Keira Bell: The High Court hands down a historic judgment to protect vulnerable children

Keira Bell

In a landmark judgment that will have repercussions around the world the High Court today ruled that puberty blockers and cross-sex hormones are experimental treatments which cannot be given to children in most cases without application to the court.

We are delighted that the High Court has handed down judgment to protect children from experimental medical interventions with serious known and unknown risks and lifelong consequences.

The judgment concluded that it is highly unlikely that a child aged 13 or under would ever be Gillick competent to give consent to being treated with puberty blockers and very doubtful that children aged 14 and 15 could understand the long-term risks and consequences of treatment in such a way as to have sufficient understanding to give consent.

The court also ruled that it would be appropriate for clinicians to involve the court in any case where there may be any doubt as to whether the long-term interests of a 16 or 17 year-old would be served by the clinical interventions of blockers and hormones.

The judgment is vindication for Sue Evans who instigated the case and first raised concerns at the GIDS over fifteen years ago. It is testament to the courage of the claimants, Mrs A and Keira Bell who, through her public testimony, has changed history.

In her witness statement, Keira Bell said

“I made a brash decision as a teenager, (as a lot of teenagers do) trying to find confidence and happiness, except now the rest of my life will be negatively affected.”

Through her court action, Keira Bell has ensured that other troubled teenagers will now be protected from the harmful consequences she has had to face.

In a lengthy summing-up of the evidence that was heard in court on October 7th and 8th, the judges reflected many of our concerns about the experimental medical treatment for children with gender dysphoria in the absence of a robust evidence base.

Transgender Trend intervened in this case particularly on the issue of the recent unprecedented rise in the referral rate of teenage girls and the specific cultural context within which the most vulnerable young people are now suddenly adopting a transgender identity. We are delighted that the judgment reflected some of the concerns we raised in our intervention about the failure of the Tavistock GIDS to ground medical intervention in evidence and objective science.

In our intervention, we submitted evidence that the GIDS operates within a core illogicality: a belief that biological sex is irrelevant to being a boy or being a girl, while providing a service that is predicated on the existence of, and ability to define, a ‘boy body’ and a ‘girl body’ that children might move between through medication and subsequent surgery. This is of course an impossibility, but it is an outcome that children are led to believe is possible.

We submitted that the service colludes in beliefs that depend on the rejection of biological facts, giving greater weight to a subjective, self-declared identity over the material fact of biological sex, and operates from within the same culture of unreality that has influenced the young people being referred. On this basis we submitted that the GIDS is not competent to safeguard the bodily autonomy and integrity of adolescents who arrive at the clinic fully conditioned in gender theory and eager for the medical interventions they have been told they need.

The court judgment referenced the fact that in 2011 the gender split was roughly 50/50 between natal girls and boys but by 2019 the sex ratio had changed so that 76 per cent of referrals were females, but that the Tavistock did not put forward any clinical explanation as to why there had been this significant change in the patient group over a relatively short period of time.

This is not surprising: denial of biological sex prevents analysis on the basis of biological sex, including the specific experiences and pressures faced by female adolescents as compared to males. The lack of curiosity at the GIDS is easily explained if children are viewed through the dehumanising lens of ‘gender identity’. This also explains the apparent lack of concern about the serious physical effects of this treatment: if biological sex is irrelevant then future sexual function and fertility must also be unimportant.

The judgment is a damning indictment of clinical practice at the GIDS. The case was decided on facts and evidence known to the Tavistock, and ultimately on the lack of facts and the weakness of the evidence in the Tavistock’s defence. The GIDS lacked even basic data on children who had been given puberty blockers. In the court judgment the judges expressed ‘surprise’ in the following areas:

  • In respect of the ages of children treated with puberty blockers between 2011 and 2020, the data has not been collated for each year.
  • In respect of the number or proportion of young people referred by GIDS for puberty blockers who had a diagnosis of ASD or any other mental health diagnosis, the data has not been collated and there has been a lack of investigation or analysis.
  • In respect of the proportion of those on puberty blockers who progress to cross-sex hormones there is no data available, even for those who commence cross-sex hormones within the GIDS itself. Children were not tracked into adult services.

