PROTECT TEENAGERS FROM HARMFUL AND IRREVERSIBLE MEDICAL TREATMENT

by Susan Evans

PROTECT TEENAGERS FROM HARMFUL AND IRREVERSIBLE MEDICAL TREATMENT

by Susan Evans
Susan Evans
Case Owner
I was in the NHS for nearly 40 years & I am now a psychotherapist in private practice. I have worked psychologically with people who present with issues around their gender identity for over 20 years
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Susan Evans
Case Owner
I was in the NHS for nearly 40 years & I am now a psychotherapist in private practice. I have worked psychologically with people who present with issues around their gender identity for over 20 years
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Latest: Nov. 9, 2024

High court Judge grants permission for Judicial Review.

On Friday my solicitors heard from the High Court that Mr Justice Foxton had given me and parent X permission to challenge the decision of the CQC to license GenderPlus Hormone Clinic. The judge was …

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The Care Quality Commission (CQC) has registered Gender Plus Hormone Clinic to provide hormone treatments to 16 and 17-year-old children.

This paves the way for other private clinics to be registered,  which would offer controversial medical treatments with lifelong consequences to vulnerable teenagers. The decision of the CQC to license a private clinic, creates a significant risk of a two tier approach, with less protection for those who seek help from the private sector. This further risks undermining the work of the Cass review for NHSE practice.


I want the court to set aside the registration by the CQC of Gender Plus Hormone Clinic to provide hormone treatment for teenagers. I also hope that this litigation will prevent the registration of other private clinics providing this controversial treatment. I want to ensure that those under 18 years old, do not suffer irreversible, lifelong harms both physical and psychological, from taking a controversial hormonal treatment which is not evidenced as safe or effective.


Why I am asking for this Judicial Review

I was in the NHS for nearly 40 years and I am now a psychotherapist in private practice. I have worked with people who present with issues around  their gender identity for over 20 years. In my clinical experience of working with children and young people, I have not, to date, encountered a 16 to 17-year-old who I would have assessed to be sufficiently fully informed and psychologically ready to make such a life changing, potentially harmful decision. They are in the process of development from child to adult which involves significant mental and physical adjustments. Many of the young people with gender dysphoria/incongruence have no clear understanding of their underlying motivations to take cross, sex, hormones. However they are usually very aware of the discomfort they experience, and often hold a strong belief that the medication will help them feel better. They hope a change to their physical body will bring about a comfort in their mind. Some also receive strong messages from certain groups that medication is the answer to their difficulties which creates an urgent pressure on them and those around them for a solution. As a result, they are rarely able to give a full, in-depth psychological consideration to the implications and consequences of commencing a physical treatment, which is known to have serious, harmful side-effects, and, as yet has a very low level evidence base for it's efficacy and safety.

Under its current registration by the CQC, Gender Plus Hormone Clinic (GHPC) is not prevented from providing GnRH analogues (blockers) for the purpose of suspending puberty. There are some 16-year-olds who have not reached pubertal maturation. Further, the GPHC  has said that it would prescribe puberty blockers “alongside oestrogen therapy to achieve feminising effects”. The NICE report (National Institute of Clinical Excellence) and the Cass review both state that this treatment model is not proven. 

There is also considerable risk of complications due to this powerful medication. There are many known side-effects, including blood clots, gallstones, vaginal atrophy and male pattern baldness for females and potential loss of fertility, amongst many others. 


The evidence base

The Cass review was commissioned by the NHS to provide a comprehensive review of the appropriate treatment for children and young people with gender dysphoria. The Cass Review sought advice from  the National Institute for Health and Care Excellence (NICE) which conducted two separate evidence reviews.

 

Neither of them has found sufficient evidence to support the use of either puberty blockers or cross sex hormones as safe and effective.

In her interim report published in February 2022, Dr Cass has emphasised the gaps in the "evidence base regarding hormone treatment" (Para 1.41). Although some of her observations related specifically to puberty blockers, she also addressed cross-sex, hormones, and hormone treatment more generally. She said, among other things:

"The Review is not able to provide definitive advice on the use of puberty blockers and feminising/masculinising hormones at this stage, due to gaps in the evidence base; however, recommendations will be developed as our research programme progresses. 

“The lack of available high-level evidence was reflected in the recent NICE review into the use of puberty blockers and feminising/masculinising hormones commissioned by NHS England, with the evidence being too inconclusive to form the basis of a policy position” (para 5.21)

“At present we have the least information for the largest group of patients – birth- registered females first presenting in early teens” (para 5.11).

