Monday, 07 December 2020

A quick guide to the Keisha Bell verdict in the UK and the effect on Families supported by the Gender Centre.

A quick guide to the Keisha Bell verdict in the UK and the effect on Families supported by the Gender Centre.

Last week the UK High Court passed down its verdict on Bell vs Tavistock and the coverage has been international. 

To summarise, the case was brought before the UK High Court by Kiera Bell, 23, a woman who had recently de-transitioned after having been referred to the UK Tavistock gender clinic at age 15. Kiera’s lawyers set out to challenge whether a child under 16 is capable to consent to gender affirming treatment (specifically the administration of stage one and two, puberty blockers and hormones respectively). Kiera argued that in hindsight at 15 she had not been capable of making such a life-changing decision around treatment and should have been challenged more by her doctors and counsellors.

The ruling was critical of Tavistock and the court was unconvinced that a child under 16 could give informed consent to such treatment, ‘doubtful’ that a 14 or 15 year old could and highly unlikely that a 13 year old might be competent to understand the nature of the treatment.  The Court expressed concerns about limited evidence for the medical treatment of gender dysphoria, and in its conclusion reached the decision that stage one and two treatment were ‘experimental’ and unlike any other forms of medical treatment. 

However, there are some important things to understand about the Australian standards of care when it comes to treating trans and gender diverse young people. Firstly, the Australian Family Court in its recent re:Imogen ruling accepted that the way transgender and gender diverse children and young people are given treatment in Australia (see: The Australian Standards) is the ‘orthodox middle ground’ and currently accepted by the majority of Australian Medical Professionals.

The Australian Family Court ruling reaffirmed that anyone under the age of 18 seeking stage 1 or 2 treatment can only do so with consent from their parents and from their specialising doctor and psychologist/psychiatrist. If there is any controversy, i.e. if parents are not in agreement, the Australian Family Court is required to decide whether a young person is able to undertake treatment.

This is a significant difference from the approach that the UK Gender Clinic, Tavistock took. Tavistock’s practice was to assess each child on their own competency including children as young as 11 or 12.  However, Tavistock could not produce any records in support of of their decision making process and therefore lost one of the most significant means they had to back their claims about competency of children under 16.

One of the most distressing and ill-considered aspects of this ruling is that the 160 children under the age of 16 who are currently prescribed stage one and stage two treatment are no longer unable to continue treatment, effective immediately. The mental health ramifications of the sudden withdrawal of treatment to vulnerable children is a shocking oversight. 

It should be clarified that the High Court that delivered this ruling will almost certainly be appealed.

The Gender Centre does not administer hormones and is not a medical service, nor do we give legal or medical advice. As a service we offer counselling and casework services for families of trans gender and diverse children and young people.