Parents say trans youth were ‘left in limbo’ following Tavistock legal case
Mermaids report shows negative impact of Bell v Tavistock legal case on trans children and their parents
Hundreds of parents and carers of trans and non-binary children have told of the devastating impact of a 2020 legal ruling against London's Tavistock gender identity clinic, with one saying they felt “lost and completely abandoned by the NHS”.
Almost 90% of respondents to a survey by trans youth charity Mermaids said the Bell v Tavistock case heard by the Court of Appeal had a negative impact on their mental health. Many reported feeling powerless and guilty about not being able to do more to support their kids.
The Mermaids report, published earlier this month, found that the case “threw up unnecessary barriers to those in desperate need of gender affirming healthcare, and propped up a system which seemed stacked against them”.
Former Tavistock patient Keira Bell, who had changed her mind after medically transitioning, argued that puberty blocking treatments were being unlawfully administered to children who could not properly consent, and that puberty blockers were experimental. (Tavistock's legal team pointed out that there had been more than 20 years’ evidence of their effectiveness and argued that the evidence submitted was “partisan”.)
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Puberty blockers are prescribed to give a child time to explore their options before changes to their body take place that may be difficult to reverse.
The initial ruling, issued in December 2020, found in Bell’s favour. NHS England immediately stopped the Tavistock clinic – the UK’s only dedicated gender identity development service (GIDS) clinic for children and young people – from accepting any new referrals. The clinic also froze access to puberty blockers and cross-sex hormones for under-16s.
The ruling was rejected in September 2021 by the Court of Appeal, which said that Tavistock had been acting within the law – and finally overturned by the Supreme Court in May this year.
But its impact has been far-reaching. As Mermaids’ head of policy Kai O’Doherty explains in the report, Bell v Tavistock continues to be cited by organisations opposed to young trans people’s access to gender-affirming healthcare, despite the ruling having been permanently reversed.
O’Doherty told openDemocracy that “increasing barriers to accessing healthcare for gender-diverse youth only serves to cause more harm to an already extremely marginalised community, and pushes families to access alternative routes to care”.
Limiting access “will not stop kids from being gender-diverse, but rather make their lives even harder,” they added.
In late 2020 and early 2021, before the initial ruling was overturned, Mermaids surveyed more than 230 parents and carers of trans and non-binary children who were receiving treatment from Tavistock, on the waiting list or considering requesting a referral.
Mermaids researcher Dr Abby Barras, who compiled the report along with Dr Anna Carlile of Goldsmiths, University of London, told openDemocracy: “Mermaids knew many families would be in shock and struggling to know what to do next.”
She stressed “how long a shadow [Bell v Tavistock] cast over not just one person’s quality of life, but over their whole families – work, school, siblings, the wider trans community”.
Speaking about the personal impact of the initial ruling, one parent said they and their husband “feel like we’re in a stage of grief”.
Other negative effects have included panic attacks, insomnia, having to use anxiety medication and being sent home from work because they “couldn’t stop crying”.
Many respondents felt it was unfair that the judicial system was making decisions affecting their kids’ access to gender-affirming healthcare, and that this was an invasion of their children’s bodily autonomy.
One said: “You wouldn’t have a judge to decide whether a child should take anxiety medicine or not. Hormone blockers are reversible, and this will likely cause more harm than good.”
More than two-thirds (69%) said they were likely to pursue other, less secure pathways to treatment, such as overseas private healthcare or buying medication online. More than 90% had not reached out to their GP because they felt they could not offer any support.
Some 70% were worried about the effects of the case on their child’s access to puberty blockers.
One respondent reported: “Our daughter was due to have her first blood tests this week, and a dexa scan [to measure bone mineral density] in the new year. She’s devastated and puberty is progressing rapidly.”
Another said their child had been denied puberty blockers because they’re non-binary.
With 73% of respondents’ children on the already-long waiting list at a time of rapid bodily change, many worried about the list getting even longer. Among respondents, 67% were not expecting to receive an appointment within the next six months. One reported that their child had been “on the waiting list for over two and a half years with no communication about what is happening”, which, they said, was “very distressing” for the child and the whole family.
One parent reported fears of their child self-harming. Others said that their children were struggling to attend or fully participate at school. And almost 90% reported a negative impact on their child’s mental health.
Respondents described the ruling as “transphobic” and a “victory for anti-trans activists”. They said it included misleading information, at a time when “further misleading information is being spread in the media and on social media”. They felt their children had been “left in limbo”, a situation which Barras described as “cruel”.
The Tavistock Centre is due to close by spring next year, following recommendations made earlier this year in an interim report by the Cass Review. It will be replaced by two new regional centres connected to children’s hospitals – one in London, one in the north-west – due to open in 2023.
Led by Dr Hilary Cass, the Cass Review was commissioned in 2020 to investigate gender identity services for children and young people, and is still ongoing.
O’Doherty said: “Given the ongoing public ‘debates’ over the rights of gender-diverse youth to access timely, necessary healthcare, it’s more important than ever to centre the real, lived experiences of those impacted. As the Cass Review continues its review of gender healthcare services for youth, it must ensure the voices of those impacted are heard.”
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