Your help:

I need your help to ensure that the registration of GPHC is cancelled and the other private clinics are unable to prescribe this controversial treatment to children under 18. We should not be careless or look away from the potential harms this medical treatment might cause to childrens previously healthy bodies. 

Please support me with the legal fees required to mount a judicial review and challenge the  CQC decision. I was the original claimant who started the Kiera Bell JR with Mrs A and our application on that occasion was successful in providing further scrutiny and attention in this area of paediatric healthcare. That judicial review potentially helped prevent irreversible harms to much younger children too as it led to a much wider scrutiny of the model of treatment in the GIDS.

I have assembled an expert legal team and will be lodging my claim with the High Court in the next few days. Please join me in seeking to protect vulnerable young people and share this crowdfunder link. I know these cases keep coming but we need to protect the next generation. 

My X (twitter) handle is @sueevansprotect

Thank you very much.



Update 4

Susan Evans

Nov. 9, 2024

High court Judge grants permission for Judicial Review.

On Friday my solicitors heard from the High Court that Mr Justice Foxton had given me and parent X permission to challenge the decision of the CQC to license GenderPlus Hormone Clinic. The judge was very concerned that the CQC may have licensed GenderPlus without having all the necessary information it needed to assure itself that providing cross sex hormone treatment to teenagers was a safe treatment. The judge was also concerned that by granting licensing to GenderPlus the CQC was acting irrationally.

We now know that, in the light of the Cass Review, there are hugely significant concerns about cross sex hormone treatment. The consequences are lifelong and the evidence to support this treatment is currently extremely poor.

Our case will now proceed to trial. We are so grateful for those who have supported us thus far. We need to raise funds to get this case across the line and finally protect vulnerable teenagers from experimental treatment that is not evidenced and may have profound lifelong irreversible consequences. The serious and troubling question regarding the ability of young patients to give 'informed consent' to this treatment remains.

Please donate and share with others. Thank you so much.

Sue and Parent X


Update 3

Susan Evans

May 16, 2024

CQC send their defence response

We have now received the CQC’s defence in licensing GenderPlus Hormone Clinic – the first private paediatric hormone clinic led by ex- Tavistock clinicians. Assurances of the Secretary of State for Health that she would be ensuring patient safety from this highly controversial hormonal treatment have not filtered through to the CQC. They have instructed a KC to defend their decision and state the Final Cass Review is irrelevant. Despite the NHS now requiring an independent second opinion from a multidisciplinary team before treatment can be authorised GenderPlus Hormone Clinic treat vulnerable patients without that safety net. The Secretary of State has also decided not to get involved in the case despite being notified.

We are now waiting for the Court to decide whether it is arguable that the CQC has acted unlawfully. If permission is granted then the case will go to trial. This case is crucial to protect vulnerable young people from a highly controversial treatment which is delivered in the private sector without adequate protections in place. Thankyou to those who have given to this case thusfar. Please share this crowdfunder. Thankyou.

Update 2

Susan Evans

April 22, 2024

Update 2 - After Cass

The Cass report published on 10th April 24 has provided a clear message that puberty blockers should not be prescribed for children. It also says that 16 to 17-year-olds should only be given cross-sex hormones with extreme caution and following an assessment by a multidisciplinary team, independent of the referring clinical team. This is now the position of the NHS - but NOT private clinics.


Some people have asked if it is necessary to continue the judicial review because of the Cass review outcomes and the pressure being brought to bear by the Secretary of State for Health on the CQC to "look again at the age thresholds in their licensing conditions” for private providers.

However, at this stage this is a request from the health minister to the CQC. There has been no change in law. It is vital that we keep the feet of the CQC to the fire by continuing with this litigation.


We have therefore decided to continue with the request for a judicial review. This approach will continue until we are certain that all private clinics are no longer by law, allowed to prescribe hormones to under 18s.

We hope you can continue to share the link about the case and will be in touch again as soon as we have further news on its progress.

Sincerely yours

Sue and Anon 'Mother X'



Update 1

Susan Evans

April 9, 2024

Papers have been submitted

Dear Backers

You are all fabulous- thank you so much for your generosity in supporting  our request for a judicial review. As the headline suggests we have now successfully submitted our papers to the High Court and await a decision on whether we will be granted a judicial review.

You are probably aware that the Cass review final report is due out on Wednesday 10th April. Our team will be interested to read and assess the findings.

 We will keep you updated on progress  but for now we just want to let you know how important the combination of your support, messages and generosity has been for us.

with kind regards

The #First do no harm team

-aka 'Mother X ' and me (sue) 

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