children should not receive the controversial drugs unless they understand the "long-term risks and consequences" of them, amid warnings it is "highly unlikely" that most teenagers could consent to this process.

On Tuesday night, the NHS updated its guidance to reflect the judgment, meaning "no-one under the age of 16 can now be referred for puberty blockers unless a court rules it is in the child's best interests".

The ruling prompted lawyers to warn that the "floodgates could be opened" on retrospective claims of clinical negligence and hundreds of transgender children could sue, arguing that they were unable to consent to the transitioning process when they began taking puberty blockers.

The landmark case was brought against the Trust by Keira Bell, a 23-year-old woman who began taking puberty blockers before "de-transitioning". She said the clinic should have challenged her more over her decision to transition to a male when she was 16.

It was also brought by a woman who can only legally be identified as "Mrs A", the mother of a 15-year-old autistic girl who is currently on the waiting list for treatment.

At a hearing in October, their lawyers said children going through puberty are "not capable of properly understanding the nature and effects of hormone blockers".
[...]
The judges said: "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."

During the High Court hearing in October, the Trust – as well as University College London Hospitals NHS Foundation Trust and Leeds Teaching Hospital NHS Trust, to which Tavistock refers children and young people experiencing gender dysphoria – argued that taking puberty blockers and later cross-sex hormones were entirely separate stages of treatment.

However, the judges concluded: "It is said… the child needs only to understand the implications of taking puberty blockers alone... in our view this does not reflect the reality. The evidence shows that the vast majority of children who take puberty blockers move on to take cross-sex hormones."

The judgment said both treatments were "two stages of one clinical pathway, and once on that pathway it is extremely rare for a child to get off it".

Speaking outside the Royal Courts of Justice after the ruling, Ms Bell said she was "delighted" with the result, adding that "common sense has prevailed". "This judgment is not political," she said. "It's about protecting vulnerable children."

I known, of course, that there are plenty of PC brigades that would like to burn people at the stake for saying "not so fast" on these things. Which is why a court ruling on it was necessary: civil public discussion was drowned out under threats and intimidation. No interest in discussing the actual issue, only in silencing critics. An attitude which I'm sure this thread will only produce more evidence of...

Another piece on the history of some of the people who fought for this ruling says something that I personally know to be truth and that has been and is currently a reason why many gay men are moving way from the "LTBT charities" and regarding the current directions of several of them as enemies:

Evans began to become concerned by the influence of transgender organisations on clinical practice at the Tavistock. “It was becoming increasingly difficult to discuss the needs of the patients who displayed clinical curiosity. The beginnings of the more ‘affirmative model’ of care [whereby the cross-sex identity of a child with gender dysphoria is affirmed by referring to the child as if it were the opposite sex] were taking root”.

To this day, Evans believes this practice “has not been proven to alleviate mental distress”, and that its use within the GIDS is “based on political pressures and fears of litigation, rather than what would be clinically, professionally appropriate”.
[...]
Due to personal circumstance, Evans withdrew, passing on her role as claimant to Keira Bell, who was prescribed puberty blockers by GIDS when she was 16. She had a double mastectomy aged 20, and now regrets transitioning, which has left her with “no breasts, a deep voice, body hair, a beard, affected sexual function and who knows what else that has not been discovered”. She may well be infertile as a side effect of the drugs.
[...]
Between 2016 and 2019, a total of 35 clinicians left the Tavistock, many reporting concerns. One psychologist, who wished to remain anonymous, feared that “young people are being over-diagnosed and then over-medicalised”. Others felt the influence of lobby groups on clinical practice.

Clinicians reported being alarmed that underlying issues, such as homophobic bullying, sexual abuse or other traumas, were systematically overlooked. New light was shed on their concerns in June, when transcripts of staff interviews from an internal review of GIDS were leaked to BBC Newsnight.

