Bell v Tavistock [2021] was a landmark case concerning the application of the Gillick test on patients with gender dysphoria. 

In this case, the appellant was an operational NHS foundation trust which operates a Gender Identity Development Service (GIDS) for patients up to the age of 18 suffering with gender dysphoria. The Respondent was a former patient of Tavistock, who was referred on for further Puberty Blocker (PB) consideration, the respondent later de-transitioned.

The judgement was delivered by Lord Burnett, with the court holding that Gillick was an outdated test put in place at a time where contraception for under 16-year-olds was still a highly controversial topic. Whilst Lord Burnett concluded that the DCs restrictions were wrong, he also stressed that in certain circumstances it is relevant to make an application to the court for them to decide the further action (the DC tried to impose a requirement that anyone fitting into the age criteria would have to make an application to the court if they wished to be referred by GIDS).

Whilst this case is a step forward regarding trans rights, the judgement refuses to acknowledge one key point…

No recognition was given to the future effects on trans youth if the treatment they require is withheld. Both courts were clear to argue that PBs lead to permanent treatment which will be regretted. This controversial stance is clearly not the case, with only 16% of people referred to GIDS getting referred on for PB consideration, and of the 16%, only 55% proceed with PBs. It is clear that the DC concluded what they wanted to conclude, that PBs will always lead to hormone treatment.

When commenting on the case, Giordano stressed that

“broader concern lies in the way in which de-transitioning is being used to support those wishing to prevent all adolescents from accessing treatment”,

Reports show that inability to access treatment will lead to increased mental health issues among transgender youth. Stonewall concluded that an alarming 45% of transgender youth have tried to take their own life, and when given access to gender-affirming care, this lowered by a staggering 73%.

It is clear that receiving correct care has extreme positive effects, therefore it is only assumed that if this care is withdrawn, we will see extreme negative effects. But why was this not considered by either court?

It needed to be stressed by the courts that the outcome of Bells treatment does not reflect broadly on all transgender youth, with statistics from 2021 showing that only 3% experience some form of regret (these youth do not necessarily detransition). Another survey found that 0.47% of those surveyed experienced transition related regret, with very few of these going on to detransition.

The lack of recognition regarding the effects of withholding treatment has been viewed as one sided, with worried that this case will create incorrect precedent if it is applied to similar matters.

Whilst this case is a step forward for the rights of transgender youth, we must ask if this is only because the previous decision made by the DC was such a step back?