A panel of the High Court for England and Wales ruled on Monday that children under the age of 16 are probably not capable of providing informed consent when being prescribed puberty-blocking drugs to address gender dysphoria. As such, the high court suspended such clinical treatment for children below 16 unless the parties are able to gain the authorization of the court to proceed with treatment.

The court applied the Gillick competency test to make its determination. This test comes from a 1984 case that requires an assessment of a child’s “maturity and understanding and the nature of the consent required” before concluding that the child has provided informed consent. The child must be told the advantages and disadvantages of a proposed treatment and they must be able to make a “reasonable assessment” of such factors first.

The court held that:

There will be enormous difficulties in a child under 16 understanding and weighing up this information and deciding whether to consent to the use of puberty blocking medication. It is highly unlikely that a child aged 13 or under would be competent to give consent to the administration of puberty blockers. It is doubtful that a child aged 14 or 15 could understand and weigh the long-term risks and consequences of the administration of puberty blockers.

In contrast, the court stated that those 16 and over enjoy a presumption of their ability to provide consent to medical treatment. In making its decision, the court weighed legal competency standards, the testimonials of individuals who were glad they were able to transition, and the testimonials of those who were not.

While the court acknowledged the thorough efforts by prescribers to provide information to the children, parents and caregivers about any potential short- or long-term effects of puberty blockers, the court did not believe children were capable of understanding and weighing the significance of potential effects.