Keira Bell is a complainant in an important legal case. Her journey from girl to adult woman included a detour through believing she was transgender.
In 2013, when she was 16, Keira Bell was prescribed puberty blockers by the Gender Identity Development Service (GIDS), part of The Tavistock and Portman NHS Trust. GIDS is the UK’s only facility practicing gender-based medical interventions on children.
Bell went on to take testosterone at 17, before getting a double mastectomy when she was 20 years old.
By late 2018, Keira Bell was having doubts:
“I started to realise that the vision I had as a teenager of becoming male was strictly a fantasy and that it was not possible. My biological make-up was still female and it showed, no matter how much testosterone was in my system….I started to just see a woman with a beard, which is what I was. I felt like a fraud and I began to feel more lost, isolated and confused than I did when I was pre-transition.”
Bell has now detransitioned – she stopped believing she was a man – and she joined two others in a legal case against the Tavistock and Portman NHS Trust. The judicial review challenged the whether those under 18 can consent to hormone blockers and other medical routes towards transition.
Keira Bell gave an interview to Meghan Murphy explaining all this in her own words.
https://www.feministcurrent.com/2020/11/30/podcast-keira-bell-fights-the-unethical-prescribing-of-hormone-blockers-in-minors-in-the-uk/
The court heard testimony from experts in the field of gender medicine.
On December 1st 2020 the High Court issued its judgment in favor of Ms Bell: https://www.judiciary.uk/wp-content/uploads/2020/12/Bell-v-Tavistock-Judgment.pdf
Specifically, the court held that in order for a child to be competent to give valid consent the child would have to understand, retain and weigh the following information:
- the immediate consequences of the treatment in physical and psychological terms;
- the fact that the vast majority of patients taking puberty blocking drugs proceed to taking cross-sex hormones; and puberty blockers are therefore, a pathway to much greater medical interventions;
- the relationship between taking cross-sex hormones and subsequent surgery, with the implications of such surgery;
- the fact that cross-sex hormones may well lead to a loss of fertility;
- the impact of cross-sex hormones on sexual function;
- the impact that taking this step on this treatment pathway may have on future and life-long relationships;
- the unknown physical consequences of taking puberty blocking drugs; and
- the fact that the evidence base for this treatment is as yet highly uncertain.
The court ruled it doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blocking drugs. Therefore, the court considered that it was highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers.
For young persons aged 16 and over, the ability to consent to medical treatment is the legal norm. For puberty blocking drugs, the court took account of the long-term consequences of the clinical interventions and the innovative and experimental nature of the treatment. It’s conclusion was that there will be cases when clinicians should seek permission from the court before starting treatment.
The story is reported on by the BBC https://www.bbc.co.uk/news/uk-england-cambridgeshire-55144148
There was very little coverage of the ruling outside of the UK.
On our website, we made an initial response and subsequently reproduced statements from Keira Bell and from the Society of Evidence Based Gender Medicine (SEGM).
On 22nd December 2020 The Tavistock requested permission to appeal and this was granted by the Court of Appeal on 18th January 2021. The appeal will be heard before March 2022.
Keira Bell in her own words:
https://www.persuasion.community/p/keira-bell-my-story
Update: May 2022
An application was made to The Supreme Court to challenge the ruling at the appeal court in favour of The Tavistock. Unfortunately, The Supreme Court decided not to allow the appeal on the basis that there was no ‘substantive point of law’ in need of clarification.
From Keira Bell’s Crowdfunder:
Despite the shock that this has not been taken further in the courts, I am overjoyed at the positive changes that have happened and are currently underway since the ground-breaking High Court findings…
- The NHS corrected its guidance, reflecting the true unknown nature of puberty blockers
- The pioneers of the ‘Dutch Protocol’ (affirmative approach) cautioned healthcare providers on ‘blindly adopting’ their research
- Sweden & Finland has ceased using the ‘Dutch Protocol’ as its main approach
- Prominent ‘trans care’ providers & WPATH members (including the doctor who operated on Jazz Jennings) have admitted that how children are being treated in this area is concerning and have hinted that the WPATH guidelines are dogmatic
- NICE reported on the very limited evidence base for puberty blocking treatment
- The NHS announced an independent review of ‘Gender Identity Services’ by Dr Hilary Cass. The interim report states that these services are “not a safe or viable long-term option” for children and young people.
- The UK health secretary is preparing to launch an inquiry into this type of treatment amidst concerns that the system is “failing children”
