On Sept. 17, Britain’s Court of Appeal overturned a High Court decision to limit the use of puberty-blocking drugs for children. Kids under the age of 16 will now be allowed to take the drugs without parental consent.
Puberty-blocking drugs are aimed at preventing a child’s body from reaching a sexually reproductive state. Administered either as implants or injections, the drugs obstruct hormones that trigger changes of puberty like the growth of breast tissue, testes, and facial hair, as well as the onset of menstruation.
In the past, these drugs had mostly been used to treat medical conditions where a child’s body would mature early. However, in recent times, the drugs have been repurposed to serve kids who experience gender dysphoria, a situation where their gender identity does not align with their physical characteristics. The purpose of delaying puberty is to give the child and parents time to think about their future.
In Dec. 2020, the High Court had ruled that children under the age of 16 did not have the capacity to give informed consent for medical treatments that would delay puberty.
“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,” the High Court said.
The ruling came in a case led by two people against a National Health Service (NHS) trust that runs the country’s gender identity development service for kids. One of the claimants, 23-year-old Keira Bell, argued that the clinic should have challenged her decision to transition to a male.
“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,” Bell told the High Court last year. Bell said that her life would have been “very different” if the court ruling had come before she decided to take puberty blockers. She added that the ruling would “protect vulnerable young people.” As a result of her treatment, Bell does not have fully developed breasts and instead has increased body hair, a beard, and a deep voice. Her sexual and procreational functions have been affected.
This High Court decision was overturned by the Court of Appeal on Sept. 17. The judges said that the High Court was “not in a position to generalize” about a person’s capability to understand whether to take puberty blockers or not. The High Court was accused of issuing “inappropriate” guidance on the matter. The decision on whether a child is competent enough to consent to puberty blockers was thought to lie with clinicians rather than with the courts.
“The effect of the guidance was to require applications to the court in circumstances where the divisional court (a branch of the high court) itself had recognized that there was no legal obligation to do so. It placed patients, parents, and clinicians in a very difficult position… In practice the guidance would have the effect of denying treatment in many circumstances for want of resources to make such an application coupled with inevitable delay through court involvement,” the judges said.
Following the Court of Appeal’s ruling, Bell stated that she was “surprised and disappointed” by the decision. However, Bell does not regret bringing the case to court. “It has shone a light into the dark corners of a medical scandal that is harming children and harmed me,” Bell said. She plans on seeking permission to appeal the matter to the Supreme Court. Bell added that the medical service has become “politicized.”
Though activists claim that puberty blockers help children with gender dysphoria deal with stress and suicidal thoughts, research has warned of severe negative effects as a result of taking the drugs.
According to research from the Journal of the Endocrine Society (JES) that studied children taking puberty blockers for two months, the use of the drugs resulted in lower adult bone mineral content. Another study from Canada found that the drugs temporarily delayed fertility and vertical growth.