Minors’ Capacity to Consent to Puberty Suppressing Treatment

Though not all transgender people wish for medical treatment to affirm their gender, for those who do, there are several ‘stages’ of treatment which might be appropriate. The first stage, which is only effective for children and young people who have yet to go through the puberty of their sex assigned at birth, is the administration of hormone treatment to suppress puberty. The second stage is the administration of hormones which align with the person’s gender identity, and the third stage includes any surgical treatment aimed at affirming the person’s gender. In December 2020, the Divisional Court made a declaration in Bell v The Tavistock and Portman NHS Foundation Trust which made signifi cant changes to the practice of prescribing puberty blockers to minors experiencing gender dysphoria, a condition where the person’s sex assigned at birth does not match with their gender identity. In September 2021, the Court of Appeal allowed an appeal against the declaration and found that the claim for judicial review should have been dismissed (the Bell appeal). Questions about whether, and in what circumstances, minors and their parents can consent to gender affirming treatment (including puberty blockers) have been extensively litigated in Australian courts over the past two decades. However, prior to Bell, these issues had not previously been the subject of litigation in the United Kingdom.