By Rachel Savage
LONDON, Oct 7 (Openly) - Transgender children cannot understand the dangers of drugs that block puberty so should only be able to take them if a court approves, a lawyer argued on Wednesday in a landmark case against Britain's lone youth gender identity clinic.
The case has shed light on the sharp rise globally in adolescents seeking to change gender, with some fearing medics are prescribing the drugs without due process and others worried about access to medication they deem life-saving.
The puberty blockers may make it more likely that children will opt for cross-sex hormone treatment later in life, said Jeremy Hyam, a lawyer for Keira Bell, 23, who received the drugs when she was a 16-year-old patient at the London clinic.
The case at the Royal Courts of Justice against the Tavistock and Portman NHS Foundation Trust has become a lightning rod for concerns about a nearly 30-fold rise in child referrals to the clinic in the past decade, to 2,560 last year.
"Because the children are so young and short of relevant life experiences... there is just no way they can make informed decisions about loss of sexual functions, ability to orgasm," Hyam told the court.
"This vulnerable class of children cannot give informed consent to hormone-blocking treatment and... it requires the supervision of the court," he said.
The clinic said it would not comment on the case before judgment, defending its "safe and thoughtful service which puts the best interest of its patients and their families first".
The clinic's lawyer, Fenella Morris, said that Hyam's call for a court order was a "radical proposition" that departs from existing law enabling under 16s to consent to medical treatment.
She said that discussions about patients' future sexual relationships were "not shied away from" by clinicians.
Puberty blockers may avert the negative mental impact of gender dysphoria in puberty, according to the World Professional Association for Transgender Health, a global body of doctors specialised in treating trans people.
It described them as "fully reversible" but has acknowledged concerns about a possible impact on bone development and height.
A study of 20,619 trans adults published in January found those who had taken puberty-blockers were less likely to have a history of suicidal thoughts or suicide attempts by their mid-30s.
Critics say their long-term fallout is unknown.
Trans advocates said the case threatened a host of child rights to determine their own healthcare, including over contraception or abortions.
"This is a case of a significance that cannot be exaggerated," said Lui Asquith, legal director of Mermaids, an advocacy group that supports trans children and their families.
Under some proposed U.S. state laws, doctors could be barred from prescribing puberty blockers to children. Last year Mexican authorities said children should be allowed the medication.
(Reporting by Rachel Savage @rachelmsavage; Editing by Lyndsay Griffiths. Please credit the Thomson Reuters Foundation, the charitable arm of Thomson Reuters, that covers the lives of people around the world who struggle to live freely or fairly. Visit http://news.trust.org)
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