Bell & anr (claimant/resp) –v- The Tavistock and Portman NHS Trust (def/appellant)

Wednesday 23rd – Thursday 24th June 2021

This is an appeal against the Order of the President of Queen’s Bench Division, Lewis LJ and Lieven J (1/12/20).

The claim for judicial review was of the practice of the Tavistock and Portman NHS Foundation Trust, through its Gender Identity Development Service of prescribing puberty-suppressing drugs to persons under the age of 18 who experience gender dysphoria.

The Court declared that the relevant information that a child under the age of 16 would have to understand, retain and weigh up in order to have competence to consent to the administration of puberty blocking (PB) drugs is set out at para. 138 of the judgment: (i) the immediate consequences of the treatment in physical and psychological terms; (ii) the fact that the vast majority of patients taking PBs go on to CSH (cross-sex hormones) and therefore that they are on a pathway to much greater medical interventions; (iii) the relationship between taking CSH and subsequent surgery, with the implications of such surgery; (iv) the fact that CSH may well lead to a loss of fertility; (v) the impact of CSH on sexual function; (vi) the impact that taking this step on this treatment pathway may have on future and life-long relationships; (vii) the unknown physical consequences of taking PBs; and (viii) the fact that the evidence base for this treatment is as yet highly uncertain.

Lower Court Judgment:

https://www.bailii.org/ew/cases/EWHC/Admin/2020/3274.html

View hearing:

Day 1

Part 1

Part 2

Day 2

Part 1

Part 2