UK high-court rules under 16s can't take puberty blockers without court review and approval

[Doran754]

Yesterday the UK high court decided under 16's can't give informed consent about puberty blockers.

'Children under 16 with gender dysphoria are unlikely to be able to give informed consent to undergo treatment with puberty-blocking drugs, three High Court judges have ruled'

One of the claimants, Keira Bell, said she was "delighted" by the judgment.

Ms Bell, 23, from Cambridge, had been referred to the Tavistock Centre, which runs the UK's only gender-identity development service (GIDS), as a teenager and was prescribed puberty blockers aged 16.

She argued the clinic should have challenged her more over her decision to transition to a male as a teenager.

In a ruling, Dame Victoria Sharp, sitting with Lord Justice Lewis and Mrs Justice Lieven, said: "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."

At a High Court hearing in October, lawyers representing the claimants said there was "a very high likelihood" children who start taking hormone blockers will later begin taking cross-sex hormones, which they say cause "irreversible changes"

The NHS says It welcomes the clarity and will implement the decision immediately.

Thoughts? Personally I'm very happy with this decision. For once a legal decision isn't pandering and is looking out for the health and mental wellbeing of our children.

 

[Seliph]

Me and every other trans person I have spoken to has said they would do anything to get puberty blockers as soon as possible if they had the ability to when they were younger. Growing up and feeling the changes puberty imposes on your body against your will is a horrible experience for trans people, even traumatic, and puberty blockers are the best option to mitigate those unwanted changes. This is just another one of the UK's numerous attacks on the existence of trans people.

 

[Seliph]

-snip-

https://www.forbes.com/sites/jamiew...but-will-open-three-new-gics/?sh=7f255fdf12d3
https://www.stonewall.org.uk/system/files/lgbt_in_britain_-_trans_report_final.pdf
https://www.theguardian.com/society...gland-face-soul-destroying-wait-for-treatment
https://www.independent.co.uk/news/...s-reforms-theresa-may-diagnosis-a9565001.html
Plus the UK is home to one of the biggest anti-trans feminist movements, aka TERFs (Trans Exclusionary Radical Feminists)
https://www.nytimes.com/2019/02/07/opinion/terf-trans-women-britain.html

It is not very easy being trans in the UK. I am not from the UK myself but ask anyone publically trans in the UK and I think you'll find lots more info than I could ever give you.

 

[Deleted member 513667]

https://www.forbes.com/sites/jamiew...but-will-open-three-new-gics/?sh=7f255fdf12d3
https://www.stonewall.org.uk/system/files/lgbt_in_britain_-_trans_report_final.pdf
https://www.theguardian.com/society...gland-face-soul-destroying-wait-for-treatment

Plus the UK is home to one of the biggest anti-trans feminist movements, aka TERFs (Trans Exclusionary Radical Feminists)
https://www.nytimes.com/2019/02/07/opinion/terf-trans-women-britain.html

Thanks, i'll start reading them tonight!

It is not very easy being trans in the UK. I am not from the UK myself but ask anyone publically trans in the UK and I think you'll find lots more info than I could ever give you.

I do actually have a trans friend, i'll talk to them about it.

 

[DevonTheRaymaniac]

I'm not trans and I do not know any trans people personally, but what I can say is that I hope the best for transgender people, and that if this truly is a problem for the trans community, it gets sorted out as soon as possible

 

[Seliph]

I do actually have a trans friend, i'll talk to them about it.

That's good to hear!
Here's a Twitter thread from Jay Hulme, a trans poet from the UK that I think will be pretty enlightening.

The UK is so transphobic that at least one trans person has been granted asylum in a foreign country because of it.

They didn't just move (though many of us do), they were Granted Asylum.

— Jay Hulme (@JayHulmePoet) November 18, 2020

 

[AmandaRose]

I would say what you are saying is true for the rest of the UK but not in Scotland. The Scottish government does a heck of a lot for the trans community but yes they could do a bit more. We have very little incidents of transphobic abuse ect. Unlike when I travel to England and Wales where the amount of abuse is I see is shocking.

 

[Seliph]

I would say what you are saying is true for the rest of the UK but not in Scotland. The Scottish government does a heck of a lot for the trans community but yes they could do a bit more. We have very little incidents of transphobic abuse ect. Unlike when I travel to England and Wales where the amount of abuse is I see is shocking.

Oh! I didn't know that about Scotland, that's good to hear because I've always wanted to travel there.

 

[FAST6191]

For any medical test there are at least four outcomes (not two as some think)

1) Positive positive. Aka yes you have gonorrhoea and actually do.
2) Positive negative. Aka no you don't have gonorrhoea and actually you are clean.
3) False positive. Aka yes you have gonorrhoea but actually you are clean.
4) False negative. Aka no you don't have gonorrhoea but actually you do have it.

