An 11-year-old cannot give informed consent about future fertility
Andrew Neil said:
“you did so on the basis that the child could give informed consent to the process then underway. That meant that she needed to understand how an adult version of herself would feel about having children years down the road. How could that be possible for an 11 year old?”
The intuition that an 11-year-old cannot meaningfully imagine their adult self's wishes about parenthood is widely shared and sounds like common sense. It appears to expose a logical flaw in the consent process.
Gillick competence is not a threshold of adult imagination: it is a clinical assessment of whether a child understands what is being proposed, what it means for them now, and what the options are, including fertility preservation. Every paediatric specialty applies exactly this framework, because no child, and frankly no adult, can perfectly simulate a future self's feelings when making a medical decision under pressure. An 11-year-old consenting to chemotherapy is not required to fully inhabit their adult relationship with the long-term effects of that treatment before the oncologist will proceed: the standard is sufficient understanding of the choice in front of them. Applying a uniquely impossible bar to this specific group of children, a bar no other branch of medicine would recognise, does not protect them; it simply denies them the same standard of care every other child is entitled to.
What I said at the time:
“we mustn't treat 11 year old transgender children from any different from any other child who's going to undertake medical interventions. What about cancer care, diabetes care, operations, heart care?”
Trans children and their families are harmed when a legal and clinical framework that applies across all of paediatric medicine is presented as uniquely inappropriate when applied to trans healthcare.