Stopping under 18’s access to puberty blockers could risk healthcare rights of all young people

This case isn’t just about healthcare for trans young people, it’s about a much wider issue: whether we believe children and young people have a right to treat their bodies as their own

While this might sound quite technical and specific, the outcome of the judicial review brought against the Tavistock & Portman NHS Trust, which runs England’s only Gender Identity Development Service (GIDS) for children and young people, could have far-reaching consequences for young people and their medical autonomy. 

The case asks whether under 18-year-olds can give valid informed consent – which is where a young person voluntarily consents to a treatment after being given all the relevant information about what that treatment involves – to receive hormone blockers. 

Not only could the case affect trans people’s ability to get hormone blockers, it could throw into question all young people’s ability to access wider healthcare treatments, like contraception and abortion services.    

If you haven’t heard of GIDS before, they provide specialist healthcare for children and young people under 18 years old who are trans or questioning their gender. It’s a hugely important service because many trans young people are bullied at school and targeted for being themselves. Services like GIDS can play a vital role in supporting trans young people and those who are questioning their gender.   

Contrary to reports that young people are being ‘fast-tracked’ through this service, the waiting list for a first appointment at GIDS is 18 months. This is far longer than the 18-week maximum for non-urgent, consultation-led treatments, set out by the NHS Constitution. What this means is that many young people and their families are being left without the support they need.  

When a young person is seen by GIDS, the care that they need will vary. Some children and young people may simply need to be given time and space to explore who they are, without any medical treatment. Some may choose to wait before making decisions about future medical care. And for some young people who are certain about who they are, and who may become increasingly distressed by changes in their body as they get older, hormone blockers can be the right course of action.  

Hormone blockers are puberty-delaying medications that have been used for decades by clinicians – initially for children going through precocious (early) puberty, and more recently, for trans young people. GIDS prescribes hormone blockers, which are a physically reversible treatment, after a young person has undergone lengthy and intensive assessment by multiple clinicians, including psychologists and endocrinologists. 

By delaying puberty, hormone blockers give trans young people the time they need to explore and understand their gender, without the distressing dysphoria that can accompany puberty. This court case seeks to prevent trans young people accessing this vital treatment. It is arguing that under-18s cannot give valid informed consent to receive hormone blockers, and that in the future, trans young people must each get permission from a court before receiving this treatment.  

If successful, this would have a devastating impact, by forcing trans young people through a lengthy legal process to access puberty blockers in every individual case (on top of the waiting lists for an initial assessment). 

If we also chip away at the idea that children and young people know what’s best for them, we open the door towards eroding Gillick Competency. ‘Gillick’ was a case in 1985 which established that young people under the age of 16 can consent to their own medical treatment, without the need for parental knowledge or permission.  

Gillick is a cornerstone of children and young people’s rights and helps ensure young people can access the healthcare service they may need, including abortion, contraception or sexual health services. 


The lawyers representing the people bringing the case say it would push Gillick to ‘breaking point‘. This would give a green light to those who want to use this an opportunity to roll back the healthcare rights of not just LGBT young people, but all young people. 

During a year where our communities have endured so many challenges, from the Government falling short on its promise to reform the Gender Recognition Act, to the countless new difficulties brought by the Covid-19 pandemic, now more than ever, we need to stick together to support trans people.  

Wednesday’s hearing is a vital opportunity for the courts to protect the right of trans young people – and all young people – to access the healthcare support they need, when they need it.

Nancy Kelley is the Chief Executive of Stonewall