On Monday Keir Starmer had an interview with Mumsnet. He was asked the, by now, depressingly standard question on children and young people having access to treatment and support for gender identity issues. His incompetent response threw every under 16 in the country under the bus.
“I feel very strongly that children shouldn’t be making these very important decisions without the consent of their parents. I say that as a matter of principle. […] We all know what it’s like with teenage children, I feel very strongly about this. This argument that children should make decisions without the consent of their parents is one I just don’t agree with at all.” – Keir Starmer
In a few sentences Starmer committed the Labour party to undoing nearly 40 years of medico-legal practice in the name of appeasing a tiny minority of authoritarians. At a stroke stating he would deny the children and young people of this country access to everything from paracetamol to abortion, vaccination to blood transfusions, if their parents don’t agree they should have access to it.
The right of under 16’s to make decisions about their own medical care without the consent of their parents based on an individual assessment of the child’s ability to understand the risks and possible outcomes of that treatment is governed by a principle called Gillick Competency. It has been used since 1985 in England and Wales (with similar legislation existing in Scotland).
In an ideal world of course children and young people would have the kind of relationships with their parents where they could openly discuss their medical issues. Where their guardians respected their autonomy and right to have different values and beliefs. However, we simply do not live in that world. Should a 14-year-old be forced to have a baby because their parents don’t agree with abortion? No Liberal could honestly answer yes to that but that is the effect of Starmer’s words.
As a lawyer, politician and former DPP Starmer has made himself look either incompetent, foolish or authoritarian (or any combination of the three). If he didn’t realise the effect of what he said he’s incompetent – no competent lawyer should be ignorant of Gillick. If he didn’t realise that’s the path the questioner was leading him down he’s foolish – Trans inclusive feminists have been warning about this exact attack for years and again no competent politician should be able to be led into making statements striking down long-established rights like this. Finally, and most importantly, Starmer genuinely believes what he said then he is dangerously out of touch with the lives many young people are forced to endure and dangerously authoritarian in seeking to curtail these long-held rights.
We cannot deprive young people of the right to make medical decisions simply because their parents or a random stranger they’ve never met might disagree with their choices. We long ago moved away from the idea that parents own their children. Young people will eventually become adults and we have a duty to give them the skills to assess risk and reward in all areas of their lives in a safe, supportive and individualised environment. As Liberals we believe in the right of the individual to have the ultimate say in their own lives. Gillick is one of the best expressions of the rights of the individual to be the owner of their own life and body based on an individualised assessment of understanding and risk. So, as Liberals, we must defend it at all costs – even when we ourselves may disagree with the decision being made we must remember it is not our right to control the bodies of others. Let’s leave taking the power of self-determination away from people for the authoritarians.
* Charley joined the Lib Dems in 2010, has stood in Local elections in Stoke on Trent and London and was PPC for Eltham in the 2019 General Election and a GLA list candidate in 2021. They have been a Youth Worker, Early Years Teaching Assistant and FE College Governor. They are currently an Emergency Services Worker in London and Chair of LGBT+ Lib Dems.
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15 Comments
Gillick is a really good system – if a doctor thinks you are capable of giving consent, then they don’t have to check with your parents; if they don’t, then they do.
We should be clear that we support it and think that parents shouldn’t get between a child and their doctor, whether that’s about trans things or anything else.
What a dreadful statement by Starmer – treating children as the property of parents.
This is a difficult area. I broadly agree with Keir Starmer on this.
Parents have primary responsibility for the welfare of their children, with the state overriding this in certain circumstances. The default position should be that parents are informed of what treatment their children are to receive, and be the ones who make that decision, subject to legal override when required.
There are serious misapprehensions throughout the article above.
There are legal restrictions which are required to be followed in terms of consent to surgery or any treatment likely to have a physiological impact on the child.
For instance, no child under 18 can have tattoos in the U.K. legally. No children under 18 can have Botox or lip fillers legally.
Plastic surgery advice for surgeons is to involve the parents in decision making.
GMC advice is to involve the parents or guardians in the decision making and also that multi-disciplinary expertise is applied in treating children to ensure it is appropriate.
PRASIS who indemnify surgeons clearly advise taking extreme care when dealing with those under 16 and advice is to involve the parent / guardian in decision making.
Research shows that children start to develop logical thinking from about 13 and it reaches its peak at age 22.
Studies by GIDS (in the BMJ) show no significant improvement in thoughts of self harm after treatment has started.
Any treatment for children should be handled carefully, but anything invasive has quite clear guidelines and that includes parental involvement.
@Mohammed Amin
The current legal position is that doctors make the decision for all medical issues of children (bar specific decisions where the child is deemed Gillick competent), and is subject to legal override by the parents (or legal guardian) where necessary. So the other way round to what you propose. Turning this position around and on its head would require extensive change to primary legislation.
