Young people in England and Wales with gender dysphoria are being left “in limbo” and unable to access time-sensitive puberty blocker medication, VICE World News has been told.
A recent court ruling makes it clear that under-16s can receive time-sensitive puberty blocker medication with parental consent, but many are still not receiving treatment they are legally entitled to.
“We are in a position where a significant population of young people who are currently in the pathway [to transition] just simply don't know whether they're going to access the medication that they need,” Lui Asquith, director of legal and policy for youth trans charity Mermaids said. “It is leaving them completely on hold whilst the puberty, which is the reason they're being recommended for this treatment, is continuing to establish itself.”
In December 2020, the High Court in London banned the prescription of puberty blockers – a reversible treatment used to delay puberty – to under-16s unless sought through a court order. The case was bought by Keira Bell, a woman who detransitioned, and the mother of a trans child. At the time, charities and lawyers condemned the ruling, arguing it would have damaging ramifications for trans adolescents, who face a heightened risk of suicide and depression.
In March of this year, a ruling in the family court, however, said that under-16s were entitled to the referral of puberty blockers if they had parental consent. NHS England subsequently updated its guidance to state that, in light of the family court ruling, a new process would take place. Once parental consent is given along with clinical approval, the parent and child would need to be assessed by a panel or “review group” looking to confirm the decision-making process was “robust.”
But charities say that the ruling to allow access to puberty blockers with parental consent is in effect being ignored, as children are still waiting until the “review group” is in place.
“It's horrendous to watch and be part of and there's very little we can do while these people's families are in this limbo,” says Asquith. “For those people that have not been prescribed hormone blockers yet, or those that had but hadn't started them, they’ve essentially had the door closed on them.”
An NHS England spokesperson told VICE World News: “The Courts have underlined the need for increased and appropriate safeguarding on the use of what they define as experimental puberty blocker treatments, which the NHS is therefore ensuring."
Puberty blockers are a widely standardised form of treatment for gender dysphoria as well as other conditions such as precocious puberty, where puberty affects children too early.
Ellen, who spoke to VICE World News on the condition of anonymity, is the mother of a 12-year-old trans child who has been attending London’s Tavistock gender identity clinic for six years. In October 2020, Ellen and her daughter were told she would receive a referral for puberty blockers in the next couple of sessions, after an ongoing consultation and assessment with clinicians.
“I think what is on the top of many parents' minds when they've got a young trans person is I want my child to be alive, I want them to reach adulthood,” says Ellen. “I don't want them to get so distressed with their body and the fact that the system isn't supporting them, and they're not getting access to the right care, that they just think, what's the point?”
But despite parental consent, they are still unable to access the treatment.
“I think she really worries about going through male puberty,” says Ellen. “We know how many young trans people do try to self harm and commit suicide. I don't want [my daughter] to be a statistic.”