The London Court of Appeal ruled on Friday that it is up to doctors to determine whether or not adolescents can agree to undergo puberty-blocking treatment before they begin a transition process to change their gender.
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British justice thus overturns a decision rendered on December 1 and criticized by associations for the defense of LGBT rights.
This judgment concluded that minors under 16 who want to start a transition process should only undergo treatment that blocks puberty if they understand the consequences, doubting that this is the case.
Understanding "the consequences"
Keira Bell, a 23-year-old woman who started taking puberty inhibitors at the age of 16 before going back in the process, has taken legal action against the Tavistock and Portman NHS Trust, a public body that operates the only gender identity change service for minors in the UK.
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At first instance, the High Court of London had ruled that children under 16 must understand "
the immediate and long-term consequences
" to be able to take a treatment blocking their puberty.
"
It is highly unlikely that a child aged 13 or under is competent to consent to the administration of puberty inhibitors
," the judges ruled, also expressing their doubts "
that a child aged 14 or 15 can understand and weigh the risks and long-term consequences
”of such treatment.
"
With regard to adolescents aged 16 and over, (...) there is a presumption that they have the capacity to consent to medical treatment
", added the first judges.
The establishment appealed and won on Friday.
The High Court cannot generalize
The Court of Appeal indeed considered that it was wrong that the judgment of first instance fixed such age limits and that it is up to the doctors to exercise their judgment to determine whether their patients are or not. able to give informed consent.
She said the High Court "
was unable to generalize about the ability of people of different ages to understand what is necessary for them to be able to consent to the administration of puberty blockers
."
The Tavistock and Portman NHS Trust praised the ruling on Friday, which upholds "
established judicial principles that respect the ability of our clinicians to actively and thoughtfully engage with our patients in decisions about their care and future
."
Complainant Keira Bell said she was "
surprised and disappointed
" by the decision.