Can children and teens struggling with gender confusion make informed decisions about “transitioning” to live as the opposite sex?
Do children really understand the life-long medical, psychological, physical and social consequences of receiving puberty blockers, opposite-sex hormones and surgeries that attempt to make them look like the opposite sex?
Those are question that the High Court in the United Kingdom will be considering as a legal challenge was launched against the National Health Service (NHS) and the country’s only gender identity clinic, the Tavistock and Portman NHS Foundation Trust.
Sue Evans is a psychiatric nurse who worked at the clinic. She filed the lawsuit along with the mother of an autistic, gender-confused 15-year old girl. The teenager is on the wait list for treatment at the Tavistock clinic, and in order to protect the girl’s privacy, the mother is known as “Mrs. A.”
Evans was troubled about her work at the clinic, seeing children and adolescents with gender dysphoria rushed toward treatment without appropriate assessment and ongoing psychological treatment. She believes children are too young to make fully informed, intelligent decisions about experimental medical treatments with life-long consequences.
The BBC reported that when she worked at Tavistock, Evans had concerns over puberty blockers being given to teenagers, “But now, the age limit has been lowered – and children as young as perhaps nine or 10 are being asked to give informed consent to a completely experimental treatment for which the long-term consequences are not known.”
An article from the National Center for Biotechnology Information, part of the U.S. National Institutes of Health, explains that informed consent is a legal and ethical obligation for medical practitioners. Informed consent means a patient understands the nature of a proposed procedure, knows about its risks and benefits, learns about possible alternatives, and recognizes the risks and benefits of alternatives.
Evans and Mrs. A use a crowdfunding site to help with legal fees for their lawsuit. They explain that there are many questions surrounding the use of puberty blockers, hormones and surgeries for children and adolescents with gender dysphoria.
They write: “Many professionals are now highly concerned about the treatments for under 18 gender dysphoric children and adolescents which remain largely experimental. There are so many unanswered questions that include the age at start, reversibility, serious adverse health events, long term effects on mental health, neurological effects on cognitive functioning, the effect on bone density, circulatory systems and sexual functioning in adulthood.”
Yet children are expected to understand these concerns and make an informed decision about their own treatment.
In addition to being too young to understand the consequences, Evans notes that diagnosing gender dysphoria is not straightforward – like identifying and treating a physical ailment “like a skin rash or something of that nature.”
She told BBC Radio that many suffering from gender dysphoria “are confused or distressed and very often have other comorbid aspects,” making a clear diagnosis difficult. She continued: “For example, 30 per cent plus are autistic, many of them have suffered some form of trauma in their earlier lives. Some of them are just very confused, anxious, or socially anxious children.”
While at the Tavistock clinic, Evans says she was pressured to agree with and affirm patients who believe that they are the opposite sex. She says the clinic and senior staff were being influenced by and had connections to non-medical, transgender activist groups such as “Mermaids” and “Gendered Intelligence.”
Mrs. A explains her involvement in the case on their crowdfunding site, expressing concern over her daughter’s autism and “other mental health issues.” She worries that the current treatment approach from Tavistock “means that my daughter will be subjected to an experimental treatment path that is not adequately regulated, where there are insufficient safeguards, where her autism will not be properly accounted for and where no-one (let alone my daughter) understands the risks and therefore cannot ensure informed consent is obtained.”
The bottom line, for Evans, is that children are too young to understand and give meaningful agreement to treating their identity confusion with drugs, hormones and surgeries. She argues, “No matter how clever or mature they seem, I don’t think a child can possibly comprehend what their future adult life will be like and what they’re consenting to potentially give up or risk to their medical health.”
A Tavistock official told the BBC, “It is not appropriate for us to comment in detail in advance of any proposed legal proceedings.” They also said they had been rated “good” by the Care Quality Commission, an independent organization in the U.K. that monitors, inspects and regulates health and social care services.
For all Focus on the Family videos, books and articles about transgender issues, go to: Transgender Resources