The transcripts included staff fears that some patients had been placed on to “a gender-transitioning pathway” too quickly. It also highlighted claims of homophobic attitudes among the parents of children attending the clinic, with some allegedly appearing to prefer their children to be transgender and straight, rather than gay. Staff also reported feeling discouraged from referring to social services children they believed may have been sexually abused.
[...]
“As soon as clinicians hear the words ‘gender dysphoria’, they refer children to GIDS, as if this is something separate from all the other issues in the child’s life. I think that what these kids need is support while they grow into adulthood. They need help before they make any permanent decisions they may live to regret.”

To be perfectly clear: I've witnesses people being pressuring into "assuming themselves as trans" who were very clearly merely homossexual. It was bad enough when a "gay lifestyle" was pushed on young and impressionable people for the sake of their commercial exploitation more than anything else: the associations have always been sponsored by the night clubs, bars, etc.. but what the hell that was life and young people had to meet it at that point in life anyway. Everything is commercialized, so what if this group is specifically exploited I guess? One among others. Some became casualties to drugs, debts, suicide or AIDS that wouldn't if they hadn't been pushed head first into "affirmation" in an environment that can be rather toxic, but it was the subculture we had. Most survived. I could deal with that and still help people.

Then came the transgender fashion... what was a very specific medial problem affecting a small number of people now became a fad pushed by associations and "charities", some of witch were the old gay associations whose purpose after the last big battles (marriage and adoption) had become void. They were seriously in risk of being disbanded, having no more donations and volunteers. Law of institutions: the people living off them won't disband because the work is done, they'll find some other cause if they can. When leaders live off the association's funds... very common anywhere. Again, I've lived this...

This new fashion was salvation: it should be applicable to anyone who could be persuaded that therein lie the solution to their feelings or maladjustment - the more the people the greater the influence and the new funding. Feelings that are entirely normal to be felt by teenagers are being exploited - this is no different than the way religion exploits sex to create guilt and the need to atone for it ritually. So now gender is supposed to be a "choice" and on that choice people should act immediately when they feel maladjusted, when they are at their most vulnerable, children and teenagers, and if necessary isolated from their usual support groups other than that provided by these associations and allies: the procedures should be done in secrecy on the idea that the child or teenager alone can "consent". Obviously advised by the helpful association/trust/medical staff... This was the idea, that this curt order put a stake through at least in the UK.

This was not righting some wrong. This was not saving people from oppression. This, the way it was (is) being done, was another exploitation. Checks and balances on the advice institutionally given, a delay to consider maturely, can only be a good thing.

 

[Ajidica]

This thread is going to end well.....

All I'll say is most of my thoughts on this topic come from a series of articles run by The Atlantic, notably this one:
"When Your Child Says They're Trans"
https://www.theatlantic.com/magazine/archive/2018/07/when-a-child-says-shes-trans/561749/

I am curious though, what do you mean by "gay lifestyle"?

It was bad enough when a "gay lifestyle" was pushed on young and impressionable people for the sake of their commercial exploitation more than anything else: the associations have always been sponsored by the night clubs, bars, etc..

 

[Gorbles]

Then came the transgender fashion... what was a very specific medial problem affecting a small number of people now became a fad pushed by associations and "charities"

This is transphobic rhetoric, plain and simple.

The combination of calling such a thing a "fashion" and providing no actual scientific backing for your repeated and harmful claims leads me to believe there isn't much potential for discussion here. You're doing the usual anti-trans thing of painting all their support networks as abusive and exploitative, as well as making clichéd comparisons to religion and the like.

We also already have a thread where you can even ask for information on this, where this exact topic was recently raised.

 

[Yeekim]

1) Is there even any point in taking puberty blockers after 16?
2) What are those "long-term" consequences then?
3) The "pathway" argument seems exceptionally weak to me.

 

[Kyriakos]

This is way too thorny an issue...
To use a platitude: better to err on the side of caution.
Other than that... one has to suppose there are enough parameters to allow a case-by-case judgement.

 

[Ajidica]

We also already have a thread where you can even ask for information on this, where this exact topic was recently raised.

In fairness, it has been repeatedly noted that is an 'Ask a.." thread and not a discussion thread.

