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The Court of Appeal has ruled on healthcare for trans children – NHS England must act

22nd September 2021

Last week, the Court of Appeal reversed the damaging Bell judgment in a hugely significant victory for transgender children and their families. 

Once more, doctors are allowed to make their own assessment about whether their young trans patients have the capacity to choose being prescribed puberty blockers. 

The judgment means it is now unlawful for NHS England to require a Court order to give the Gender Identity Development Service (GIDS) permission to refer a young trans patient for puberty blockers or continue treatment for current patients.

This could not be more urgent to resolve. Trans children have been denied puberty blockers since 1 December 2020. Despite the ruling in AB v CD, there have been no referrals from GIDS to endocrinology services since 1 December 2020. This means many children have been left to go through puberty and experience permanent and distressing changes to their bodies – suffering which could have been avoided.

Our lawyers have written to NHS England urging them to act as swiftly as possible to clarify the guidance. We know they can act quickly, and there is no excuse not to – they changed their guidance within hours of the original Bell decision in December to halt new referrals. 

This judgment is a big and necessary step in the right direction for trans young people, who face unimaginable hardships every day. It should make their lives, and the lives of their loving families, easier and happier. 

NHS England has been told very clearly what it needs to do. But if they drag their heels on implementing the Court of Appeal’s decision, we will bring expedited proceedings against them. 


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