This morning there was a preliminary hearing of the Bell v Tavistock appeal (re: whether young people can give informed consent to treatment with puberty blockers), where the court decided whether there could be any new interveners in the case 1/
The hearing confirmed that those who intervened in the original case – University College London Hospitals Trust, Leeds Teaching Hospitals Trust, and Transgender Trend – would all be allowed to do so again in the appeal. 2/
In response to a joint application made by Stonewall, Gendered Intelligence, the Endocrine Society and Brook – the court ruled Stonewall were not granted permission to intervene, but the remaining three have been. Association of Lawyers for Children will also be interveners. 3/
Dr David Bell – adult psychiatrist and former Tavistock staff governor - has also been granted permission to intervene. Dr Bell submitted a report to the Trust in 2018, after being approached by 10 members of GIDS staff who had concerns about the way the service was operating. 4/
None of the new interveners will be allowed to make oral submissions nor submit any fresh evidence. The court made the point that all of these parties could have sought permission to intervene in the original case, and that this was an appeal – not a fresh hearing. 5/
The court said that Liberty and the BMA were considering whether to apply to intervene, and they have until 12th February to submit their applications. 6/
In terms of timings, no date has been set for the actual appeal hearing yet, but there was an acknowledgment that this is a ‘very important matter’ that needed to be heard. It was hoped a hearing could take place in May/June/July. Two days will be set aside for the hearing. 7/7
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NEW:Tavistock Gender Identity Development Service (GIDS) Executive - leadership team - to be ‘disbanded’ in response to CQC’s ‘inadequate’ rating of service & decision in Keira Bell judicial review on whether under 16s can consent to treatment with puberty blockers @deb_cohen 1/
“In response to the CQC report and the breadth of existing actions flowing from the Judicial Review judgment we are proposing to take immediate action to strengthen management arrangements for the service and increase our clinical and operational capacity to deliver change” 2/
This will see “a new Interim GIDS Management Board, chaired by the Divisional Director for Gender. This will replace existing senior management structures in GIDS and will provide a single point of accountability for both improvement programmes and existing service delivery.” 3/
NEW: Tavistock’s Gender Identity Development Service rated ‘inadequate’ by CQC after inspecting GIDS in autumn. CQC say inspection prompted by concerns reported by healthcare professionals & Children’s Commissioner, who’d been given evidence by me&@deb_cohen for @BBCNewsnight. 1/
This is a long thread. Bear with it if you can. Inadequate is the CQC’s lowest safety rating. This means that a service is ‘performing badly.’ GIDS’ smaller clinic based in Leeds was also rated inadequate. GIDS had been rated good at its previous CQC inspection in 2016. 2/
Since then, concerns have been raised about the service: @BBCNewsnight revealed how some GIDS staff had raised serious concerns about safeguarding, the speed of assessments, and whether patients’ other difficulties were always adequately explored. tinyurl.com/y7frzsr6 3/
Court has resumed after lunch. Barrister for endocrinologists explains:
For UCL, median age for blockers 14.6, for cross sex hormones 17.4, youngest 10
For Leeds, median age for blockers 16, cross sex hormones 17.2, youngest 12
Of 145 patients referred to Leeds, 38 experienced delays to treatment. On two occasions pressure was seen to be coming from parent and choice not freely made. Barrister says evident there is no immediate access to treatment after referral
Barrister for endocrinologists says the relevant information on risks/benefits is very different for stage 1 (blockers) and 2 (cross sex hormones). ‘It’s no answer to say the majority of patients do go from stage 1 to stage 2.’
Citing Dutch team again, “concerns have been raised that blocking treatment itself may increase the persistence of gender dysphoria”, but adds that we don’t know this yet.
Medium and long terms consequences of starting blocker treatment, it’s argued, include:
Inability to orgasm, compromised cognitive function, lifelong need for medication, repeated surgical intervention.
Case being made by Bell is that the blocker is not fully physically reversible, as claimed.