No certainty means no medical intervention for trans youth
Kellie-Jay Keen-Minshull said:
“I don't think you can ever say with 100% certainty that an 11-year-old, 12, 13, 14, 15-year-old telling you that they are definitely born in the wrong body and they're not what they are, I don't think you can ever be certain enough to make any medical interventions whatsoever with that child.”
The principle that medicine should not act without sufficient certainty sounds like basic patient safety. Applied to children, it sounds especially protective. Most people accept that children cannot always know what is best for them.
Medicine never demands certainty before it acts, and it could not: it weighs harms on one side against harms on the other, for every patient, at every age. A child starting chemotherapy, having a congenital heart defect corrected, or being put on long-term anti-epileptic medication faces real uncertainty and real irreversibility, and nobody suggests those interventions should wait until the outcome is guaranteed. The harms on the untreated side of gender dysphoria are just as well documented: significantly elevated rates of depression, self-harm, and suicidal crisis in adolescents who are assessed, recognised, and then denied care. Holding trans healthcare to a standard of certainty that would shut down most of paediatric medicine is not a safety position, it is a specifically targeted barrier, and the young people it stops are the ones paying the price.
What I said at the time:
“There are many medical pathways that we put children on, um, when their body hasn't worked in the way that necessarily it was designed to do, and we've talked about asthma, we've talked about diabetes, we've talked about cancer suppression... So sometimes in medicine there is a longer pathway.”
Trans adolescents who are denied assessment and care on the basis of a standard of certainty that is applied to no other area of paediatric medicine.