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English Teen Alex Vellins Says Puberty Blocker Ruling Will Make a Difficult System Harder for Trans Youth

Teen Vogue logo Teen Vogue 12/4/2020 Lucy Diavolo
a group of people standing in front of a crowd © Wiktor Szymanowicz/Barcroft Media via Getty Images

This week, a new court ruling in England dramatically altered the lives of the country’s transgender youth. As Reuters reported, three High Court judges ruled that children under 16 aren’t capable of giving fully informed consent for trans medical care — meaning that any trans kids attempting to obtain medication like puberty blockers will now need to go to court to get them.

That’s a significant change in policy. The informed consent model has completely changed the way trans people can access medical care, empowering patients to obtain their own care by giving them the power to decide on their own treatment. Given the history of medical gatekeeping around gender-affirming care for trans people, informed consent is a model that lets trans people pursue their own care without having to jump through as many hoops as other models.

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But, as Reuters reported, the judges ruled in the lawsuit Bell v. Tavistock that people under 13 are “highly unlikely” to be able to provide informed consent, and that it’s also “very doubtful” for those ages 14-15. The case was brought by a woman named Keira Bell, who took puberty blockers as a teen and later detransitioned, according to Cambridgeshire Live.

Mermaids — one of the best-known U.K.-based LGBTQ advocacy groups — put together a helpful guide to what this all means. Already, there was an extremely lengthy process to seek care at a gender dysphoria clinic through the National Health Service (NHS). Now, according to Mermaids, people under 16 will also need to obtain a court order to get puberty blockers, the medication that can prevent someone from experiencing the wrong puberty for their gender.

To get a better sense of how England’s new policy will impact the country’s trans youth, we spoke with 18-year-old trans man and Mermaids service user Alex Vellins from Manchester, who shared his reaction to this week’s sad news. Here’s what he had to say.

Teen Vogue: Could you share your reaction to the news this week?

Alex Vellins: I'm terrified this judgment is going to sentence trans teens to years of excruciating puberty causing unmanageable levels of dysphoria and distress. I sympathize with Keira Bell, and understand that blockers have risks and that the evidence base is uncertain, but this has to be weighed against keeping children from transitioning and the resulting mental health crisis.

TV: Transition is a very personal and private journey, but could you tell us a little about what your journey has been like in the legal framework that existed prior to this ruling?

AV: It took me 18 months to get onto blockers. And I was lucky in that I came up quite a while ago, so the waiting list was short. Just waiting for blockers between the ages of 12 and 14 was excruciating. I remember hating, like, everyone involved. But they were so firm on it, like, “This is the protocol. We have to wait, and we have to make sure that you're fully okay with this,” and all that kind of thing. It's not an affirmation model. It's very critical of what you say, and they challenge everything that you say. There's a social worker involved and a clinical psychologist, and then there's countless questionnaires.

TV: That sounds like a lot of obstacles to receiving care.

AV: Yes. A hundred percent. Like, the waiting list now is two years just to be seen, and then how long it takes to get into blockers. I think the nature of the process has been lied about. It's not like [I say], “I'm trans,” [and then they say,] “Okay. Stab! Here's the blockers.” It's very excruciating.

TV: That feels emblematic of the larger conversation about trans youth and trans issues over there and here — a lot of misrepresentation of fact and reality.

AV: Yeah. It's very frustrating.

a person posing for the camera © Courtesy of Alex Vellins

TV: What have you been hearing from other folks in the community?

AV: It's a lot of fear. I know people that are still waiting and they're like, old — like 19 — and they still can’t get blockers. It's a difficult system to get into, just to be seen, never mind to go through it. So now, to require a court case — I mean, how long is a court case going to take, if it takes two years just to be seen? Puberty would be over by then, and then it would be pointless. Blockers would be pointless by the time a court case would happen. It's terrifying.

TV: How does this latest move fit into the kind of reactionary transphobic politics common across the pond, from your perspective?

AV: I mean, all I can say is the extent of the exaggerations does make it seem like there is intent going on. So it does: It seems like it's intended to try and harm the community.

TV: Do you have a message to other young trans folks in England who are freaked out about this right now?

AV: I'm sorry. I remember what it's like when I was waiting. It just — it really sucks. I mean, I guess people say the standard, “It gets better,” and that's technically true, but it doesn't help when you're going through this stuff. Nothing really I can say, but I'm sorry. Like, Christ.

TV: What do you wish more people understood about trans youth?

AV: The fact that the severity of dysphoria and the fact that transitioning isn't like a flippant one; it's something that we need to do. We're trans for our entire lives. I didn't choose to be trans. I'm not doing it for attention or anything like that. I need to do it, just to be able to function. That's the level of the stakes. If you prevent transition, you're not like, “Oh, no. Now this kid can't go and dress up as a fairy.” It's like, “Oh, no. I'm going to have various mental health issues because of this.” And I think the need to transition is really important and needs emphasizing in this discussion. They talk about irreversible damage; letting kids go through the wrong puberty is irreversible damage.

TV: What do you wish people in the States knew about what's been happening in the U.K.?

AV: Just the fact that it's not an affirmation model. We should emphasize the nature of the system: how challenging it is, how many barriers there are in place, and how much the clinicians don't believe you. They'll pick apart everything that you say. That, yeah.

TV: Now on top of those medical gatekeepers, there are going to be legal ones as well, huh?

AV: Yeah. And I mean, especially for testosterone, like the nature of the consent process, it was just so rigorous and so long. And there's all that space to stop and think. I went and looked at my fertility, talked to experts about it. Oh, there's this idea that [puberty] blockers and T[estosterone hormonal therapy] impact on fertility, but that's not true, as far as I know, as far as the experts have told me. There's, again, a level of misinformation.

They're saying, “Oh, a lot of people that go on blockers go on testosterone, so [getting] blockers cause [them to later get on] testosterone.” But the type of people that go on blockers are the type of people that go on testosterone because the type of people [who] would be on blockers are trans and therefore benefit from a medical transition. It's like saying, “Those that go to therapy suffer from mental health conditions, so therapy causes mental health conditions.” Bad logic. Obviously, we know the type of people that go to therapy are the type of people that have mental health conditions. So when we're talking about the long-term risks of blockers, we need to separate it from hormone replacement therapy and understand that it's not — it's not like once you're on blockers, you're on this lifelong path towards medical intervention. It's just a starting point.

TV: Is there anything else you think Teen Vogue readers should know about what's happening over there?

AV: Just emphasizing that the necessity to transition is not a whim; it's something that we have to do. And preventing it — obviously, we know the stakes are really high, like with mental health issues. It's necessary to function, essentially.

See more of what Alex has to say about the case in the video below.\

Want more from Teen Vogue? Check this out: Transgender Youth Are Being Targeted With State Laws in South Dakota and Several Other States

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