Under-16s can take puberty blockers without parental consent, the Court of Appeal has ruled.
The Tavistock Trust, which runs the UK’s only youth gender identity clinic, filed the appeal.
The decision overturns a 2020 ruling that children under the age of 16 lacked the capacity to provide informed consent to the treatment, which delays the onset of puberty.
Keira Bell filed the original case, claiming that the clinic should have challenged her more about transitioning.
The Court of Appeal judges acknowledged “the difficulties and complexities” of the issue, but added that “it is for the clinicians to exercise their judgement knowing how important it is that consent is obtained properly according to the particular individual circumstances.”
Puberty blockers are drugs that “pause” puberty by suppressing hormone release.
They are given to some children who have gender dysphoria, which the NHS defines as “a feeling of unease caused by a mismatch between a person’s biological sex and their gender identity.”
The Tavistock Clinic applauded the decision.
“The decision upholds established legal principles that respect our clinicians’ ability to actively and thoughtfully engage with our patients in decisions about their care and futures,” a spokesperson said.
“It confirms that doctors, not judges, must decide on the capacity of under-16s to consent to medical treatment.”
According to the Tavistock Gender Identity Development Service (Gids), hormone treatment “allows a young person time to consider their options and continue to explore their developing gender identity before making decisions about irreversible forms of treatment.”
In December 2020, the High Court ruled that under-13s were “highly unlikely” to be able to give informed consent to what it called “experimental” treatment, and that those aged 14 and 15 had a “very doubtful” understanding of the implications.
Keira Bell, one of the case’s claimants, began using puberty blockers at the age of 16 after being referred to Gids.
She later regretted her decision to transition to a male, believing that there had not been enough investigation or therapy prior to that point.
Following the success of the Tavistock’s appeal, she stated that she would seek permission to take the case to the Supreme Court.
“I am obviously disappointed with the court’s decision today, particularly because it did not address the significant risk of harm that children face as a result of being given powerful experimental drugs,” she said.
Ms Bell went on to say that she had “no regrets” about bringing the case, which she described as “shining a light into the dark corners of a medical scandal that is harming children and harmed me.”
Separately, the court’s Family Division ruled in March that parents could give consent for under-16s to use puberty blockers, with other safeguards considered.
Following the rulings, the Tavistock temporarily halted new referrals to its endocrinology service.
Eligible under-16s with parental consent who have already been referred for treatment are having their cases reviewed by Gids, with decisions overseen by an independent NHS England review group.