It gets marginally more complex for things like counts, levels and of course there are many other factors (a mass of 100kg is not much if you are a giant rugby player, an awful lot if you are a tiny woman that works in an office) that... it is almost like being a medic is considered a hard profession.

Some might take exception to the classification as a medical issue above but I would argue if you are taking serious big boy (or girl as the case may be) chemicals then you are within their purview, not to mention the maths underpinning it still applies. Others seem to opt for "but the numbers of false positives are low", which I may or may not want to question, but rolling with the assumption it is then you do get to ask the next question. Estimates are tricky here but if 1% of the population are transexual then 1% of 1% is still 6000 people (I later contemplate the nature of anecdotes would you wish someone a false positive any more than you would wish them death?). Or if there are 700000 people born per year (and no genetical, social* or environmental factors) these days then 7000 per year might be transexual and thus 70 per year false positive if 1% failure rate (which is good for a medical test, never mind a psychological one). Some also argue 1% is actually a low estimate of the population count as well which does not improve numbers here.

*there are those that would claim it is socially contagious (divorce, fatness, depression, smoking, desire to be autistic/Asperger's, desire to be a sociopath... many things nominally are). We can play with stats again if you want on how 7000 per year vs 17,000 state primary schools means the clusters (never mind urban-rural and FTM vs MTF variances) some have noted speak to either something in the water, massive under accounting/estimation of total counts, a localised genetic trait or potentially contagious psychology. I can leave that as an aside for now though.

Among medics there is also the principle of "first, do no harm".
For this we get to weigh the positives against the negatives.

What are the harms done if the person is false positive as transexual and later comes to regret the decision. If it can be reversed that is one thing but at the same time if you deny someone their formative years it is generally viewed as bad by psychologists. If it is hard (time, cost, end results obtained... there is a long list of considerations), if not impossible, to reverse then that is a whole different kettle of fish.
What are the harms in allowing such a person with positive positive to go through puberty? There are plenty of conditions that see people have to wait to adulthood to obtain medical treatment.
What are the positives to allowing a positive positive to get such treatment? There should be plenty of data on life satisfaction type metrics for those that did (late treatment, before availability, false negatives later corrected, simple opt out) to compare against. This can also include abilities to achieve "passing" type results, if indeed that is a desirable outcome (we might also get to consider FTM vs MTF in such a scenario too as things change quite radically there, both in numbers and results).
Are there any alternatives, need not be as "effective" (or effective in the case of positive positive). This can include additional counselling, milder chemicals to lessen puberty changes, chemicals to have people ignore or lessen effects of dysphoria until a later date (and side effects of those). Also any additional research to reduce false positives and negatives.

What those that say "they would have done anything" is worth taking into account (if nothing else an estimate for the black market size or extent by which seeking behaviour might occur), however you also risk variations on the theme of sunk cost fallacy, post hoc justification and similar such psychological traps. Or if you prefer the plural of anecdote is not data. It is a hard thing to assess but never the less we try.

This is also before we consider the actual claims of the case if indeed those supposed to be treating did railroad people (medics will be the first to tell you every cardiologist thinks it is a heart problem, every neurologist a brain, every surgeon wants to cut...) and did not due due diligence, or indeed if the current levels required to call it due diligence are in fact too lax (if "too many", and especially if too many clearly not edge cases, are slipping through the cracks then it hardly speaks to a robust system).

This is the sort of logic (and a massively simplified snapshot) the medics and legal people (which might well be medics in their own right, have not checked here though but quite often they do keep a bunch of them with domain expertise to do things) will be employing.
I would run that analysis before I make claims of bigotry, especially in a country wherein the transition itself might be paid for by the health service (one notoriously averse to anything optional which presumably means they consider it a valid thing to be doing), where not giving someone a job, loan, services, renting a place or similar on such a basis will get you a slap by the courts, and while I would consider the notion of "hate speech" laws to be ridiculous in the extreme (makes you an arsehole, does not make you a criminal) never the less features in such things.

 

[SG854]

Me and every other trans person I have spoken to has said they would do anything to get puberty blockers as soon as possible if they had the ability to when they were younger. Growing up and feeling the changes puberty imposes on your body against your will is a horrible experience for trans people, even traumatic, and puberty blockers are the best option to mitigate those unwanted changes. This is just another one of the UK's numerous attacks on the existence of trans people.

You should also speak to the number of people that thought they were trans but realized they are not once they got older. If you want a more complete non biased perspective.

Or better yet look at data instead of anecdotal evidence. Most desist once they get older and many turn out to be gay instead.

 

[AmandaRose]

while I would consider the notion of "hate speech" laws to be ridiculous in the extreme (makes you an arsehole, does not make you a criminal) never the less features in such things.

You really should research the damage verbal abuse can do to someone's mental wellbeing if you believe hate speech should not be legal.

You should also speak to the number of people that thought they were trans but realized they are not once they got older. If you want a more complete non biased perspective.

Or better yet look at data instead of anecdotal evidence. Most desist once they get older and many turn out to be gay instead.

