J (Transgender: Puberty Blocker and Hormone Replacement Therapy), Re
[2024] EWHC 922 (Fam)
O v P & Anor
8 May 2024
[2024] EWHC 1077 (Fam)
High Court
A 16-year-old who identifies as male wants gender-affirming treatment. The judge said the teen can decide for themselves because they're old enough. Even though there are worries about the treatment, the judge said doctors and the government should handle it, not the court. The case ended, and the teen's dad promised to make sure the teen doesn't get treatment from places that aren't properly checked.
Key Facts
- •16-year-old Q (born female, identifies as male) seeks gender-affirming treatment.
- •Parents are divorced and have opposing views on Q's treatment.
- •Mother applied for a prohibited steps order to prevent private treatment.
- •Father supports Q's desire for treatment.
- •First private gender clinic in the UK (Gender Plus) gained CQC registration.
- •Cass Review findings raise concerns about evidence base for gender-affirming treatment in minors.
- •Q is over 16 and has capacity to consent to treatment under section 8 of the Family Law Reform Act 1969.
Legal Principles
A minor who has attained the age of 16 can consent to medical treatment.
Section 8(1), Family Law Reform Act 1969
Parental right to determine medical treatment for a minor under 16 terminates if the child has sufficient understanding and intelligence to consent.
Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112
Concurrent powers to consent to medical treatment can exist (parent and child).
Re R (A Minor)(Wardship: Consent to Treatment) [1992] Fam 11
Court retains welfare jurisdiction to override a child's decision on medical treatment, but this is not absolute and primarily applies to life-saving treatment refusal.
Re W (A Minor)(Medical Treatment: Court’s Jurisdiction) [1993] 1 FLR 1; Re X (A Child)(No 2) [2021] 2 FLR 1187
It is for doctors, not judges, to decide on the capacity of a person under 16 to consent to medical treatment.
Bell v Tavistock and Portman NHS Foundation Trust and others [2021] EWCA Civ 1363
Courts should be reluctant to address ethical questions unless necessary to resolve a practical problem.
R (Burke) v General Medical Council [2005] EWCA Civ 1003
Parents can consent to puberty blockers on behalf of their child without court approval.
AB v CD [2021] EWHC 741
For consent to be valid, it must be informed.
Montgomery v Lanarkshire Health Board [2015] UKSC 11
Outcomes
Discharge interim orders and end proceedings.
Q, being 16 and possessing capacity, has the right to consent to treatment; the court finds no basis to override this. Continuing proceedings would be detrimental to Q's well-being.
Refusal to make a declaration that private prescribing of puberty blockers or hormones to under-18s requires court oversight.
This is a matter for medical professionals, regulators, and government, not the courts.
Father to give an undertaking not to facilitate Q seeking treatment from offshore agencies.
To ensure Q's safety and well-being.
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