Keira Bell's experience shows blockers prevent clear thinking
Jo Coburn said:
“This so called pause put me into what felt like menopause with hot flushes, night sweats and brain fog. All this made it more difficult to think clearly about what I should do. By the end of a year of this treatment, when I was presented with the option of moving on to testosterone, I jumped at it.”
Keira Bell is a named individual who went to court, and the description of cognitive symptoms during puberty blocker treatment sounds like direct evidence that the treatment impairs the very decision-making it is supposed to support.
What Keira Bell experienced was a mandatory year on blockers regardless of clinical need, a protocol specific to the Tavistock and one that has since been criticised precisely because it was applied rigidly rather than to the individual in front of the clinician. The Endocrine Society guidelines and WPATH Standards of Care do not work that way: they call for assessment that is responsive to the person, which means the timing, duration and sequencing of treatment follow what is right for that young person, not a fixed institutional rule. The cognitive and physical symptoms described, the hot flushes, the brain fog, the sense of being pushed toward a decision, are real and they matter, and they are also what happens when someone is held on a hormonal pause far longer than their situation warranted by a system that had stopped looking at them as an individual. Using that experience to close the door on gender-affirming care as a whole means the young people who would have been helped by the individualised approach the guidelines actually recommend are the ones who lose out.
What I said at the time:
“The Tavistock didn't and what the what the Tavistock said was, regardless of your age, you must have puberty blockers for a year before and gender affirming hormones. That was wrong. And that's what Kiribell had. So Kiribell did have an oestrogen menopause and then had to endure that for a year and then had testosterone. But that's not what if you have a look at the Endocrine Society guidelines and WPATH standards of care that's not the clinical guidance that they would have done.”
Trans young people whose access to individualised, appropriate care is restricted because a flawed institutional protocol is treated as representative of all gender-affirming practice.