The puberty blocker ruling offers trans people hope

On Friday (17 September), a ruling that had prevented trans adolescents under-16 from accessing puberty blockers was overturned. The Bell v Tavistock ruling, which had come into effect in December of last year via the High Court, specifically targeted the NHS England Gender Identity Development Service (GIDS) and decreed that under-16s were unable to meaningfully consent to reversible puberty blockers. The ruling hinged on Keira Bell, who brought the case after taking puberty blockers at 16, living as a transgender man and later seeking to ‘detransition’.

Medical intervention for trans adolescents was effectively cut off overnight – new referrals to the clinic were paused and pre-existing patients thrown into uncertainty about whether they would still be given their ongoing medication. Trans adolescents would have to individually apply for court approval to access puberty blockers, a cruel and inhumane process for acquiring potentially life-saving medication.

While The Good Law Project won a case establishing that parents can consent on behalf of their trans children in March this year, the original Bell v Tavistock ruling remained an enormous blow to trans rights in England. Trans adolescents without supportive parents were still unable to access puberty blockers as the ruling did not deem trans youth ‘Gillick competent’, a legal criteria that allows under-16s to consent to treatment independent of their parents.

Last week, the ruling was finally completely overturned after an intervention led by trans charity Gendered Intelligence alongside Brook, The Endocrine Society and Liberty, backed by the legal expertise of The Good Law Project. The original ruling was deemed a transgression of the Gillick competence test and the appeal stated GIDS had not broken the law by prescribing puberty blockers to trans adolescents. Medical treatment for trans youths in England can now resume as normal, subject to NHS England guidelines.

The successful appeal was, rightly, celebrated across social media by trans people and allies as a much-needed win amidst an increasingly hostile and transphobic landscape in the UK. The appeal is not only good news for trans adolescents seeking healthcare, but also a spark of hope for trans people in the UK that we can fight transphobia and win.

In recent years the fight for trans liberation in the UK has often felt like an uphill battle. In 2018 the public consultation for Gender Recognition Act (GRA) reform, which proposed easier and cheaper routes for trans people to change the gender on their birth certificates, was met with open hostility from multiple mainstream media outlets. One research paper found that in 2018 alone The Times published 323 articles largely critical of transgender rights and lives, averaging nearly one article per day. After two years of delay, the government scrapped most of the proposed reforms in 2020.

More recently, Tory equalities minister Kemi Badenoch has been criticised for calling trans women ‘men’ in a leaked audio recording, while Labour MP Rosie Duffield lashed out against GRA reform and referred to trans women as ‘male-bodied biological men’ on Twitter. In a 2020 study conducted by LGBT+ anti-violence charity GALOP, 93 per cent of trans respondents stated that they had experienced transphobia in the previous twelve months and 81 per cent reported they had experienced a transphobic hate crime. Meanwhile, a 2021 Freedom of Information request revealed the current wait time for an initial appointment at the UK’s leading NHS Gender Identity Clinic currently stands at 106 weeks, or just over two years. Trans life in the UK is still marked by inequality and violence, whether from the halls of parliament, transphobic street harassment, or medical neglect.

Amidst this, the success of the trans-led appeal against the Bell v Tavistock ruling comes as welcome good news that, I hope, signals a pushback against entrenched English transphobia. While true trans liberation cannot be achieved without abolishing capitalism, there are immediate actions which, if taken, would drastically improve trans life in the UK that we must continue fighting for. We must push for an informed consent model of trans healthcare where any trans adult can access hormone therapy with no psychiatric gatekeeping, in line with Australia and parts of the USA. We must also demand a radical overhaul of GIDS, ensuring they no longer pathologise trans youths and expand their services to see the thousands of young people waiting for a first appointment.

This work has already begun – gender services such as TransPlus in London, Indigo Gender in Manchester and CMAGIC in Merseyside are trialling holistic transition care outside of the traditional gender clinic model. In Scotland, the new policy coalition between Scottish Greens and SNP includes a complete reform of Scottish trans healthcare and the GRA. The repeal of the Bell v Tavistock ruling is another encouraging sign that significant trans healthcare reform is within our reach but we must keep pushing. 

The fight for trans liberation is not linear nor a guaranteed victory, and is reliant on trans people and cisgender allies working in coalition against those who would divide us. Overturning the Bell v Tavistock ruling is a cause for celebration and a brief moment of respite amidst often brutally transphobic conditions in the UK. We must, however, keep demanding radical trans healthcare reforms that depathologise and expand access to medical transition for both trans adults and adolescents alike. 

To support transgender children and adolescents, please consider donating to Gendered Intelligence.

Follow Robin Craig on Twitter.

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