The Times - UK (2020-12-02)

the times | Wednesday December 2 2020 2GM 7

News

Britain’s only NHS gender clinic for

children has suspended referrals for

hormone therapy after a ruling on the

experimental use of puberty blockers.

Judges at the High Court found it was

“highly unlikely” that 13-year-olds, and

“doubtful” that anyone aged 14 or 15,

would understand the full implications

of the hormone treatments, and there-

fore could not give informed consent.

In almost all cases people who take

puberty blockers go on to take cross-

sex hormones, which may lead to life-

changing consequences, such as loss of

fertility and impaired sexual function.

The Gender Identity Development

Service (GIDS) clinic, also known as

the Tavistock, has been prescribing

them to under-16s since 2011. The drugs

are not licensed for gender dysphoria in

the UK and there is little evidence of

their long-term safety in this context.

The High Court also recommended

that doctors should not prescribe the

drugs to those aged 16 and 17 without

first seeking the consent of the courts.

Anyone who continues to prescribe

puberty blockers to under-16s without

court authorisation now runs a higher

risk of pursuit for clinical negligence.

The Queen and the Duke of

Edinburgh leading the royal

family’s traditional visit to

St Mary Magdalene Church

in 2017. Her first televised

Christmas speech was made

at Sandringham in 1957

CHRIS JACKSON/GETTY IMAGES

The delayed expansion of the capital’s

low emission zone when Boris Johnson

was mayor exposed poorer Londoners

to more toxic pollutants, an inquest has

been told.

Philip Barlow, an assistant coroner

for inner south London, is considering

whether pollution caused the death of

Ella Adoo-Kissi-Debrah, nine, in 2013.

Ella lived near the South Circular in

Lewisham, south London, and had sei-

zures that required more than 30 hospi-

tal admissions in the three years before

she died after a severe asthma attack.

Yesterday Southwark coroner’s court

was told that deprived communities —

particularly from ethnic minorities —

were likelier to live near busy roads.

Under Mr Johnson, who was mayor in

2008-2016, plans to include minibuses

Charlie Parker

clean air

for all

Johnson ‘delayed action on toxic air’

and larger vans in the low emission

zone (LEZ) from October 2010 were

put on hold until January 2012 on the

basis that drivers needed more time to

adjust after the 2008 economic crisis.

Philip Graham, executive director

for good growth at the Greater London

Authority, told the inquest that the city

was unlikely to meet legally binding

limits on nitrogen oxide emissions until

at least 2025. The targets, which were

set by the EU, came into force in 2010.

The inquest was told that in 2010 offi-

cials knew that parts of the capital were

“nowhere near” reaching safe, legal

limits near roadsides. The health bene-

fits of the LEZ, particularly for people

with respiratory problems, were also

known. The coroner asked: “Is it fair to

say delay in the introduction of LEZ

phase three is going to affect people

with respiratory problems in deprived

areas more?” Mr Graham replied: “I

think that’s likely to be the case.” He

agreed that Mr Johnson had been told

that deferral would have a “negative im-

pact” on hitting legal clean air targets.

Richard Hermer, QC, for Ella’s

family, said: “The deferral decision...

was impeding progress to reaching the

threshold.” Mr Graham told the court:

“It was a balance between the economic

factor in the aftermath of the financial

crisis and the health impacts.” He said

that it had been a “political decision”.

Mr Hermer said that Sadiq Khan, the

present mayor, had brought in meas-

ures to cut pollution, such as upgrades

to public transport. “There’s no reason

why those could not have been intro-

duced earlier... and had a material im-

pact on nitrogen dioxide levels,” he said.

Mr Graham agreed. He also said that

all three mayors had found asking the

government for help on pollution

ineffective and “a source of frustration”.

The inquest continues.

