Consent to Treatment for Transgender Youth: The Next Chapter – Bell & Anor v The Tavistock and Portman NHS Foundation Trust & Ors
Published date | 01 January 2023 |
Author | Hillary Chua |
Date | 01 January 2023 |
DOI | http://doi.org/10.1111/1468-2230.12734 |
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Modern Law Review
DOI:10.1111/1468-2230.12734
CASES
Consent to Treatment for Transgender Youth: The
Next Chapter – Bell & Anor vThe Tavistock and Portman
NHS Foundation Trust & Ors
Hillary Chua∗
In September 2021, the Court of Appeal reversed the controversial decision of Quincy Bell v
Tavistock and Portman NHS Trust in a victory for transgender r ights. At rst instance, the Divi-
sional Court had set a high legal threshold for transgender children to attain Gillick competence
to consent to treatment with puberty blockers – eectively restricting access to treatment for
many. On appeal,the Court of Appeal held that children are capable in law of giving valid con-
sent to treatment for gender dysphoria, and court authorisation would not be routinely required
before children could access such treatment.This note consider s the implications of the Court
of Appeal decision for the law on minors and consent to medical treatment in the transgender
health context.
In December 2020, Keira Bell succeeded in challenging through judicial
review, the practice of the Tavistock and Portman NHS Foundation of
referring young patients with gender dysphoria for treatment with puberty-
blocking drugs to supress the onset of puberty.This practice was conducted via
the Tavistock’s Gender Identity Development Service (GIDS). For Keira, the
matter was personal: as a teenager, she had identied as transgender and was
referred for treatment with puberty blockers (PBs) by the GIDS. Consequently,
she underwent medical transition to male through testosterone shots and a
double-mastectomy.1As an adult, she regretted her actions and ‘detransitioned’
back to female.2In her own words: ‘I was treated like an experiment’ and ‘I
want the message of cases like mine to help protect other kids from taking a
mistaken path’.3Her evidence that PBs were ‘exper imental’ was accepted by
the Divisional Court, which ruled that children under 16 are unlikely to be
∗Sheridan Fellow,Faculty of Law,National University of Singapore.I would like to thank the anony-
mous referee for comments. I am also grateful to Marcus Teo, Associate Professor Tracey Evans Chan
and Professor David Tan for their comments on an earlier draft. Unless otherwise stated,all URLs
were last accessed 26 October 2021.
1R (on the application of) Quincy Bell and A vTavistock and Portman NHS Trust and others [2020]
2ibid at [83].
3 K. Bell, ‘Keira Bell: My Stor y’ Persuasion 7 April 2021 at https://www.persuasion.community/
p/keira-bell-my-story.
© 2022 The Author.The Modern Law Review © 2022 The Modern Law Review Limited. (2023)86(1) MLR 214–225
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