The GIDS puberty blocker ‘trial’ did not even track outcomes.

The judgment handed down today has established the salient facts about puberty blockers and cross-sex hormones:

  • Puberty blockers are not ‘fully reversible’.
  • Puberty blockers do not ‘buy time’, they are the first stage of a medical pathway very few children come off.
  • There is no evidence that puberty blockers alleviate distress.
  • The pathway of blockers and cross-sex hormones has serious physical consequences, including the loss of fertility and full sexual function, with profound long-term risks and consequences.
  • The treatment is experimental.

The most damning evidence of complacency in the service is the fact that the GIDS offers troubled adolescents no alternative therapeutic treatment pathway. Far from being a last resort treatment, blockers and hormones are the only treatment for children with complex histories and mental health conditions. This is the result of a service that operates on the basis of ideology in place of clinical standards. The judgment raises the issue of medical negligence and our immediate concern is for the children who have already been through this medical system.

This case has shone a light on the worst and most unforgivable result of the institutional capture throughout society by the gender lobby: the medical experiment on children’s healthy bodies, with serious irreversible and lifelong consequences.

The judgment is also vindication of Transgender Trend and our work over five years to raise awareness and facilitate open debate about the very issues this court hearing was about. It is a judgment that raises serious questions not only about the Tavistock’s service, but about the transgender lobby groups that have influenced the NHS and pressured the Tavistock into providing these treatments for children at ever younger ages.

In response to our application to intervene we were instructed by the court to submit our full witness statement and evidence which had to be helpful to the court, relevant to the case and had not already been presented in any witness statements. Stonewall and Mermaids also applied to intervene and were similarly instructed. The court granted Transgender Trend permission to intervene on the basis that we had introduced new evidence that was potentially relevant to the case. The submissions from both Stonewall and Mermaids were judged on exactly the same grounds, and they were refused permission on the basis that they had either repeated evidence already before the court in witness statements, or that the evidence they submitted was irrelevant to the case. The evidence presented by Stonewall and Mermaids focused on issues such as bullying, hate crime and the human rights of the ‘transgender child’ to an identity; in other words, the activist rhetoric we are used to hearing from such groups.

The difference between our submissions was that our evidence was based on reality and facts, whereas the submissions from Stonewall and Mermaids were based on a political and ideological view of children as ‘transgender’. The most striking aspect of the court case was the complete absence of ideology and ideological language. Nobody claimed that some children have a ‘gender identity’ that doesn’t match the sex they were ‘assigned at birth’ to justify the use of blockers and hormones. In the absence of the ideology, the justification for this treatment falls apart. It was revealed that in the real world, there is no justification for serious medical intervention on children’s healthy bodies.

This raises serious issues about why these lobby groups have been allowed to influence our health service so radically, causing harm to so many children. The Tavistock and Portman NHS Trust is a Stonewall Diversity Champion, as is the Care Quality Commission who judged the Tavistock service ‘good’. A senior clinician at the GIDS was a member of Gendered Intelligence, a lobby group the GIDS has worked with. GIRES has produced training resources for the Royal College of General Practitioners. All these groups promote the ideology of ‘gender identity’, none are qualified doctors or clinicians.

On the basis of the landmark judgment handed down in court today, the government needs to take action to remove all transgender guidance and resources from schools and social services departments to safeguard children and prevent any further teaching of this ideology to children as ‘fact’. The Health Secretary must take steps to curb the influence of these lobby groups and eliminate ideology from medical theory and practice. Government departments, health bodies and schools must cancel their membership of the Stonewall Diversity Champions scheme.

Proper therapeutic pathways need to be developed within a psychoanalytical model that can be delivered by professionals already trained in counselling troubled young people. Children must be treated as children, not as political mascots for an ideology. ‘Gender identity’ must be removed from the Memorandum of Understanding on Conversion Therapy, and therapists and counsellors must be given back their freedom to do their jobs properly and offer children a normal duty of care.

The judgment today is a watershed moment. As a society we must ask ourselves how we allowed this to happen. The threats, bullying and the silencing of alternative views must stop here.

Today the right judgment has been handed down in the High Court. But we should never have had to learn about the dangers of institutional capture in this way.

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