A coroner will rule

whether pollution

caused the death

of Ella Adoo-Kissi-

Debrah in London

Gender clinic

halts drugs

after ruling

Lucy Bannerman The NHS said: “The Tavistock have
immediately suspended new referrals
for puberty blockers and cross-sex hor-
mones for the under-16s, which in
future will only be permitted where a
court specifically authorises it.”
A former GIDS clinician who blew
the whistle, with four colleagues, in a
Times investigation last year, said the
ruling was a vindication. They had
claimed that children were being sent
down an irreversible path towards in-
fertility and surgery after as few as
three sessions with a therapist, without
sufficient investigation of the cause of
their distress.
“The Tavistock were given chance
after chance to moderate their ap-
proach, after staff voiced our concerns,
but they essentially called us transpho-
bic,” the clinician said. “The High Court
has said no, we weren’t transphobic, and
the judges agreed with our concerns.”
The number of referrals to GIDS has
risen from 97 under-18s in 2009 to 2,
last year. Thousands are on a waiting list.
Keira Bell, 23, who began puberty
blockers as a teenager and went on to
have a double mastectomy, which she
now regrets, brought the legal action
against the Tavistock and Portman
NHS Trust. She said that she was “de-
lighted” and hoped the ruling would
protect young vulnerable people, who
she said needed better mental health
services, not experimental drugs.
The judgment “exposes a compla-
cent and dangerous culture at the heart
of the national centre responsible for
treating children and young people
with gender dysphoria”, she added.
The action was also brought by Mrs
A, the mother of a 16-year-old autistic
girl on the waiting list. Mrs A said: “I
hope this judgment will provide a safety
net to prevent the unsupervised medi-
cal experimentation on children... by
an institution charged with helping to
alleviate [their] distress.”
Nancy Kelley, Stonewall’s chief exec-
utive, said that the ruling was shocking
and could have a “chilling effect”
on young trans people’s access to
“timely medical support”.
The NHS trust said that it was
“working through” the
implications of the ruling and
would “not be making new
referrals to endocrinology
until we have more clarity”.
A victory for common sense,
leading article, page 31
Keira Bell talks to
Janice Turner, Times

T

his ruling heralds the

end of the “Wild West”

approach to treating

children who are

exploring whether they

may be transgender (Lucy

Bannerman writes).

For years puberty blockers

have been described by trans

rights charities such as

Mermaids and Stonewall as a

benign and reversible way of

giving distressed young people

“time to think”.

In fact, as the High Court has

ruled, their use to treat gender

dysphoria is highly

experimental, with an

unknown long-term effect on

adolescent bodies. What was

certain, the judges found,

was that most children

who began puberty

blockers went on to

take cross-sex

hormones. As one

treatment led to the

other, informed

consent was

required for both.

Analysis

T

he Queen and

the Duke of

Edinburgh are

to break with

tradition by

spending Christmas at

Windsor Castle instead of

Sandringham in Norfolk

(Valentine Low writes).

They may see members

of their family briefly

over the holiday but there

will be no large family

gathering at the castle in

Berkshire.

The Queen will also not

attend a public church

service on Christmas Day

to avoid drawing crowds.

She may attend a service

in the private chapel in

the state apartments.

Buckingham

Palace said:

“Having

considered all the

appropriate

advice, the

Queen and the

Duke of

Edinburgh have

decided that this

year they will spend

Christmas quietly in

Windsor.”

The announcement

follows speculation about

where the Queen, 94, and

Prince Philip, 99, would

spend Christmas. Three

households can mix from

December 23 to 27 but

the combination must be

exclusive over the period.

The large gathering at

Sandringham, when

members of the family

stay with the Queen and

Philip and attend a

service with them on

Christmas Day at St Mary

Magdalene Church, has

long been part of the

royal Christmas. The

family often used to

spend Christmas at

Windsor Castle but

switched to Sandringham

in 1988 when the castle

was being rewired.

The Queen and Philip

have spent much of the

lockdown at Windsor

being looked after by a

reduced number of staff

known as HMS Bubble.

Several members of the

family live close by. The

Duke of York and his

former wife, Sarah,

Duchess of York, are at

Royal Lodge, Windsor,

and the Queen’s grand-

daughter Princess

Eugenie and her husband,

Jack Brooksbank, are at

Frogmore Cottage.

Queen gives up beloved

Christmas in Norfolk

el in

ts.

d

n

ent

Keira Bell, 23, now regrets

taking puberty blockers

Call me he/they, says Juno star

The star of the film Juno, formerly

known as Ellen Page, has announced

that he is transgender. The actor said in

a social media post that his pronouns

are “he/they” and his name is Elliot.

“I feel lucky to be writing this. To be

here. To have arrived at this place in my

life,” Page said. “I feel overwhelming

gratitude for the incredible people who

have supported me along this journey.”

Page, 33, who also stars in the Netflix

series The Umbrella Academy, said that

his “joy is real, but it is also fragile. To be

clear, I am not trying to dampen a mo-

ment that is joyous and one that I cele-

brate, but I want to address the full pic-

ture. The statistics are staggering. The

discrimination towards trans people is

rife, insidious and cruel, resulting in

horrific consequences.”

Addressing trans people, Page said

that he would “do everything I can to

change this world for the better”. Page,

who is married to the choreographer

Emma Portner, added: “I love that I am

trans. And I love that I am queer.”