 

[innonimatu]

As entirely predictable the standard invocation of the word "transphobic" to suppress discussion was made. You may disagree on a matter of opinion, it is a matter of opinion whether the sudden and unprecedented rise on the number of these cases (a fact) is an indication that it is fad or not. I know what I saw, personally here where I live too. Time will tell and I'm content (or rather, resigned, because I do have an opinion) to wait and see.

But the issue up for discussion is how elective medical intervention should be performed on children and teenagers as a matter of their will. And how to properly ascertain that will.

1) Is there even any point in taking puberty blockers after 16?
2) What are those "long-term" consequences then?
3) The "pathway" argument seems exceptionally weak to me.

I don't know. There is one example of consequences in the case, one of the people who pressed it had specific complains. I'm b default on the "err on the side of caution" side in general, on this one I had already seen cases myself of pressures on individuals that got me quite crossed, and sympathetic to the arguments put to the court in this case.

In fairness, it has been repeatedly noted that is an 'Ask a.." thread and not a discussion thread.

Didn't want to raise the question there as it was likely to be (even more) taken as hostile. And it's not a "ask a" question, it's a general issue really. Most of the persons involved in call capacities in this court case, from the NHS staff to social workers to the people pressing the complaints to the judges, were not trans. One of the two people had been.

The decision has been polemic, and does merit discussion. More, it's logic should also raise question regarding medical interventions and informed consent in different situations. Who has and has not a right to weight in and influence decisions. I just don't think that discussion should be restricted to a particular group.

 

[aimeeandbeatles]

Then came the transgender fashion... what was a very specific medial problem affecting a small number of people now became a fad pushed by associations and "charities",

Yeah no it's not a fashion. You're just being transphobic.

 

[Ajidica]

As entirely predictable the standard invocation of the word "transphobic" to suppress discussion was made. You may disagree on a matter of opinion, it is a matter of opinion whether the sudden and unprecedented rise on the number of these cases (a fact) is an indication that it is fad or not. I know what I saw, personally here where I live too. Time will tell and I'm content (or rather, resigned, because I do have an opinion) to wait and see.

You are conflating two issues though.
One issue is medical intervention on minors who say they are trans. That is a tricky subject with no good answers, as illustrated in the article from the Atlantic and interviews.
The other issue, which is where most of the "you're being transphobic" come from, is presenting "trans issues" as a lifestyle/fashion that is somehow being pushed on people by a shadowy cabal of permanent activists to perpetuate their existence.

I am also curious as to what the "gay lifestyle" is.

It was bad enough when a "gay lifestyle" was pushed on young and impressionable people for the sake of their commercial exploitation more than anything else: the associations have always been sponsored by the night clubs, bars, etc..

 

[Yeekim]

I don't know. There is one example of consequences in the case, one of the people who pressed it had specific complains.

It would be kind of relevant, don't you think? If you refer to Ms Bell, I think her complaints were more to do with surgery than blockers. I could be easily persuaded that irreversible steps after one has turned 16 perhaps require more oversight and mandatory delays, to minimize chances that people would regret later... but unless there are serious and as of yet unclarified potential consequences to blockers alone, I see no reason to restrict access to them.

 

[GenMarshall]

Yeah...I can see this thread ending well.

 

[innonimatu]

You are conflating two issues though.
One issue is medical intervention on minors who say they are trans. That is a tricky subject with no good answers, as illustrated in the article from the Atlantic and interviews.
The other issue, which is where most of the "you're being transphobic" come from, is presenting "trans issues" as a lifestyle/fashion that is somehow being pushed on people by a shadowy cabal of permanent activists to perpetuate their existence.

I am also curious as to what the "gay lifestyle" is.

Gay lifestyle is the self-segregation encouraged primarily, now, by commercial interests. It started as a real segregation, that had to be fought against. That was the point or organizing! Now? It's going to gay (only in practice) bars, tourism to "gay spots", buying the "gay brands" of clothing, even doing "gay sports... all of which feed into commercial interests, which also just happen to be the ones that finance many of the surviving gay associations, which repay this support by promoting these businesses.

