Bell v Tavistock

In October 2019, a legal claim (a request for judicial review) was lodged against the NHS Gender Identity Development Service (GIDS) at its satellite site in Leeds. The suit was brought by "Mrs. A", the mother of a 15-year-old patient on the GIDS waiting list, and Sue Evans, a former nurse at the Leeds GIDS satellite site. It alleged that advice around hormone therapy was "potentially misleading" and that true informed consent could not be given under such circumstances. The suit described hormone therapy as "experimental" and stated that there was "robust evidence" to show long-lasting medical effects of hormone therapy. Bell (referred to in court documents as Quincy Bell) began puberty blockers when she was 16, 1 year and 9 months after being referred to GIDS, with the hope of progressing on to testosterone later – which she did at 17. At age 20 Bell had a double mastectomy. In 2019, when she was 22, she stopped taking testosterone. Bell describes regretting her transition. == High Court judgment ==

In the judgment delivered on 1 December 2020, which has now been overturned on appeal, the judges said that it was highly unlikely that a child aged 13 or under would be competent enough to give consent to puberty blockers, and that it was doubtful that 14 or 15 year olds could understand the long-term risks and consequences associated with them. The Court said (126) "Where the decision is significant and life changing then there is a greater onus to ensure that the child understands and is able to weigh the information" and concluded: {{Blockquote| {{Ordered list|start=151 == Reactions to the High Court judgment ==

A spokesperson for the Tavistock and Portman NHS Foundation Trust (the defendant in the suit) said it was disappointed in the decision and intended to appeal. Bell, one of the claimants, expressed approval of the judgment. The UK human rights groups Amnesty International UK and Liberty issued a joint statement expressing disappointment in the judgment and concern "not only for what this means for the health and well-being of trans young people, but the wider implications this will have on the rights of children and young people of all genders, particularly on consent and bodily autonomy." Mermaids, a UK charity for gender-variant and trans youth, described the ruling as a "potentially devastating blow to trans under-16s", and a "betrayal of trans young people". and that even care for patients over the age of 16 was being affected. Stonewall, Mermaids, and Gendered Intelligence conducted an online survey of over 200 parents whose children were being seen at Tavistock, on the waiting list, or considering a referral to gauge their responses to the ruling. They found that it negatively impacted mental health and education experiences. More than two thirds of respondents said they were likely to pursue other less secure pathways to treatment. The World Professional Association for Transgender Health and European, Asian, Australian, Aotorean, United States, and Canadian Professional Associations for Transgender Health released a statement in response to the ruling that "We are gravely concerned that the ruling will have a significantly adverse impact upon gender diverse youth and their families by imposing barriers to care that are costly, needlessly intimidating, and inherently discriminatory" and recommended "that capacity to consent is evaluated on a case-by-case basis by the treating clinician and not by a court of law." Sandra Duffy, writing in Irish Legal News said "Through the declaration and guidance issued in the [High Court] judgment, it set a near-impossibly high standard for competence to consent, including a requirement to understand the effects of cross-sex hormones – a treatment which is only prescribed to adults." == Appeal ==

Leave to appeal against the decision of the High Court was granted in January 2021. The appeal was heard on 23 and 24 June 2021 by Lord Burnett of Maldon (Lord Chief Justice), Sir Geoffrey Vos (Master of the Rolls) and Dame Eleanor King (Lady Justice of Appeal), and judgment was given on Friday 17 September. The Court of Appeal found that it was "for clinicians to exercise their judgement" in relation to puberty blocking treatment. == Reactions to the Court of Appeal judgment ==

Alistair Robertson, a solicitor who advised the Tavistock and Portman NHS Foundation Trust, said going into the appeal "Our strategy had to be to focus the courts on the specific legal issues raised and away from the moral controversy around the treatment of children for gender dysphoria." Describing the appeal judgment, Sandra Duffy of Irish Legal News said "The Court of Appeal disagreed profoundly with the findings of the Divisional [High] Court on both evidentiary and legal bases. Its decision to overturn found that the Divisional Court had relied on flawed expert evidence, 'implied factual findings that the Divisional Court was not equipped to make', and was incorrect in issuing both its declaration of law and its guidance on the application" (citations omitted) and highlighted the importance of "the Court of Appeal's finding that Gillick competence applies to puberty blockers in the same way that it would to any other medical decision". In July 2022, the NHS decided to close GIDS (the Tavistock Clinic) and replace it with regional healthcare centres in 2023, following the release of an interim version of the Cass Review, a report conducted by paediatrician Hilary Cass. == AB v CD and others ==

AB v CD and others is a separate case involving the Tavistock & Portman NHS Foundation Trust, on the related matter of whether parents can give legal consent to their child receiving puberty blockers. In a judgment issued on 26 March 2021, the High Court ruled that parents are able to give such consent "save where the parents are seeking to override the decision of the child" [para 114 of the judgment]. The case does not overrule, nor have any legal effect on, the judgment in Bell v Tavistock; the ruling reads [para 9] "Nothing that is said below is intended to depart, to even the smallest extent, from anything that was said in Bell." ==Subsequent legal move by Keira Bell==

In January 2025, it was reported that Keira Bell's lawyers had written to the Health Secretary, Wes Streeting, saying that unless he banned the use of cross-sex hormones for those under 18, they would challenge by judicial review his decision to allow their use by private clinics. ==Summary of judgments==