Bell v Tavistock And Portman NHS Foundation Trust [2020] EWHC 3274 (Admin)

Competence/capacity and puberty blockers (1) The relevant information that a child would have to understand, retain and weigh up in order to have the requisite competence in relation to puberty blockers, would be as follows: (i) the immediate consequences of the treatment in physical and psychological terms; (ii) the fact that the vast majority of patients taking puberty blockers go on to cross-sex hormones and therefore that he or she is on a pathway to much greater medical interventions; (iii) the relationship between taking cross-sex hormones and subsequent surgery, with the implications of such surgery; (iv) the fact that cross-sex hormones may well lead to a loss of fertility; (v) the impact of cross-sex hormones on sexual function; (vi) the impact that taking this step on this treatment pathway may have on future and life-long relationships; (vii) the unknown physical consequences of taking PBs; and (viii) the fact that the evidence base for this treatment is as yet highly uncertain. (2) Gillick competence is treatment- and person-specific but the court gave clear guidance that it is highly unlikely that a child aged 13 or under, and very doubtful that a child aged 14 or 15, would ever be Gillick competent to give consent to being treated with puberty blockers. (3) There is a presumption that young people aged 16 or over have capacity to consent but, given the long-term and potentially irreversible consequences and the experimental nature of the treatment, clinicians may well consider that it is not appropriate to move to treatment such as puberty blockers or cross-sex hormones without the involvement of the court, and it would be appropriate to involve the court when there may be any doubt about long-term best interests.

CASES DATABASE

Full judgment: BAILII

Subject(s):

  • Medical treatment cases🔍

Date: 1/12/20🔍

Court: High Court (Administrative Court)🔍

Judge(s):

Parties:

  • Quincy Bell🔍
  • Mrs A🔍
  • Tavistock And Portman NHS Foundation Trust🔍
  • NHS England🔍
  • University College London Hospitals NHS Foundation Trust🔍
  • Leeds Teaching Hospitals NHS Trust🔍
  • Transgender Trend Ltd🔍

Citation number(s):

What links here:

Published: 3/12/20 22:16

Cached: 2021-01-18 09:37:32