The high court ruled that Children under 16 are unlikely to be able to give informed consent toe undergo treatment with puberty blocking drugs.

The case was brought by key Rebel who've been prescribed the drugs age 16 against London's Tavist Aacm Portman Trust.

Over the past 18 months.

Newsnight is reported on a Siris of concerns raised about the trusts use of puberty blockers.

We've also reported on the challenges some clinicians said they had in raising questions about the care some young people received at the trust's Gender Identity Development Service, England's only NHS service for young people questioning their gender identity.

Okay, at the heart of today's ruling is the role puberty blockers play in a young person's treatment.

The court found.

There is really uncertainty over the short and long term consequences of the treatment with very limited evidence as to its efficacy.

This means it is in our view properly described as experimental treatment.

But what is the purpose of the drugs?

The Tavis Stock and others have long argued that puberty blockers allow young person time to think about the gender identity without the added distress of going through puberty.

But the judges questioned whether it was that straightforward.

The court also went further, rejecting The Tavis Doc trusts argument that the decision to take puberty blockers was entirely separate from the next stage of transitioning the use of cross sex hormones, testosterone for girls or east region for boys, the court said.

The evidence that we have on this issue clearly shows that practically all Children and young people who start puberty blockers progress on to cross sex hormones.

So what does all this mean for informed consent?

The available evidence suggests that starting puberty blockers would likely mean a young person would then go on to take cross sex hormones with a child under the age of 16.

Fully understand the implications of this on their bodies in the long term.

In effect, the court said no.

It said it was doubtful informed consent was possible for under 16, and even for those who were 16 or 17, it would be appropriate to involve the court where there is any doubt treatment was in their long term best interests.

There is no age appropriate way to explain to many of these Children what losing their fertility or full sexual function may mean to them in later years.

In this ruling, there are no winners.

As of today, there will be no new referrals for puberty blockers for under 16 from the Gender Identity Development Service.

Andi Tonight Newsnight has learned that Jed's will have to review all current cases of Children under 16 who are on blockers and get a court order if they wish to continue treatment.

But for the thousands of Children waiting to be seen by the clinic, it's unclear what help there will be for them.

Deb Cohen with that report What we asked the Tavis Stock Trust to join us tonight.

Nobody there was available.

In a statement, they said the trust is disappointed by today's judgment, and we understand the outcome is likely to cause anxiety for patients and their families.

Our first duty is to our patients, particularly those currently receiving hormone blocking treatment on.

We're working with our partners to provide support for patients concerned about the impact on their care, it added.

The trust, seeking permission to appeal the judgment will not be making new referrals to endocrinology until we have more clarity.

Joining me now is one of the claimants.

In that case, Kira Bell won the case today.

Curator for those who don't know you just outline your own story for us.

Briefly?

Uh, yes.

So I was referred to the clinic at age 15, and I was seen from age 16 on.

I was put on puberty blockers that same year, on gone to test us throwing the next year on Ben.

I went on to surgery through the adult clinic.

Just explain to us you suffered gender dysphoria.

A za girl on you felt that you wanted to transition to become a bought a man.

Yeah.

Yeah.

And then what happened?

Eso Yeah, when I when I first arrived at the at the clinic.

You know my belief.

You know that I was a boy or you know, that I should become a boy was affirmed.

Um, you know, there was no investigation into why I had those feelings, you know, it was it was pretty much accepted from the get go on, you know?

Yeah.

Medical interventions were spoken off quite quickly.

So you went ahead.

You had you had the blockers you had surgery on.

Then you decided that that wasn't the right course for you.

Yeah, Yeah, I'm just realizing.

I think that a lot of it isn't based in, you know, it doesn't have scientific evidence behind it, you know, and just realizing that, you know, it's not a healthy route to go.

If you know, Aiken, you know, if I don't need to continue on with it, so I mean, it's it's incredibly personal.

It's very sort of you specific.

But in your case, you felt that what?

They let you have access to the drugs too quickly.

Is that right?

That you should have been denied that because you weren't making a sound judgment?

Yeah.

Yeah, that's right.

I was dealing with a lot of other mental health issues.

Also on Do you know a lot of past issues that hadn't been brought up again?

It wasn't investigated, so yeah, there's always a lot of issues going on behind the scenes, you know, definitely in my experience.

And I think, you know, with current kind of trend that we're seeing off young girls being referred to the clinic.

I guess that this judgment would stop them handing out the treatment straight away or after a short amount of counseling.

But if you you know it's an articular young woman went to the court and said, I really mean this and I'm serious about it.

There's every chance that the court would still have allowed you to do something which you would later regret, isn't there?

I wouldn't say so because, you know, they would have actually looked into the reasons why I wanted Thio proceed with the treatment.

I'm sure that the mental health issues and everything that should have bean discovered at the Tavistock would have bean brought out in the courts.

There will be thousands of young people tonight who will be terrified by this judgment, as you know, terrified that this will stop them living the life that they need to be incredibly distress.

Because something that didn't work for you may still work on be very important to them.

