O vs P and Q

This case concerned a parental dispute over the medical treatment of a transgender minor, focusing on the child's capacity to consent and the role of the court in overseeing such decisions.

TLDR:

• Mother applied for a prohibited steps order to prevent father from arranging gender dysphoria treatment for their child, Q.
• Father and Q sought to dismiss the proceedings, arguing Q's capacity to consent to treatment.
• The court ruled in favor of Q's autonomy, allowing him to pursue treatment with a regulated provider.

The applicant, O (the mother), applied for a prohibited steps order (PSO) under section 8 of the Children Act 1989 to prevent the respondent, P (the father), from arranging medical treatment for their transgender child, Q, who had recently turned 16. The mother also sought a best interests declaration under the Inherent Jurisdiction. The father applied for the interim orders to be discharged and for the proceedings to be terminated.

Q was born female but identifies as male. His parents are divorced and have had a contentious relationship. Q initially split his time between both parents, but after coming out as transgender in 2020, his relationship with his mother deteriorated, leading him to live full-time with his father since 2021.

In August 2022, the mother applied for a PSO to prevent the father from arranging treatment for Q's gender dysphoria. Despite a GP's letter confirming Q's gender dysphoria and no mental health issues, the mother opposed private treatment, favoring NHS treatment. The court made an interim PSO preventing private treatment, which remained in place.

The Guardian suggested an expert assessment, but Q was reluctant. The case proceeded to a final hearing in October 2023. The mother obtained crowdfunding for legal representation, while the father continued to represent himself. Expert assessments were sought but proved difficult due to Q's refusal to engage and the lack of willing experts.

In January 2024, the first private clinic for gender-related treatment in the UK, Gender Plus, gained CQC registration. Q turned 16, and the final Cass Review was published. The mother agreed to Q's assessment by Gender Plus but sought court oversight for any hormone treatment. The father and Q argued for the dismissal of proceedings, emphasizing Q's capacity to consent.

The court considered the legal framework, including the Family Law Reform Act 1969 and the Gillick competence. The court emphasized the importance of respecting Q's autonomy, given his maturity and understanding of the issues. The court found no basis to override Q's consent to treatment by a regulated provider and dismissed the proceedings.

The court acknowledged the mother's concerns but emphasized that regulatory bodies should address the broader issues of medical treatment for transgender minors. The court discharged the interim orders and asked the father to undertake not to seek treatment for Q from offshore providers while he remains a minor.

The court expressed hope for the restoration of Q's relationship with his mother and commended the legal representatives for their efforts in the case.

Legal representatives: Sarah Phillimore (instructed by Sinclairs Law) for the Applicant, J M Wilson (instructed by Irwin Mitchell LLP) for the 1st Respondent, Emma Favata (instructed by Tozers Solicitors) for the 2nd Respondent.

Judicial Panel: The Honourable Mrs Justice Judd

Case Citation Reference: [2024] EWHC 1077 (Fam)