Prof. Xinyu Wang (China University of Political Science and Law) and He Xiao (a law PhD student at the University of Bristol)
Since October 2020, a “Stop Period Shaming” campaign has been quietly taking place within universities in China. It all started in early 2020, during China’s fight against the COVID-19, with various socially sponsored donations of medical supplies and an extreme shortage of feminine period products. The female doctors and nurses, who made up more than half of the medical team that went to Wuhan, overcame their cycles’ fragility and fought like the male doctors. (more…)
by Sandra Duffy, Law School, University of Bristol
On December 1st, the High Court handed down its decision in the case of Bell and A v Tavistock and Portman NHS Trust. This ruling concerned a judicial review of the practice of the Tavistock Gender Identity Development Service in prescribing puberty-blocking hormonal treatments to children under 16 years of age.
Puberty blockers are given to transgender children with a diagnosis of gender dysphoria. They are used to spare these children from going through the puberty associated with their assigned sex and to give them time to reflect on their gender identity without the pressures associated with puberty. Puberty blockers have an inverse correlation rate with suicidal ideation in transgender persons and can sometimes be a life-saving treatment for these children. Most young persons who take puberty-blocking treatments will go on to take adult hormonal interventions (CSH) also (approx 98%, per Bell). However, this is neither automatic nor inevitable. Puberty blockers are fully reversible as they pertain to pubertal developments and the individual is given the choice at 16 as to whether they wish to continue on to adult medical services.
The standard used to assess competence to receive medical treatment in children under 16 is known as Gillick competence. Children are considered competent to give consent to treatment without their parents’ consent if they have “sufficient understanding and intelligence” to understand the “nature and implications of the proposed treatment.” (Bell, 105)
The interested party in this case is Keira Quincy Bell, who identified as a trans boy as a teenager and young adult, but now identifies as a woman. She does not believe that she was fully competent to make transition-related decisions as a minor, alleging that she could not understand the consequences of those decisions, nor that they would entrain the later decisions she made as an adult (such as a mastectomy).
The High Court’s conclusion in this decision is that “it is highly unlikely that a child aged 13 or under would ever be Gillick competent to give consent to being treated with [puberty blockers]… In respect of children aged 14 and 15, we are also very doubtful that a child of this age could understand the long-term risks and consequences of treatment in such a way as to have sufficient understanding to give consent.” (Bell, 145) Within the list of “long-term… consequences” the Court believes it is necessary to understand are the effects of CSH on sexual function and fertility. CSH are voluntary treatments undertaken after the age of 16, in a separate decision to that which is involved in consenting to puberty blockers. The Court here uses the high correlation rate between puberty blockers and CSH as destiny, conflating the two decisions into one – which is not the case in reality.
In making the above-quoted statement, the Court refines Gillick competence as it relates to trans children as a class. As Ruth Fletcher has pointed out, this is antithetical to the usual way in which capacity decisions are made – on a decision- and person-specific basis. It also singles out trans children and applies stricter standards on them than on other children when consenting to healthcare. Asking trans children to understand the consequences for sexual and other health matters of taking CSH (Bell, 138) – which is a treatment they will not encounter until later in their teenage/early adult years – involves a leap of the imagination which will render this standard difficult to meet.
Puberty blockers are characterised as an experimental treatment with unknown consequences in the decision. This impacts strongly on the Court’s holding that it would not be possible for young teenagers to understand the consequences of their decision to take them. However, this has been denied in the medical literature.
This decision is highly cisnormative. It positions cisgender (non-transgender) identity as normal and transition as a dangerous process to be avoided if possible. It is also heavily pathologised. There is no rights-based, affirming language used about trans youth. Trans identity itself is only referred to in terms of the psychological disorder ‘gender dysphoria,’ which people are said to “suffer from.” This adds to the othering of transgender persons and removes the perspective of the individuals concerned from the decision itself.
Lastly, the decision is likely to have an influence on other aspects of minors’ healthcare. Particularly troubling are the implications for reproductive healthcare decisions such as abortion which may also be said to have “lifelong consequences.” The tightening of Gillick competence in Bell is a worrying precedent for those seeking to protect minors’ reproductive autonomy.