In practice, doctors (in the field of medicine in general) seek to steer and build a consensus between all relevant parties, based on counselling of the child involved, and consultation with parents/legal guardians. Rather like British policing, British medical practice isn’t as black and white as the law projects, and this is to our advantage. In gender dysphoria medicine however, activists have made medical practice very difficult. Counselling the child is labelled “conversion therapy” and involving the parents is deemed “outing the child”. Mistrust is therefore built up across all parties, and this is very damaging to the relationship of doctors with the public
As a doctor I have on multiple occasions prescribed a blood transfusion to a child of Jehovah’s Witnesses in express opposition from both the child and their parents who seek legal override. And I have not prescribed a blood transfusion to an adult Jehovah’s Witness because of their advanced directive and watched them die, as was their right. Make what you like of the these examples, which come about due to the current position.
Looks likely that NHS counselling and treatment for such things, and many others, will disappear due to lack of financing – the charity sector will have to step in. I have seen parents actively encouraging their children to be more feminine even though it may just be a passing phase, nothing is black or white in children and they should be left to develop at their own pace, re gender.
Most parents will respect a decision made in partnership between a young person and their GP that takes into account their maturity to make health decisions that effect them. Children mature at ever decreasing ages and it is often a relief for parents or guardians to allow them to decide on decisions that they alone will have to live with. My only caveat is to ensure the children are given sufficient information and time to make their decision.
Charley Hasted…So, as Liberals, we must defend it at all costs – even when we ourselves may disagree with the decision being made we must remember it is not our right to control the bodies of others….
So we, as Liberals, should allow children to have sex with anyone of their choice, to experiment with drugs, to take their own lives during puberty related depression, etc.?
I absolutely agree with Keir Starmer on this. Such a shame that the lib dems are all over the place
@David (and others) – did you read the statement in full?
“This argument that children should make decisions without the consent of their parents is one I just don’t agree with at all”
Taken as read, that states that parents have an absolute veto to override both the child’s informed wishes and the advice of medical professionals in all circumstances.
Of course the ideal situation is a consensus between child, parents and doctors, but it is a sad fact that parents occasionally do not act in a child’s best interests.
@expats – I believe the point of the article was in effect about parental veto over a child making an informed decision supported by medical professionals.
Laws around sex, drugs etc can be debated, but are about society (not parents) setting rules intended to protect people in accordance with medical or other expert advice. Nobody is suggesting that parents set the age of consent, or choose to allow certain drugs for individual children on a case by case basis.
@Nick…
Point being made Nick is wether that child can make that informed decision ….
Especially as the state thinks they are not mature enough to smoke , drink, drive , have sex, vote , marry , have a tattoo etc etc.
@Martin Gray – no, that’s not the point. The point is whether the Gillick Competency applies, or if parents have an absolute veto.
@NickBaird
This isn’t necessarily the choice of GillickCompetence OR parental consent
There are a whole range of things that are off limits to a minor, irrespective of GillickCompetence and/or parental-consent. By law, minors cannot get a tattoo, consume recreational drugs, have sex, make pornography, or get married
The question is whether interventions to convert a genetically male or female body to a phenotypically male to female body (or vice-versa) with hormones and/or surgery should be off limits to minors. I have long believed that it should be off limits. A tattoo can be removed, the effects of recreational drugs are mostly transient, and a marriage can be divorced (or annulment). But a boy who has been castrated or a girl has has had a double-mastectomy cannot have such things reversed later in life. Getting drunk results in a temporary hangover. Taking sex hormones will have permanent effects on the anatomy and physiology of the body.
If we make things that are transient and reversible off limits to children, why on earth would we allow children to do things to their bodies that are totally irreversible and totally lifechanging?
5 years ago, medical colleagues had no opinion on this matter. Now (because of awareness) all medical colleagues take the same opinion as me. But interestingly, except me, no one will be open and outspoken about it. The real liberal issue here is how swathes of the medical community feel pressured through conformity to keep quiet on a medical issue.
Overall I think this issue is a total minefield – politically, ethically and sociologically – and I fear that those who are 100% on one side or the other really haven’t thought things through, because like it or not, there are problems on both sides. To me this is a perfect example of why balance (a key Liberal word in the Preamble) is needed.
Nick, while accepting ‘that parents occasionally do not act in a child’s best interests,’ it is also true that doctors do not always act in a child’s best interests or even in an adult patient’s best interests. Indeed there have been occasions in recent times when standard medical practice has not been in patients’ best interests.
Peter (Hirst) says “My only caveat is to ensure the children are given sufficient information … ,” but how do we determine whether information given is sufficient or even if it is presented appropriately? Bear in mind that the huge pressures put on all of society by those who are convinced that their view is absolutely right and those who disagree are totally wrong. All in all, a bit like Brexit.
Also doctors give advice verbally, possibly expanded with written detail – but can we say we read and understand the information sheet accompanying a prescription? Harking back to Brexit, I might suggest that more people believed what was written on the side of a bus. Or are we being told we must always trust a single fallible human being?