Yeah.

I mean, I think when we're dealing with the topic of mental health, you know, obviously emotions will be running high, and I understand that, you know, I would have been in the same position, perhaps as you know, you know someone, uh, age 16, for example.

You know, listening to you know, what happened today.

But, you know, again, the high court, you know, they came to their decision, You know, the high tier judges on, you know, they looked a worry about the kids.

Now who?

I mean, some of them might even have their current drug treatment.

Yeah, stopped.

Do you do?

Well, Yeah, of course.

Yeah.

I'm definitely concerned about them.

And I completely empathize with them.

You know, I think that a mental health services need to be put in place to help that person through, You know, the period that they're going through.

You know, I think that's that's the vital.

That's what needs to happen.

Because for every care, a bell, that could be somebody who isn't allowed and wants to be allowed.

Yeah.

Yeah, absolutely.

But again, the high court, you know, they came to the conclusion that it isn't possible for particularly under sixteens toe consent to that treatment in those protections are put in place for a reason.

Kerry Bell.

Thank you.

Thank you very much for coming in.

Let's speak now to Susie Green, the CEO of Mermaid to charity, which supports transgender Children and teenagers on their parents.

Susie Greene, NHS, England, have said tonight that they welcome the clarity that this judgment brings on.

They have amended their service specifications, even including those who are actually on blockers on day will be reviewed starting immediately.

Your response.

I think it's a disaster.

Quite frankly, I think this is ushering a new era of discrimination against trans people.

Nobody else has got this kind of measures in terms of young people and their autonomy over their own bodies is only young people who are transit were being subjected to this.

Andi, I can't go into individual instances because obviously that would violate people's privacy.

But we've seen today the devastating impact of this judgment is already having on will continue to have over the next few months and years to come.

Our help line and our foreign has been swamped by families and young people who are personally impacted on the inevitable rising self harm and suicide suicide.

Ality we are seeing is worrying.

Let's deal.

If you don't mind, let's deal with those separately.

This is not as you'll know, it's not denial.

All it does is put it back to the courts to make the final decision.

So they're not saying no one can have this treatment.

They're just saying we need to get this right.

We need an extra level of checking so we don't end up with a kind of regret that you just heard a moment ago from Kira.

Yeah, but you've gotta appreciate that.

Kira's experience, although obviously valid, is not representative of the vast majority of people who go through this process.

There's less than a 1% regret after transition.

Are we saying that it's so much better not to be Trans?

That will sacrifice the happiness of those 99 trans young people who need this treatment?

I guess what we're saying is that the court weighed up thousands of pages of evidence.

They took those views into account.

They heard from young people three kids patients who were submitted by the Tavis Stock.

They've done their homework on this, and they think more protection on more guidance for young people is used with these highly unusual, innovative drugs that they know very little about.

These have been used for over three decades.

This is no experimental treatment, not in this specific way to start the transitioning process, which, as you know it does.

They have the Dutch.

The Dutch instigated this kind of treatment in the 19 eighties late 19 eighties.

This has been used routinely to treat gender dysphoria and to hold puberty for many, many years.

This is no experimental, and there are so many studies out there that show how efficient this is, how much it helps young people, how much it helps them to live their lives.

This is literally life saving.

Treatment is now.

I'm not sure that you can say it's life saving because we know that any suicide is way too many.

But there is no strong evidence to support that.

This is either lifesaving or that this increases the risk of suicide, kids own Website says.

Thankfully, suicide is extremely rare, so to say it is lifesaving is dangerous.

It's different territory.

I don't think so, Not when this is anecdotal.

This is what parents are saying to us.

This is what families and young people are saying to us that this is literally something that they desperately needed, that their Children desperately needed that this is something that literally saved their lives.

So this is anecdotally from parents.

I've been working in this field for, like over 21 years because, Andi, I've seen literally thousands of families, and I have seen the difference.

The positive difference that access to puberty blockers gives to young people that allows them to get on and live their lives without the torture that is puberty.

Having Thio we'll stop there is horrendous on this.

How is basically gonna force potentially thousands of young people to experience that it was e think it's different?

I wouldn't I wouldn't for a moment contradict your own experience or what you've heard from young people because, as we said a moment ago, this is intensely personal and every single person is different.

But what the judges have said is that the evidence base for the treatment is highly uncertain.

It's an experimental treatment on.

Even when I was speaking to the Tavis stock a year ago, Elizabeth Van Horn says the evidence is not gold standard.

They do not have the evidence to try and draw conclusions about the benefits of this on.

Surely an extra layer of protection can only be a good thing.

Is there any other treatment pathway, whether it is new or established or or well versed that has ever had to go through a court for a young person to be able to access?

I don't think so.

On, I think, whether it is deemed as being experimental or not, whether they're going to ignore the breadth of international evidence that shows how good this treatment works for young people in the positive outcomes, even if they ignore all of that.

Even if they ignore all of that, they listen to young people.

Susie Greene.

Thank you very much for joining us.

Thank you.

Thank you.