Thread by @JolyonMaugham

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.

More to follow but if you'd like to support a challenge please contribute here. goodlawproject.org/crowdfunder/nh…