Psychiatrists fear children are being ‘coached’ into accessing puberty blockers, Court of Appeal hears
Psychiatrists fear that transgender children are being “coached” into giving rehearsed answers when trying to access puberty blockers, the Court of Appeal has heard. Dr David Bell, a former governor at a gender identity NHS trust, expressed concern that children may be pressured by parents, friends or websites when trying to address feelings of gender dysphoria. Dr Bell, who was a psychiatrist at the Tavistock and Portman NHS Foundation Trust from 1996 until earlier this month, was granted permission on Friday by two senior judges to intervene in a landmark case examining whether transgender children can legally take puberty blockers. In November, the High Court ruled that children should not receive the controversial drugs unless they understand the “long-term risks and consequences” of them. The NHS was forced to change its guidance overnight, preventing children from accessing the hormonal treatment without a court order. The Tavistock and Portman NHS Foundation Trust has since launched an appeal against the ruling. In a preliminary hearing on Friday, lawyers on behalf of Dr Bell told the court that he wishes to intervene in the appeal as he has since retired from the NHS Trust and feels he can speak more freely. In legal papers lodged before the Court, Dr Bell is described as a “high profile whistleblower” after he published a report in August 2018 which “investigated serious concerns” raised by ten clinicians working at the Tavistock. The report found that the Tavistock’s gender identity clinic, GIDS, “is not fit for purpose” and some young patients “will live on with the damaging consequences.” Dr Bell said he felt “victimised for whistleblowing” by the Trust in the wake of the report and as a result “did not feel able to participate” in the initial High Court dispute. However, Dr Bell retired from the Trust earlier this month on January 15 and “is no longer subject to the same constraints,” the legal documents said. “There is evidence that staff members may be frightened of coming forwards,” the documents continued. “Dr Bell, a highly eminent psychiatrist who until recently occupied a senior position with the Appellant, is now free from his employment and able to describe the concerns, which he investigated in some detail.” Lady Justice King and Lord Justice Dingemans granted his application to intervene in the appeal, which will be heard over two days in April, while other groups, including the LGBT charity Stonewall, had their application denied. Lawyers for Dr Bell said he wants to tell the court about concerns that were raised to him by gender identity practitioners, including that “children may be ‘coached’, whether from parents, peers, or online resources, to provide rehearsed answers in response to particular questions.” The practitioners were also concerned that “highly complex factors” – including historic child abuse and family bereavement – can influence children’s attitudes towards gender, meaning puberty blockers is not always the best course of treatment. The landmark case on puberty blockers was first launched against the Trust by Keira Bell, a 23-year-old woman who began taking puberty blockers before deciding to reverse the process of changing gender. Ms Bell said the clinic should have challenged her more over her decision to transition to a male when she was 16. It was also brought by a woman who can only legally be identified as “Mrs A”, the mother of a 15-year-old autistic girl who is currently on the waiting list for treatment. At the initial High Court hearing in October, their lawyers said that children going through puberty are “not capable of properly understanding the nature and effects of hormone blockers”. They argued there is “a very high likelihood” that children who start taking hormone blockers will later begin taking cross-sex hormones, which they say cause “irreversible changes”, and that the NHS Trust offers “fairytale” promises to children because they are unable to give their consent to the sex-change process.