Yesterday, in an act she describes as "bold" Victoria Atkins decided to ban puberty blockers, which give young people questioning their gender identity time to think before they take partially irreversible cross-sex hormones. 🧵
The case for puberty blockers is that, in a world (and a nation) that is increasingly transphobic, they prevent the irreversible development of physical characteristics associated with the sex you were 'assigned at birth', that mean you will always find it difficult to 'pass'.
Imagine being a trans girl going through puberty, knowing your voice will drop and you will develop an Adam's apple which means you will be 'read' as a man in a transphobic world.
So you take PBs to pause that development whilst you see whether your gender identity as a girl persists. And if it does you can take (partially irreversible) oestrogen.
Anyway, in a nutshell, that's the case for puberty blockers.
The conclusions of the Cass Review - more on this another day - are heavily contested by international bodies and trans people and their allies. They think it is policy based evidence making. But even the Cass Review says PBs should be available in certain circumstances.
So what does Victoria Atkins' 'bold' statutory instrument do? Here's the explanatory note.
The political climate in the UK means it is difficult or impossible to access puberty blockers from UK prescribers. But 'mutual recognition' rules mean UK pharmacies can (ordinarily) dispense PBs prescribed by regulated prescribers in the EU. And that's what most people do.
We have become an international outlier and Victoria Atkins' regulation seeks to preserve that position. Her regulation means that (unlike other medicines) prescriptions written in the EU for puberty blockers can't be fulfilled here.
It is causing panic amongst young trans people and their families. I understand there has been a massive increase in suicides amongst young trans people since the appalling decision of the Divisional Court in Bell (more on this to follow). And this move will make things worse.
Is her move legal? The short answer, I think, is 'no'.
The first thing to note is that the regulations are made without considering the appropriate committee.
This is a reference to these provision of the Medicines Act 1968 which enable the Minister to ban medicines where it is "necessary" in the interests of safety. Necessary signals to lawyers a high bar. And, remember, Cass does say PBs should be available in some circumstances.
If that wasn't bad enough, she hasn't consulted the appropriate Committee before making the regs, which raises the bar even higher. It has to be "essential to make the order with immediate effect to avoid serious danger to health".
I can't begin to imagine how the Minister can argue this test will be met.
There are other problems too. Puberty blockers are routinely used to delay what doctors call "precocious" puberty in cis (as opposed to trans) kids. This use has not been banned, which raises questions about discrimination (as well, of course, as the necessity of banning them).
It's also worth noting that the regulations come into force on 3 June - so families can still get a prescription filled until Monday.
Moreover the regulations cease to have effect on 2 September.
This is an odd provision which I would guess is designed to head off an inevitable and likely successful legal challenge. But it also means families have only a short term problem.
My tentative view: if you think your child is benefitting from blockers ask your regulated prescriber for blockers in injectable form, which I understand to last three months (and be safer anyway) and take the injection in the EU, which puts healthcare before ugly politics.
An urgent legal challenge is being prepared to these highly irresponsible regulations and we will help to fund it.
If you wanted to use the pandemic as cover for passing money to your dodgy friends and donors who didn’t actually have anything to sell you would set up procurement exactly as the Conservative Party did in the pandemic.🧵
You would identify the PPE you wanted and then, instead of buying it from the Chinese manufacturer, you would buy it from a UK intermediary. And then choose who the intermediary was.
Putting together a good offer was not easy. It helped to have connections on the ground in China; you needed to gather lots of complicated documentation together; and you had to keep the supply available for long enough to get it over the line with Government.
Every mother who has sent her children to bed hungry, or victim who has watched her rapist go untried, or domestic violence victim who cannot leave because there is no emergency shelter, or mum who can't work because of childcare costs, knows exactly which party hates women.
And in a couple of days, when the polls with fieldwork after JK Rowling's attacks on Labour drop, we'll know her actual impact. And it will be, despite the best efforts of our noble fourth estate, exactly none.
A new Government must get serious about the tide of misogyny and violence that leaves so many, too many, women bearing trauma. And how some women feel about trans women is relevant too. The challenges posed must be resolved with care and sensitivity: there is no other way.
On Wednesday evening I spoke to a prominent journalist about a mind-blowing PPE case that will soon emerge - it looks like a small group of senior civil servants created false evidence trails to try and cover up the fact that valuable PPE contracts were diverted to Tory VIPs.
Our conversation followed a meeting we had with the lawyer - in a well known firm - acting in the case. The lawyer spoke of how it had taken him a long time to believe the evidence. He had it, but it cut so violently across his own understanding of what the State in England is.
The journalist had made their name writing about a long-running scandal involving the creation of false evidence by other trusted public bodies.
It hadn't occurred to them that there are profound similarities between that scandal and this.
I have now seen further evidence that, since the Bell decision in the High Court (1 December 2020), there has been a huge increase in deaths of young trans people on the NHS waiting list - and that NHS management has sought to suppress that evidence.
CW: Suicide 🧵
When the High Court handed down its decision in Bell, the NHS immediately pulled down the shutters on healthcare for young trans people.
But when the Court of Appeal overturned that decision - on multiple grounds - the NHS unaccountably left those shutters in place.
Kemi Badenoch has explained that much of this happened because her Government chose to prioritise ideology when it came to appointing key positions in health.
But the evidence shows the outcome was predictable (and predicted): a huge increase in deaths of young trans people.
This is a thread for trans families struggling to negotiate the emergency regulations introduced by Victoria Atkins on what is and isn't lawful. It draws on formal written advice from a top, specialist KC. 🧵
When Ministers make the law they do so because Parliament has given them power to do so. The power to make these regulations (2024 No. 727) is in section 62 of the Medicines Act 1968.
As you can see from regulation 62(1) she has power to "prohibit the sale or supply, or the importation, of medicinal products."
What she has actually done you can see Regulation 3: she has prohibited the sale or supply - but not the importation.
A society that embraced the state of being trans, runs the argument, would give cross-sex hormones to those of Gillick competence earlier: no other medical treatment imposes upon those able to make informed decisions an obligation to 'think' before making choices. Why this one?
They see this unique feature of trans healthcare as reflecting an inherent prejudice. It's a bit like our inglorious history of homophobia in which even loving parents said to their gay children, 'why are you doing this - it's such a difficult life?' as if being gay was a choice.