Court verdict on puberty blockers won't affect Scottish children

The only clinic in Scotland that can prescribe puberty blockers to children who are gender dysphoric will not change its protocols in the wake of a landmark court judgement in England that ruled children under 16 were not mature enough to give informed consent.

The successful legal challenge by Keira Bell against the Tavistock and Portman NHS Trust on the prescribing of puberty blockers will not affect the Scottish clinic which deals with gender dysphoric children.

The Sandyford Sexual Health Clinic, part of NHS Greater Glasgow and Clyde, is the only gender service for children and young people and has seen referrals rise significantly in recent years.

However, it has said it will not be reviewing its services for children after the successful legal challenge of Keira Bell against the Tavistock and Portman NHS trust in London.

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Ms Bell, a 23-year-old woman, began taking puberty blockers when she was 16, before moving on to cross-hormone drugs including testosterone and ultimately surgery, before she detransitioned.

An unnamed mother of a 15-year-old autistic girl who is on the waiting list for treatment was also involved in the case against the clinic.

Ms Bell claimed she was not able to give proper consent to the treatment at such a young age and was not offered any psychological help by the clinic before being put on a drug regime.

On Tuesday the High Court in London ruled that children under the age of 16 considering gender reassignment are unlikely to be mature enough to give informed consent to be prescribed puberty blocking medication.

In a 19-page decision, the judges also ruled that even in cases involving teenagers under 18, doctors may need to consult the courts for authorisation for medical intervention.

As a result of the judgement the Tavistock clinic immediately suspended new referrals for puberty blockers and cross-sex hormones for under-16s, and launched a wider review on the future of gender identity services.

The Tavistock deals with cases referred to it from across England and Wales.

Until 2011, puberty blockers were only available at its Gender Identity Development Service for those aged 16 or older. Last year of 161 children referred, three were aged ten or 11 and 95 under the age of 16.

At Sandyford it was revealed last year that referrals of children aged between four and ten rose by more than 80 per cent on the previous year, while across all age categories the number rose to 298 in 2018. The waiting time to see a specialist, which was 18 months last September, now stretches to two years.

However, the ruling in England will not affect the Sandyford clinic.

A spokesperson for NHS Glasgow and Greater Clyde said: “The service is staffed by a multi-disciplinary team offering assessment and diagnosis of gender dysphoria. The service works closely with colleagues in paediatric endocrinology services and will refer patients if it is indicated as part of the patient’s care plan and following a full assessment.

“Young people are considered for puberty blockers following a thorough psychological and endocrine assessment as per Scottish clinical guidelines. Anyone who commences puberty blockers continues to receive regular psychological review and support appointments.

“We do not accept referrals from patients in England.”

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