Analysis

UK court ruling on trans children’s care puts bigotry before science

The United Kingdom High Court has issued a new ruling barring transgender children in England and Wales under 16 years of age from taking puberty blockers or beginning hormone replacement therapy without the explicit permission of a judge. The ruling contradicts years of established medical practice by the National Health Service that had allowed trans children to access life-saving medical care. The decision is likely to be appealed by the Supreme Court.

The lawsuit was brought against Tavistock and Portman NHS Trust, the only clinic in the NHS to provide the service to transgender children. The NHS offered the program under the rules of informed consent, by which a patient is educated about the likely and potential outcomes of a procedure before beginning it, and does not require an outside referral to do so.

The court ruled it is “highly unlikely” a 13-year-old could give informed consent before taking puberty blockers and that it is “doubtful” a 14 or 15-year-old could. For no other procedure that children undergo is this issue called into question, but now the British state has decided to do so for an easily reversible treatment that could have life-altering consequences if denied.

The court’s decision contradicts established medical practice and imposes a transphobic ideology on some of society’s most vulnerable members.

John McKendrick QC, barrister for University College London Hospitals NHS Trust, told the High Court that “The whole purpose of NHS England commissioning this service is to reduce the suicidal ideation and distress caused by gender dysphoria in young people, and that has been achieved. We are treating distressed and vulnerable young people.”

Studies have shown that trans kids who don’t receive gender-affirming care have extremely high rates of attempted suicide — as high as 51 percent for teenage trans boys — but receiving gender-affirming care lowers this possibility dramatically.

The lawyers who brought the case argued that there was “a very high likelihood” that once children start hormone blockers, they will later go on to hormone replacement therapy, which they claimed would cause “irreversible changes.”

On the contrary, Tavistock’s lawyers noted that puberty blockers are widely deemed safe, reversible and medically necessary.

A 2019 study by the Minnesota-based Mayo Clinic noted that taking puberty blockers “doesn’t cause permanent changes in an adolescent’s body. Instead, it pauses puberty, providing time to determine if a child’s gender identity is long lasting. It also gives children and their families time to think about or plan for the psychological, medical, developmental, social and legal issues ahead. If an adolescent child stops taking [the puberty blockers], puberty will resume.”

Where the court finds fault in the original NHS policies is where proof of the court’s error is strongest. If most children who choose reversible puberty blockers later go on to take hormones to support a more permanent transition — instead of returning to the puberty they would have otherwise experienced — then that means such children were right in their initial judgment.

The court has decided it’s better to force trans children to go through a puberty they don’t want than to temporarily postpone puberty for questioning children before resuming the original developmental trajectory. The reasoning is based on an assumption of cisgender as the default and transgender as an exceptional aberration, instead of another, equally valid way of being human.

Across the United States, conservatives have introduced bills with nearly identical aims. As Liberation News has reported, these attacks are an attempt to divide the working class against itself by casting children as the victims of trans people. Instead, we must realize that trans people are highly oppressed members of the working class who deserve our full solidarity.

The oppressive underpinnings of the court’s logic become clear when you consider that in neither the UK nor the U.S. do these measures seek to end “corrective” surgeries on intersex children, who were not born with the supposed “correct” genitala for their birth-assigned sex. Such surgeries attempt to force children into gender roles based on reproductive ability — the very core of patriarchy’s oppression of women.

The UK High Court isn’t protecting children from their own lack of clarity about their identity or from meddlesome doctors pushing some kind of “trans agenda” on children — it’s intervening in the practice of medicine to appease reactionary constituencies. 

The path to trans liberation requires the abolition of patriarchy, which can only happen under socialism, when society is reorganized to prioritize human needs, including medical needs. Working and oppressed people must unite in defense of trans rights wherever they come under attack.

Feature photo: Tim Eytan, Creative Commons license.

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