By Rachel Savage
LONDON, Feb 15 (Thomson Reuters Foundation) – Almost as soon as she could speak, Nina told her parents she was not a boy and she has lived as a girl since she was seven. Until recently, she was happy.
But now aged 12 and wanting to stop the onset of male puberty, a ruling by Britain’s High Court has plunged Nina and dozens of other children struggling with gender dysphoria into limbo by restricting access to puberty-blocking drugs.
The judges ruled that under-16s were unlikely to be able to give informed consent to such medication, and doctors must now get a judge’s approval – a so-called “best interests order” – to prescribe them to adolescent patients.
Days after the ruling, Nina’s appointment the following week with specialists – whom she hoped would prescribe the medication – was cancelled and no new date was scheduled.
With the court ruling leaving a void in treatment, some parents are now filling the gap left by seeking drugs for their children from privately funded services.
“I feel like I’m living in a nightmare,” said Nina’s mother, Juliet, whose daughter has attended England’s sole youth gender clinic – the Gender Identity Development Service (GIDS) – since she was five.
“If in your head you are female but your body starts to develop as a male in your teenage years, it just must be the most horrendous thing,” said Juliet, whose name – along with those of all parents and children in this article – has been changed to protect their identities.
The ruling came as rising numbers of adolescents globally seek to change gender, dividing those who fear doctors are too hasty in prescribing puberty blockers and cross-sex hormones and those worried about access to medication they deem life-saving.
Puberty blockers, which are used to prevent the onset of sexual maturity, have become the focus of a fierce global debate about the age at which a child can decide to transition gender.
In Britain the number of children referred to GIDS has risen nearly 30-fold in the past decade and waiting lists are more than 18 months long.
About 2,660 under-18s were referred to GIDS in the year to March 2020, while 161 were referred on by GIDS to specialist endocrinologists who prescribe puberty blockers, according to the clinic’s data.
The World Professional Association for Transgender Health, a U.S.-based body of doctors specialised in treating trans people, said puberty blocking drugs can be used to help alleviate gender dysphoria and give children time to consider future options.
The medication can stop irreversible physical changes for patients, such as their voice breaking, WPATH’s guidelines state.
But the drugs’ use is controversial. There is little research about the long-term effects and critics say they are prescribed too freely – putting sometimes-vulnerable children on a course to more permanent transition treatments.
Keira Bell, who took puberty blockers aged 16, testosterone at 17 and had a double mastectomy at 20, brought the court case that resulted in puberty blockers being restricted after coming to regret the medical treatment she had to transition.
Bell, now 23, told reporters after the Dec. 1 judgment that she was delighted by the outcome and wished it had been made before she “embarked on the devastating experiment of puberty blockers”.