This may look harmless. It isn't. Being gay is still not easy. It till means, to too many people, bad relations with one's family, lack of support during youth. Into this world those people fall. Being gay is advertised to them as partying and spending time (and therefore money - in the right places to affirm themselves. Or to even be noticed. To "be gay". To not feel ostracized, they who are already being ostracized by family. It can go badly, believe me. I won't want to go into examples but I could. That's why I got sick of certain activism, certain associations that pushes people into that situation. And I'm not going to paint all with that brush. What I'm saying is that there is such a thing as toxic activism: you can't blindly believe everyone is good people fighting the good cause. Sometimes they're there just to fill their pockets and feel important and influential, and will trade and sell influence for personal gain.

On the trans thing I've been detached, which is why I've mostly abstained from commenting here despite the multiple threads on it. Know some good people who were doing work in my country on it for decades, when it was not a fad (imho it is currently), when it was hard. Where it still is hard, with immigrants, prostitutes, the "bad people" who don't matter and no one should notice... that trans people were pushed into the very lowest rungs of society is something I know about. And that there are good people doing activism. But I've seem also opportunists jumping in in recent years to "trans activism". People I know personally to be opportunists. I'm relieved it's not an issue I'm having to deal with directly now. But wary, very much.
That is why I welcome breaks on this, this ruling in particular. Youth now seems to have extended into the 30s, the existential crisis of youth combined with a very unstructured society. That's another issue, a much larger issue, but it has consequences on this one. Waiting at least past the most volatile teenage years to start any reversible medical procedures (and as the case put it once started these things tend to be carried on) is from my view a good idea.

 

[Ajidica]

Gay lifestyle is the self-segregation encouraged primarily, now, by commercial interests. It started as a real segregation, that had to be fought against. That was the point or organizing! Now? It's going to gay (only in practice) bars, tourism to "gay spots", buying the "gay brands" of clothing, even doing "gay sports... all of which feed into commercial interests, which also just happen to be the ones that finance many of the surviving gay associations, which repay this support by promoting these businesses.

This may look harmless. It isn't. Being gay is still not easy. It till means, to too many people, bad relations with one's family, lack of support during youth. Into this world those people fall. Being gay is advertised to them as partying and spending time (and therefore money - in the right places to affirm themselves. Or to even be noticed. To "be gay". To not feel ostracized, they who are already being ostracized by family. It can go badly, believe me. I won't want to go into examples but I could. That's why I got sick of certain activism, certain associations that pushes people into that situation. And I'm not going to paint all with that brush. What I'm saying is that there is such a thing as toxic activism: you can't blindly believe everyone is good people fighting the good cause. Sometimes they're there just to fill their pockets and feel important and influential, and will trade and sell influence for personal gain.

Everyone is advertised to like that. Gay people, straight people, men, women, rednecks, coastal elites, hipsters, blacks, Hispanics, Asians; everyone is told by advertising that to affirm your existence, to be true to yourself, requires you to spend money and live certain ways.

 

[Senethro]

What is it with people disliking Thing A and disliking Thing B and drawing an extremely stupid line between them, as connection or causation.

 

[JohannaK]

Does anyone know how the process used to function beforehand?

I'd be shocked if people below the age of 15 or 16 could consent to the treatment without parental consent, and I would understand that in a toxic family environment it would be necessary to recourse to legality (ideally not a court of justice) to waive that consent. I don't think we have the information to say that this was at all a necessary step unless we fall for all the transphobic canards that Rowling et al. spouse and spout.

Notably, puberty blockers are NOT HRT. I have read trans arguments against puberty blockers because puberty after all is an event that factors into someone's socialization and it can be distressing to delay it past ones peers. However, puberty blockers do not have physiological long-term effects, unlike the irreversible changes that HRT does induce.

I think Bell's story is tragic, nobody should make this journey twice. However, I am appalled that she chose to blame her prescription at age 16 when she was making irreversible choices as an adult aged 20. If transgender people are rare (I happen to be the first transgender person most of my very queer friends even know), de-transitions are a lot rarer. I think those staff reports and the rate of clinicians leaving is concerning. They raise points that I don't know are valid or just spiteful but certainly are deserving of greater scrutiny. What seems necessary here is to conduct an investigation into how the centre operates rather than blanket banning minors from accessing as powerful a tool as hormone blockers.

