Court rules against puberty blockers for trans youth in “catastrophic” decision

: A supporter holds a sign that says "Support Trans Youth"
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Three judges on the U.K.’s High Court just ruled that transgender young people cannot get puberty blockers – even if their doctor prescribes them – without a court order, effectively blocking the life-saving medication from many people who will need it.

“It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers,” wrote Dame Victoria Sharp in the ruling. “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.”

Related: Puberty blockers reduce suicidal thoughts in trans people. Republicans want to ban them.

Puberty blockers are a hormonal treatment that delays the onset of puberty – and therefore secondary sex characteristics – so that transgender youth and their parents and doctors can have more time to decide on an appropriate medical treatment.

The American Academy of Pediatrics issued a policy statement in 2018 that affirmed the use of puberty blockers as part of a care model for young people with gender dysphoria. A study published earlier this year found that transgender people who wanted puberty blockers and got them were far less likely to have suicidal thoughts later on in life than transgender people who wanted them but didn’t get them.

Sharp, along with Lord Justice Lewis and Mrs. Justice Lieven, ruled that puberty blockers are “innovative and experimental” and said that doctors who want to prescribe them will need to get a court’s approval.

The case was brought by several plaintiffs, including the mother of a 15-year-old transgender boy who doesn’t want her son to transition.

“My fear is – it’s not that [he] transitions – it’s that [he] gets it wrong,” the mother told the BBC.

The other plaintiff is a 23-year-old woman who said that she took puberty blockers as a minor but then later “de-transitioned.”

Part of their claim is that “a very high proportion” of minors who are prescribed puberty blockers undergo hormone replacement therapy later on as adults. To most people, it’s the entirely unremarkable result of the fact that transgender children grow up and become transgender adults, but the High Court appeared to interpret this as an effect of puberty blockers themselves.

“Thus, so it is said, it is possible for a young person to come off the [puberty blockers] at any point and not proceed to taking [hormone replacement therapy]. On one view, this is correct,” the decision says. “However, the evidence that we have on this issue clearly shows that practically all children/young people who start [puberty blockers] progress on to [hormone replacement therapy].”

The court also said that while there isn’t evidence that puberty blockers are harmful, there is still a chance that “missed development and experience, during adolescence, can never be truly be recovered or ‘reversed.'” The decision did not consider how irreversible the effects of puberty are.

“The trust is disappointed by today’s judgment and we understand that the outcome is likely to cause anxiety for patients and their families,” said a spokesperson for the Tavistock and Portman NHS trust, the health care organization that was named as defendants in the lawsuit, adding that they will try to appeal the ruling.

“Our first duty is to our patients, particularly those currently receiving hormone blocking treatment.”

“It’s frankly a potential catastrophe for trans young people across the country and it cannot be exaggerated the impact that this might have, not only on the population of trans young people that require hormone blockers, but it may potentially open the floodgates towards other questions around bodily autonomy and who has the right to govern their own body,” Lui Asquith of the trans youth organization Mermaids told The Guardian.

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