Question to the Department of Health and Social Care:

To ask the Secretary of State for Health and Social Care, what assessment he has made of the effect on the wellbeing of children who may be permitted to change gender below the age of 18 without parental consent.

Valid consent to treatment is a central to all forms of healthcare, from providing personal care to undertaking major surgery. If a child is not competent to give consent for themselves, consent should be sought from a person with parental responsibility. This will often, but not always, be the child’s parent.

Decisions about whether to give medical treatment in such cases before the age of 18 without parental consent are properly a matter for clinical judgment, having regard to the best interests and wellbeing of the patient. In exercising their judgment, clinicians will be guided by various pieces of evidence based guidance, such as that published in 2017, Endocrine Treatment of Gender-Dysphoric/ Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline. This is available on the National Institute for Health and Care Excellence website at the following link:

https://www.evidence.nhs.uk/search?q=Transgender+conditions

This guideline recognizes that there may be compelling reasons to initiate sex hormone treatment prior to age 16 years, but notes that there are minimal published experience treating prior to 13.5 to 14 years of age. For the care of peri-pubertal youths and older adolescents, the guideline recommends that an expert multidisciplinary team comprised of medical professionals and mental health professionals manage this treatment.

Any child under 18 thought to have gender dysphoria will usually be referred to a specialist child and adolescent Gender Identity Clinic. Staff at these clinics can carry out a detailed assessment of the child, to help them determine what support they need. Depending on the results of this assessment, the options for children and young people with suspected gender dysphoria can include family therapy, individual child psychotherapy and hormone therapy.

Psychological support offers young people and their families a chance to discuss their thoughts and receive support to help them cope with the emotional distress of the condition, without rushing into more drastic treatments. Further information on the laws and guidelines that protect transsexual people and outline how they should be treated by medical professionals is available on the NHS Choices website at:

https://www.nhs.uk/conditions/gender-dysphoria/guidelines/