Letting go is the hardest part of parenting. But when it comes to medical decisions, when does your teenager actually get the final say in the UK? πŸ₯βš–οΈ

Understand the law of 'Gillick Competence' and the delicate balance of parental protection vs. teen autonomy.

Watch our simple video explainer here to learn more: https://youtu.be/_JMrpDyB5ws

#ParentingTips #TeenHealth #GillickCompetence #UKLaw

Can Teenagers Make Their Own Medical Decisions? Gillick Competence Explained

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Hey folks

Needed to get this vent out of our system too, as it's been really bugging us lately.

Right now, the vast majority of the medical community, even those who consider themselves trans-supportive, are incredibly gatekeeping when it comes to giving trans youth any form of care, even puberty blockers like GnRH agonists.

In an ideal world, the following would happen:

  • A trans kid says they're trans.
  • If they've started or will soon start puberty, the trans kid goes to their GP or doctor with a parent or guardian.
  • The GP or doctor offers the following options to the trans kid:
    • A puberty blocker (GnRH agonist or antagonist).
    • Monotherapy GAHT (i.e., maintaining a high enough estradiol or testosterone level to block gonadal hormone production).
    • A lower level of GAHT alongside a puberty blocker.

In the real-world, this sadly isn't the case. At the very best, trans kids:

  • Won't be offered a puberty blocker unless they've at least reached stage 2 on the Tanner scale!
  • Won't be offered HRT until 14 at the very, very earliest!

In practice, it's even worse than this in many places now. Even in many countries that consider themselves to be "progressive" on trans healthcare, trans youth will need to:

  • Have been on a puberty blocker for 6-12 months before GAHT will be considered.
  • Be at least 16 before GAHT will be offered.

In the worst places, there's no healthcare for trans youth whatsoever. In the UK, there's currently a permanent ban on new prescriptions of puberty blockers to any trans person under the age of 18. There are workarounds in place by private companies for this, but they're out of the price range for most people. Getting GAHT before the age of 18 will also require going private.

This forms the basis of the "wait and see" approach, which is conversion therapy by another name. Its nefarious aim is to reduce the number of people transitioning and to reduce the number of trans people overall, as many trans kids will not reach adulthood by being actively denied the right to transition medically.

The worst thing about this isn't the transphobia and transmisia from outside the trans community, but from within it  

We've seen people agree with the age gatekeeping and the need for medical diagnoses of being trans (ICD-11 - gender incongruence of childhood or gender incongruence of adolescence or adulthood), as if they don't trust trans kids to know that they're trans.

If we're going to use that logic, then clearly no-one should be allowed to go through puberty until they're legally an adult, as clearly all kids can't be trusted, right? Oh, and we should distrust all kids about sexuality too and prevent relationships of any kind until they're 18, yes?

The false logic quickly falls apart there. It's not based on not trusting kids: it's based on not trusting trans kids. It's the same nonsense that leads people to assume that all kids are heterosexual by default ("heteronormativity") and to distrust that anyone under 18 could recognise this about themselves.

The only reason it took us so long to realise that we were trans and bi wasn't because we weren't both of these things all along, but due to external pressures (Section 28; transphobia and homophobia) that made us suppress and repress these feelings. If we had felt able to be ourselves, we'd have realised we weren't a boy in our early teens, and that we were bi not much later.

In the UK, estrogenic puberty typically starts anywhere from age 8 to 13 and androgenic puberty from 9 to 14. There's simply no reasonable argument for delaying puberty in trans kids until they're 16 or even older. The "appropriate" age to start GAHT is whenever they've met the minimum puberty start age (8 or 9), when their peers are starting, and when they feel ready to start.

So yeah, we fully support trans youth starting GAHT at 11-12 or possibly even earlier in some cases.

Puberty blockers are meant to be a short-term stop-gap only to delay puberty. Once puberty has started, they can be used alongside GAHT in order to provide an age-appropriate ramp up, but in most cases it would simply be safer and cheaper to go with GAHT monotherapy. With monotherapy, trans kids get the added emotional, physical, and psychological benefits that come with a slightly-higher sex hormone level. (Just think how shitty it feels to have a low estradiol or testosterone level.)

Anyways, that's enough venting for now. We'll probably come back to correct typos, make minor amendments, or add further thoughts later. Right now though, we need to head up to bed.

#trans #transgender #transition #PubertyBlockers #TransYouthAreLoved #TransKidsAreLoved #TransKidsDeserveBetter #TransYouthDeserveBetter #TransKidsDeserveToThrive #TransYouthDeserveToThrive #TransKidsDeserveToGrowUp #TransYouthDeserveToGrowUp #LGBTQ+ #LGBTQIA+ #queer #GAHT #HRT #TransRights #TransRightsAreHumanRights #TransLiberation #TransLiberationNow #InformedConsent #GillickCompetence

Gillick competence - Wikipedia

I don't think anyone mentioned Gillick Competence. Possibly assuming their readers are reasonably conversant with ethics in childcare (unlike the authors of the Cass Report). But yes, the report and the people pumping it up are making an outrageous attack on #GillickCompetence

Not a battle anyone should have to fight over and over again but here we are.

Update/correction: I had actually missed a key thing from my commentary on the Times' very wrong description of Gillick competence as "a loophole". That is: once you're 16, it doesn't apply anyway, because the Gillick case was about younger people.

Fiona explains:
https://graniteandsunlight.wordpress.com/2023/06/26/the-times-is-lying-about-gillick-competence/

#GillickCompetence

The Times Is Lying About Gillick Competence

Every single thing about this article from the Sunday Times is horrifying (here is a paywall-free link). One of the UK’s papers of record is violently misrepresenting Gillick Competence &#821…

Granite and Sunlight

16-year-old in the UK obtains "cross-sex hormones" from GP without parents knowing. (from the context, maybe testosterone.)

Worrying to see "the Gillick competency test" described as "a loophole". Even if you don't agree on whether it was correctly used in a particular case, Gillick Competence isn't a "loophole", it's a very important principle.

https://archive.ph/JoYAz

#GillickCompetence #trans #consent

28. "[Barber] said for kids aged 14 to 16 years it's a grey area, as they need parental consent while those aged 16 to 18 should be able to consent."

This also isn't a matter of Barber's opinion. "He said ... those aged 16 to 18 should be able to consent" makes it sound like he's winging it: "Oh well, they should be able to consent, it's fine, she'll be right". That framing suggests his practice is endangering children left and right.

In reality, he's simply accurately β€” and perhaps even slightly conservatively β€” summarising Australian and Queensland law. People under 16 have to either get parental consent, or actively prove they're GILLICK competent [1]. People over 16 are assumed competent by default [2].

SECTION NOTES

[1] i.e., that they're competent to give informed consent according to the test stipulated in the UK House of Lords ruling GILLICK v WEST NORFOLK AND WISBECH AREA HEALTH AUTHORITY [1986] AC 112. http://www.bailii.org/uk/cases/UKHL/1985/7.html

#GillickCompetence was incorporated into Australian law by SECRETARY, DEPARTMENT OF HEALTH AND COMMUNITY SERVICES v JWB AND SMB (1992) 175 CLR 2018 (#MarionsCase). http://www8.austlii.edu.au/cgi-bin/viewdoc/au/cases/cth/HCA/1992/15.html

[2] https://www.legalaid.qld.gov.au/Find-legal-information/Personal-rights-and-safety/Health-and-medical/Medical-consent

Gillick v West Norfolk and Wisbech AHA [1985] UKHL 7 (17 October 1985)