Morning Call Quick and essential guide to domestic and global politics from the New Statesman's politics team. Sign up for The New Statesman’s newsletters Tick the boxes of the newsletters you would like to receive. The desire to help these distressed young people is entirely appropriate. Gender dysphoria commonly has its onset in childhood during adolescence it is associated with high levels of psychiatric morbidity – anxiety, depression, self-harm and suicide. That capacity is assessed by doctors, not courts. At issue is the 1985 legal precedent known as Gillick competence, which states that a child under 16 can consent to medical treatment if they are sufficiently mature to understand the issues and reach a decision. On 17 September 2021 the Court of Appeal quashed the High Court judgment and confirmed that the Tavistock had acted lawfully. Tavistock suspended new referrals for such drugs in minors.

The High Court judgment last December found that it was “highly unlikely” that a child under the age of 13 would be able to consent to such treatment, and “doubtful” that a 14- or 15-year-old could fully understand its implications, and further commented that doctors would probably want to seek authorisation from a court before prescribing to 16- and 17-year-olds. Bell believes she was insufficiently challenged by her doctors at Gids and in early 2020 joined a legal action that sought judicial review of the Tavistock’s use of puberty blockers. She went on to be prescribed testosterone to promote male characteristics including voice change and facial hair, and, aged 20, to have surgery to remove her breasts. Her story made national news because when she was 16 years old she was given puberty blockers (drugs that “pause” pubertal development) while under the care of the NHS’s only gender identity development service (Gids) for children, run by the Tavistock and Portman Trust. Keira Bell is one – a woman in her mid-twenties who had previously been transitioning to become a man. Nevertheless, there is a small minority who ultimately wish they hadn’t used hormones or undergone surgery to effect permanent bodily change. The data on adults who have undergone medical procedures to assist gender transition suggest the incidence of “transition regret” is lower – around 1 per cent. No one has changed their mind as a result but for every 100 such men, six or seven will ultimately regret the decision. When counselling men requesting vasectomy, I ask them to contemplate difficult scenarios: starting a new relationship having lost their partner, or what they would do were one of their children to die.

Puberty voice change