The opinions expressed in this piece are solely those of the author, unless otherwise attributed.
The Human Rights Implementation Centre, along with the Centre for Health, Law and Society, are pleased to announce our seminar on the medico-legal consequences of the Bell v Tavistock judgment, which will be held on March 3rd at 1.15pm. Speakers include Robin White (Old Square Chambers), Professor Simona Giordano (University of Manchester), Dr Bianca Jackson (Coram Chambers), Dr Jay Stewart (Gendered Intelligence), and Dr Ruth Fletcher (QMUL). Please see further details at this Eventbrite link.
With diverse formally formations increasing, it is arguable that the birth registration system is not fit for purpose because it is tethered to ‘traditional’ understandings of family life and cannot adequately account for ‘modern’ families. This post considers mismatches between law and identity within birth registration for trans parents.
You would be forgiven for thinking that the term “male mother” is an oxymoron, but this is the conclusion the Court of Appeal reached in R (McConnell) v The Registrar General for England and Wales  EWCA Civ 559 regarding a trans man, Freddy McConnell, who gave birth and wanted to be registered as his child’s father (or parent) on the birth certificate. (more…)
The current COVID19 crisis has shone a light on the world of work by interrupting the supply and demand necessary for global capitalism to function. In the UK context, it has drawn attention to the inadequacies of our current employment rights framework; the ways in which certain types of work is insecure and de-valued; the racialised, gendered and classed boundaries of some ‘front-line’ jobs; the vast power disparities between employers and employees; and called into question the necessity of office work, or indeed a 5 day working week.
Perhaps then this period of reflection might open up new perspectives and ideas amongst the public which could radically transform the future world of work, pushing forwards positive change which forefronts worker protection, adequate remuneration, recognition, work-life balance and interests outside of traditional ‘work’ under industrial capitalism. Below, I outline some of the areas in which these changes should take place. (more…)
The recent debate on gender recognition reform, as played out in the press and on social media, has been painful to behold. With passions running high, much of the discourse has been marked by a lack of regard for the viewpoints of others, on occasion spiralling into professional and even personal abuse online. That the pursuit of equality should unleash such unkind sensibilities is troubling, particularly in a feminist context in which values such as inclusion, empathy, and respect for different standpoints have generally commanded wide respect.
What lies behind the apparent deadlock in debate between transgender activists and ‘gender critical’ feminists? On the one hand, there is the perfectly proper concern of trans people to have access to a legal process of gender recognition which they do not experience as invasive, cumbersome, and pathologizing. On the other, there are misgivings expressed by some in the feminist community that a legal regime of gender recognition, understood as ‘self-declaration’ and operating in various forms in Argentina, Belgium, Brazil, Chile, Columbia, Denmark, Ireland, Malta and Norway, will weaken the hard-won gains of decades of feminist activism particularly with regard to securing women’s access to safe sex-segregated spaces such as rape crisis centres and women’s refuges. The fact that existing equality legislation already provides a level of protection allowing same-sex service providers to deny access to transgender individuals where they can show this is a proportionate means of achieving a legitimate aim (for example, a counselling service might reasonably be concerned that sexually abused women will be less likely to attend group counselling if ‘male-bodied’ trans women are also in attendance) does not seem to have allayed these concerns, though surely they should, particularly as the Government has made clear that they have no plans to change equality law. (more…)
By Dr Katie Cruz, Lecturer in Law (University of Bristol Law School).*
On 2nd June, sex workers and activists gathered globally to mark the struggle for sex workers’ rights. International Sex Workers Day is just one day of the year dedicated to the struggle for sex workers. Activists gather on March 3rd to mark International Sex Worker Rights Day and on December 17th to mark International Day to End Violence against Sex Workers. These dates occur because of the historical and ongoing violence against, and exclusion of, sex workers. Sex workers are subject to interpersonal forms of violence, from police officers and clients, and the structural violence of criminal justice and immigration institutions. They are criminalized and affected by often-punitive anti-trafficking laws and policies, and they are subject to heightened immigration controls, including the criminalization of movement and working. The Tory government’s hostile environment has created additional layers of institutionalised insecurity for many migrant sex workers, including restrictions on access to housing, healthcare, education, and banking services.