Most actually don't detransition the number that do are less than 1%. And its mostly people in the early stages of transitioning.

https://www.google.com/amp/s/www.nbcnews.com/news/amp/ncna1102686


If fact just seen that A 2018 survey of WPATH (World Professional Association for Transgender Health) surgeons found that approximately 0.3% of patients who underwent transition-related surgery later requested detransition-related surgical care.

 

[FAST6191]

You really should research the damage verbal abuse can do to someone's mental wellbeing if you don't believe hate speech should not be illegal.

Maybe.
The trouble is it is almost completely arbitrary, unknowable beforehand, changing with time (even more so if people decide to invent workarounds, and they will) and varies between people from none other than wasted time to simple everyday word renders them in particular rocking in the corner (or maybe violent outburst).

To that end it is going to be incredibly hard to enforce, manage and predict, even if I did not go with the idea that free speech is not a better ideal to hold to than hoping someone's feelings did not get hurt.

Edit. As for detransition stats. Fractions of percent (never mind in the high tens) for populations of hundreds of thousands is a lot of people that are considerably troubled. Drugs have been withdrawn, treatments have been stopped, companies bankrupted and more besides over far less.

 

[AmandaRose]

Maybe.
The trouble is it is almost completely arbitrary, unknowable beforehand, changing with time (even more so if people decide to invent workarounds, and they will) and varies between people from none other than wasted time to simple everyday word renders them in particular rocking in the corner (or maybe violent outburst).

To that end it is going to be incredibly hard to enforce, manage and predict, even if I did not go with the idea that free speech is not a better ideal to hold to than hoping someone's feelings did not get hurt.

Its not that their feelings get hurt its the fact that it can cause mental damage to them. There is a shit load of research that shows verbal abuse is just as bad as physical abuse and that the damage lasts longer from verbal abuse. We are not a robots with no feelings that can simply say IT'S JUST WORDS.

 

[Ericthegreat]

Sorry but as a community as a whole weve decided there is an age to make your own decisions, unless we let people drink/smoke/sign a contract at earlier ages, I cant see children making any other decisions either.

--------------------- MERGED ---------------------------

For any medical test there are at least four outcomes (not two as some think)

1) Positive positive. Aka yes you have gonorrhoea and actually do.
2) Positive negative. Aka no you don't have gonorrhoea and actually you are clean.
3) False positive. Aka yes you have gonorrhoea but actually you are clean.
4) False negative. Aka no you don't have gonorrhoea but actually you do have it.

 

[DBlaze]

Personally i'm against anything that implies needing to take medication of any sort to force or block something that is supposed to be natural, unless you're curing a disease.
Take that as you like.

 

[FAST6191]

Its not that their feelings get hurt its the fact that it can cause mental damage to them. There is a shit load of research that shows verbal abuse is just as bad as physical abuse and that the damage lasts longer from verbal abuse. We are not a robots with no feelings that can simply say IT'S JUST WORDS.

And there are those that walk away more or less bored with the situation, and those that can't debate hard topics, and indeed those that might find their speech compelled (if we are staying vaguely on topic then should using the "wrong" pronouns be punishable by law?).

The easier solution then is some people are going to get hurt. Sucks but it happens. Is it not better to have those suffer a bit and instead be able to actually have a discussion?

 

[AmandaRose]

And there are those that walk away more or less bored with the situation, and those that can't debate hard topics, and indeed those that might find their speech compelled (if we are staying vaguely on topic then should using the "wrong" pronouns be punishable by law?).

The easier solution then is some people are going to get hurt. Sucks but it happens. Is it not better to have those suffer a bit and instead be able to actually have a discussion?

Important discussions can be had without the use of hate speech.

 

[BeniBel]

As a psychologist, who deals a lot with trans teens, I can only fully agree with this. No important or life-altering decision should actually be allowed under the age of 25, when the brain has fully developed. In my opinion, no child under the age of 16 can ever be able to trully understand the consequences of their actions, and should be protected against themselves.

It's not easy for teenagers dealing with congruence, but there are other courses of action that should be explored way before even talking about hormones therapy or surgery.

Speaking out of experience, often trans feelings have an underlying cause, that goes away once the root of the issue is tackled. Transition also rarely yields a positive outcome, and has a high chance of resulting in depression or even suicide.

 

[FAST6191]

Important discussions can be had without the use of hate speech.

Trouble is it is an arbitrary definition that varies between location, time and even group you are talking to.
Also do we make an exception for discussing the terms themselves? For jokes? For exceptions in jokes? For art?

Being arbitrary makes it difficult, if not impossible, to enforce, even more so if you allow a selectively permeable membrane.

 

[jimbo13]

The bigotry makes my soul hurt, I can think of no group more equipped to make life altering decisions and upend a natural human biological process using powerful hormone therapies than pre-pubescent minors. What could possibly go wrong?