by Dan Hitchens
Wednesday, 2
December 2020

In the Keira Bell case, the NHS trust had no answers

Many open questions remain about puberty-blockers
by Dan Hitchens
Keira Bell

Yesterday’s High Court judgement, which set strict limits on how far children can consent to puberty-blockers, was not meant to be a verdict on gender-identity treatment, let alone on the transgender movement. As Keira Bell, who brought the case, said: “This judgment is not political, it’s about protecting vulnerable children.”

Nevertheless, the case has political implications. For years, anyone who raised concerns about gender-identity treatment was shouted down, and told that the experts knew what they were doing. But now those experts have had to present evidence in court: the defendant was the NHS trust responsible for gender-identity treatment, and the judges heard evidence from the country’s leading specialists. And the result is a judgement — from senior judges — that the standard practice was not doing enough to protect children. Moreover, the ruling exposed just how little is understood about these treatments.

For instance: in 2011 the male-female split in those seeking treatment was 50/50. Now, three-quarters are girls uncomfortable with a female identity. That seems worth accounting for; but, according to the judgement, the NHS trust “did not put forward any clinical explanation as to why there had been this significant change.”

What about the numbers who have a diagnosis of Autistic Spectrum Disorder — which some studies suggest could be linked? No, the NHS trust doesn’t collect those statistics either. “Again,” the judges write, “we have found this lack of data analysis — and the apparent lack of investigation of this issue — surprising.”

Were there any examples of children giving consent for PBs, but the doctors concluding that they weren’t really able to consent? You guessed it: the Trust “could not produce any statistics on whether this situation had ever arisen.” How often are PBs a direct pathway to more serious cross-sex hormones? “No precise numbers are available” on that either.

Not only is this kind of data absent, the actual effects of the treatment are also unclear. The judges note that until June 2020, the NHS website claimed that the effects of PBs are “considered to be fully reversible”. This has since been updated to say that “Little is known about the long-term side effects.”

PBs should, the judges say, be considered an “experimental treatment”, since there is “very limited evidence as to its efficacy, or indeed quite what it is seeking to achieve.”

The same mystery, of course, hangs over the trans revolution of the last decade. It, too, is an experiment. But what is it seeking to achieve? And what effect will it have? Given the furious reaction towards anyone who looks critically at these questions, we may not find out until it’s too late.

Join the discussion

  • Interestingly, I had a long comment in reply to this post which has not been approved. Unherd should seriously consider the benefit of open debate rather than censoring opinions, lest opponents accuse them of not being genuine in their stated beliefs of free speech.

  • …the NHS trust had no answers.’

    Never trust any organisation with the word ‘trust’ in its title. I find this to be an infallible rule.

  • Keira Bell had a total of 3 one-hour sessions before she was ‘affirmed’ into medical intervention. I’d suggest that this was manifestly inadequate. There were clinicians and staff who had left their jobs in Tavistock because of disquiet over its overall direction. So a psychiatrist being reluctant to begin Bell on her transition is hardly a fact that destroys the “narrative”.

  • To get involved in the discussion and stay up to date, become a registered user.

    It's simple, quick and free.

    Sign me up