This blog considers the Supreme Court’s adjudication on standing. It argues for a literal interpretation of the Northern Ireland Act 1998 and Human Rights Act 1998 (HRA) to argue that, contrary to the UK Supreme Court’s majority judgment, the Commission is empowered under the Northern Ireland Act to bring proceedings in cases of an unlawful act of a public authority and for review of the compatibility of Northern Irish primary legislation with the European Convention on Human Rights (the Convention). (more…)
By Mr Marc Johnson, Teaching Associate in Law (University of Bristol Law School).
On 7 February 2018, Bermuda’s Governor approved the Domestic Partnership Act 2017 (DPA) which withdraws the right for same-sex couples to marry in Bermuda. The ‘Domestic Partnership’ purports to offer the same legal standing as marriage though there is a degree of scepticism around whether this will be the case. There is a substantial body of writing in the UK on whether the civil partnerships established under the Civil Partnership Act 2004 were in fact equal to marriage, or whether creating a second form of legal partnership also created a subordinate form of legal partnership.
This may not however, be the end of the story. According to Reuters News Agency, on 20 February 2018, a Bermudian Lawyer has filed a motion asking for the Supreme Court of Bermuda (a court of first instance unlike the Supreme Court of the UK which is the UK’s final appellate court), to consider whether the DPA is inconsistent with the Bermudian Human Rights Act 1981 (HRA). This blog piece will briefly consider whether the Bermudian constitution has been altered by the HRA to include protections for same-sex marriage, to what extent is the HRA constitutional, and can rights given under the HRA be removed. (more…)
Last week’s reports of the Presidents Club charity dinner once again revealed the troubling culture of the City: ‘that weird mix of cutting-edge high finance and caveman misogyny’ (Patrick Jenkins, Financial Times, 24 January 2018). Journalist Madison Marriage’s exposé recounted how 130 ‘hostesses’ were recruited for a fundraising dinner to be attended by 360 men from the worlds of politics, business and finance (Financial Times, 23 January 2018). Although it is not clear who attended, press reports have stated that the guest-list included senior executives from well-known corporate groups, bankers and hedge fund managers.
The well-intentioned aim of the evening’s auction was to raise money for charity. According to the Club’s website, ‘over the years, esteemed members of the investment, real estate, sports, entertainment, motor industry and fashion world have come together to support and raise millions of pounds for the trust in its work to help as many worthy children’s causes.’ Marriage’s report, however, painted a picture of the highly sexualised City culture that Linda McDowell so vividly captured in her 1997 book Capital Culture and by the Fawcett Society in its 2009 report on Sexism and the City. While ‘hostesses’ were apparently groped, subjected to lewd comments, and, in one instance, asked to join an attendee in his bedroom, the men attempted to outdo each other’s bids for lots including ‘an exclusive private night’ at a strip club, plastic surgery to ‘take years off your life or add spice to your wife’, and a combined lot of lunch with the Foreign Secretary and tea with the Governor of the Bank of England. The winning bid for this last lot was reportedly £130,000. The hostesses were asked to dress as though attending a ‘smart, sexy place’ and asked to sign a non-disclosure agreement (“NDA”) relating to the evening. (more…)
By Mr Peter Dunne, Lecturer in Law (University of Bristol Law School).
In the coming months, the United Kingdom (UK) and Irish governments will (separately) review the legal processes by which transgender (trans) persons can have their preferred gender (currently referred to as the ‘acquired gender’ in UK law) formally recognised. Drawing upon my scholarship from recent years, in this post, I consider current movements for reform in the UK and Ireland, with a particular focus on trans minors (who are largely excluded from the UK and Irish frameworks) and non-binary individuals. I conclude this discussion, in the last section, by reviewing the question of ‘self-determination’, and asking if/how the UK can move beyond its current diagnosis-orientated recognition model. (more…)