Autistic trans teenager must not be prescribed hormones, court rules
An autistic transgender teenager must not be prescribed hormones, the High Court has ruled in a potential landmark case.
The 16-year-old, known as “J”, was put on cross-sex hormones aged 15 by Gender GP, a Singapore-registered private clinic, despite having just one online appointment with a counsellor.
After the case was brought by the child’s father, the court said a child accessing high doses of testosterone from an “off-shore, online, unregulated private clinic” gave rise to “serious concerns as to the safety of patients”.
The court ruled that J should no longer receive hormones from Gender GP, and both parents agreed that the child undergo proper assessment in the UK.
Expert evidence presented to the court found a litany of safety issues including the prescribing of a “dangerously high” dose of testosterone to a child born female that left them “at risk of imminent death”.
The case comes as polling revealed the majority of British people believe clinics offering gender reassignment surgery to under-18s should be shut down and teenagers should not be prescribed puberty blockers.
Eating disorders and self-harming
J, who was born female but identifies as male, had suffered from eating disorders and self-harm aged 12 and was detained in a children’s mental health unit for nine months. The child was diagnosed with autism and anorexia at 13.
Sir Andrew McFarlane, president of the High Court family division, ruled on Wednesday that Gender GP would need to provide “a detailed account from the clinic setting out their proposed course of assessment and treatment” in order to overturn its decision.
Sir Andrew also issued a warning to other courts making decisions involving the controversial clinic in the treatment of children, in what could be a precedent for future cases.
“I would urge any other court faced with a case involving Gender GP to proceed with extreme caution before exercising any power to approve or endorse treatment that that clinic may prescribe,” he concluded.
In 2022, J’s mother agreed to contact the clinic, and the child then began receiving injections of testosterone from an NHS GP every six weeks, beginning in January 2023.
The court heard how the counsellor at Gender GP, registered in Britain, had declared: “I have no concerns, at this time, with him getting the help he needs from hormones.”
Do not treat children outside NHS
A prescription for a “double” dose of testosterone was then written by a doctor registered in Barcelona, and posted from Romania.
The father, who had separated from the mother when J was aged 10, had disagreed with the decision and appealed to the court in April 2023, on the grounds of consent and competence, and claimed under-18s should not be allowed treatment outside of specialist NHS services.
Dr Jacqueline Hewitt, a consultant paediatric endocrinologist based in Melbourne, Australia, was the court’s expert witness after no UK specialists agreed to take part.
In her evidence, Dr Hewitt was “highly critical” of Gender GP, and hit out at the absence of physical examinations, bone density checks, therapy, and the “extremely poor quality” of psychological assessment.
However, her biggest concern was that the clinic had administered “dangerously high” doses of testosterone to a child that had never had it before.
She said there was “no professional society of paediatric endocrinologists internationally who would consider this anything other than a highly abnormal and frankly negligent approach” and said it would be “unlawful” in Australia.
‘Risk of imminent death’
The court sought NHS intervention after “receipt of Dr Hewitt’s worrying advice that J may be at risk of imminent death” but these were “unsuccessful”.
All parties agreed to pause the treatment at Gender GP, with the last dose being delivered in August 2023.
Dr Hewitt queried whether there had been top-up doses since, given the high levels of testosterone still in the child’s blood.
An independent consultant paediatric haematologist analysed J’s testosterone levels in late 2023 and said they were normal “relevant to an adult male”.
The father has agreed for J to be assessed by a UK-based private clinic, Gender Plus, for the period of six months.
Sir Andrew said it was not the court’s place to set a precedent or “trespass on the role of Parliament” and would “limit the court’s involvement in terms of decision to that which is currently necessary”.
“In the absence of intervention by Parliament, the court should be careful to move forward on a case by case, decision by decision, basis so that the approach under the common law is developed incrementally as may be required, rather than by judicial diktat,” he said.
‘Ban life-changing medication for vulnerable’
The hearing took place in February 2024, before the Cass review into transgender children’s healthcare was published, which it acknowledged may have further bearing on future hearings and cases.
Paul Conrathe, human rights lawyer at Sinclairslaw, representing J’s father, said in light of the case “the Secretary of State should immediately seek to prevent vulnerable children from accessing powerful life-changing hormonal medication from unregulated providers”.
“This litigation has also exposed a dangerous gap in NHS provision which urgently needs to be remedied,” he said.
“Despite the child being significantly overdosed with testosterone and there being concerns about the risk of sudden death due to thromboembolic disease, there was no gender emergency service nationally that could offer urgent assessment and treatment other than basic blood testing.”
Poll calls for gender clinics to be shut down
It comes as polling found most British people want clinics offering gender reassignment surgery to under-18s shut down.
Some 61 per cent say the clinics should close, compared with just 17 per cent who disagree.
More than two thirds (68 per cent) say puberty blockers should never be given to teenagers, while nearly four-fifths (79 per cent) say they should never be offered surgery.
The poll of 2,000 adults, conducted by Whitestone Insight, was commissioned by the campaign group Family Hubs Network.
It found that nearly half of people – 46 per cent – believe JK Rowling is a “brave critic of trans ideology”.
This far outweighs the 23 per cent who believe she has been too vocal and just 7 per cent believe she should go to prison as a transphobe.
It found that a majority of parents want the Government to take a tougher stance against the promotion of gender change in schools.
A total of 56 per cent of parents want an outright ban or for the current guidance urging schools to take a “cautious approach” to pupils changing gender to be given the full force of law.
The survey exposes widespread public unease about the “woke” agenda. Only one in five people (19 per cent) consider themselves woke while 50 per cent reject the label.
By a significant majority, people do not believe being woke is an admirable trait. Only one in four regard it as positive – as opposed to 43 per cent who do not.
Lord Farmer, the former Conservative Party treasurer, said the poll confirmed that trans activists were out of line with public opinion.
“Ministers should take heart from these findings and halt completely the promotion of transgender ideology in schools, which is causing much distress to parents and pupils and creating a legal minefield for teachers, some of whom have already lost their jobs for using the wrong pronouns,” he said.
“The classroom should not become a pulpit for any kind of social or political indoctrination and teachers should not have to go in fear of tripping up by using the wrong language or failing to affirm everything adolescents feel. Strong feelings can ebb away with time, but surgery and off-licence puberty blockers are life-changing.
“I am delighted to see the courageous stance taken by JK Rowling applauded by the public. She is far more in tune with public opinion than the woke ideologues dominating Holyrood.”