Disphoria and transition are emotionally painful and distressing processes. Thank you for dismissing them as a 'fad' and a 'fashion'. Really. Thanks.

 

[innonimatu]

Everyone is advertised to like that. Gay people, straight people, men, women, rednecks, coastal elites, hipsters, blacks, Hispanics, Asians; everyone is told by advertising that to affirm your existence, to be true to yourself, requires you to spend money and live certain ways.

But at least they're not advertised that by purportedly non-profit associations whose purpose was to protect them This "be true to yourself" is, we both know, a technique commonly used by advertisers who are pushing something they want to sell as being necessary for that. A much larger issue as I admit.
Trying to go more on-topic, I fear that excessive pressure is being put on people to go early on a path they cannot easily deviate from later. And part of it, a rather sad irony to that given the current ideas, is also conflating biology with gender in this.

Disphoria and transition are emotionally painful and distressing processes. Thank you for dismissing them as a 'fad' and a 'fashion'. Really. Thanks.

I'm not denying that people have problems. I'm arguing that the current spike in a specific solution presented to that problem is a sign of a medical fashion, a fad. That caution is very much warranted because we've seen similar things come and go in the past, fully supported by medical groups that in a couple of decades switched opinion again.
I do suspect that it's not the best solution to many of those people. That there are young people being influenced to try this as they would be to try something else in any other time, and that the path towards changing sex is a rather radical move to push people into.
Do you feel that this case before the court was misconstructed somehow?

 

[GenMarshall]

Gay lifestyle is the self-segregation encouraged primarily, now, by commercial interests. It started as a real segregation, that had to be fought against. That was the point or organizing! Now? It's going to gay (only in practice) bars, tourism to "gay spots", buying the "gay brands" of clothing, even doing "gay sports... all of which feed into commercial interests, which also just happen to be the ones that finance many of the surviving gay associations, which repay this support by promoting these businesses.

My guess is that you’re largely against the commodification of the LGBT+ community. That’s the nature of the beast in a market economy. Though calling it “gay lifestyle” will earn you a bit of flak, especially on mostly left leaning boards.

 

[NinjaCow64]

1) Is there even any point in taking puberty blockers after 16?
2) What are those "long-term" consequences then?
3) The "pathway" argument seems exceptionally weak to me.

1) Nope
2) There doesn’t seem to be any serious side-effects that have been recorded (or at least serious enough to warrant this exceptional court ruling). Even if there were most under 16 year olds are allowed to have drugs with much more serious and credible side-effects (e.g Isotretinoin) without a court order.
3) That’s because it is.

 

[Ajidica]

But at least they're not advertised that by purportedly non-profit associations whose purpose was to protect them This "be true to yourself" is, we both know, a technique commonly used by advertisers who are pushing something they want to sell as being necessary for that. A much larger issue as I admit.

Maybe its a Euro-specific thing, but I'm not really following you.
I don't follow any LGBT groups on social media, so maybe I'm a bit out of it, but my understanding is that a lot of LGBT advocacy groups are trying to get rid of the "gay people are supposed to act in a certain way/look a certain way" Thing. Society by and large has gotten over its "ewww, icky gay stuff" reaction, but assuming that gay people should all be either fashion twinks, theater majors, or being generally hot and muscled isn't great for gay people's mental health either. Noting that people should be themselves, that they can dress, shop, and do what they like while still being gay is a good thing.

Trying to go more on-topic, I fear that excessive pressure is being put on people to go early on a path they cannot easily deviate from later. And part of it, a rather sad irony to that given the current ideas, is also conflating biology with gender in this.

I encourage you to read the Atlantic article I posted. That article, along with a number of companion pieces, go into great depth on the interaction between a minors agency and significant medical procedures.

 

[Zardnaar]

Beats me what's right but generally support the parents. It's their job basically.