An influential ruling about puberty blockers has been overturned | The Economist

Judges rule that doctors, not courts, should decide on treatment | Britain

On September 17th the Court of Appeal overturned that ruling, saying that decisions about whether to prescribe puberty-blockers should be left to doctors. The ruling might seem of interest only to specialist medical lawyers. But the legal saga has been watched around the world, for gender dysphoria is a fast-growing diagnosis and the treatments prescribed for it are controversial. Referrals to the Gender Identity Development Service (GIDS), England’s only dedicated youth clinic, have risen from 77 in 2009-10 to 2,383 in 2020-21. Other rich countries have seen similarly sharp rises.

Proponents describe the treatments as life-saving. Sceptics point to the lack of clinical evidence showing that they work, and to worries about severe side-effects later in life. After the original ruling, GIDS suspended puberty-blocker treatments for new patients.

But kicking decisions back to doctors does not mean that the wider argument about puberty blockers is over. Medical opinion in several countries is becoming more cautious. The National Institute for Health and Care Excellence reviews the scientific underpinning of medical treatments in Britain. In March it said that the standard of evidence for puberty blockers, and for cross-sex hormones prescribed to teenagers, was “very low”. In the same month the prestigious Karolinska Hospital in Sweden cited lack of evidence in its decision to stop prescribing puberty blockers or cross-sex hormones to teenagers, except in clinical trials. Finland recently revised its guidelines to prioritise talking therapies over drugs. An NHS review of gender medicine is due to report later this year.

And the Court of Appeal noted that, although medicine is generally best left to doctors, there are limits to their discretion. “Clinicians”, it wrote, “would be alive to the possibility of regulatory or civil action which allows the issue of whether consent has been properly obtained to be tested in individual cases.” The arguments are far from over.

Source: An influential ruling about puberty blockers has been overturned | The Economist

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