FA-2025-000058 - [2025] EWHC 2685 (Fam)

Dr. Anna Barnes’ report dated 28^th February 2024

Dr. Barnes is a Consultant Psychiatrist at the Tavistock Clinic. Her report also contains a diagnosis of gender dysphoria, with the Applicant’s gender identity recorded as male. This is the second report on which the Applicant relied for the purposes of the Application.

Dr. Barnes noted that the Applicant presented, in what she describes as, “a straightforwardly male role”; observing that he “lived fully as [W] and a man since around the time of his 2016 legal name change”; that he had “no regret” associated with the transition; and living in his acquired gender “continued to feel right”. She stated that she was “supportive” of his application for a GRC. The report recorded (under “Testosterone therapy and fertility”): “[W] was endorsed for testosterone therapy by Dr Barrett in 2019. He took Testogel 2 pumps between November 2019 and April 2020, but reported that he did not notice any significant masculinising changes. He then stopped it in order to try to conceive. He does not anticipate that being pregnant will make him significantly dysphoric. Since stopping testosterone therapy he has completed 3 full rounds of IVF and a frozen transfer. He sadly had a miscarriage in January 2024. (He reported that he also previously had 2 miscarriages in 2016 and 2018, at a time when he had been to conceive via artificial insemination.) He currently has one frozen embryo and is considering his options, including surrogacy. He reported that it is not clear why he is struggling to conceive… He is not sure when he will restart testosterone therapy. He wants to have at least 2 children and he may restart testosterone therapy temporarily when he has had 1 child, or may wait until he has completed his family.”

The report further stated:

“[W] had privately funded chest surgery in 2020… Once he has finished IVF he intends to seek privately funded revision surgery. In the longer term he thinks that he will ‘definitely’ want genital surgery and is leaning towards metoidioplasty. He also thinks that he is likely to want a hysterectomy and oophorectomy. However, he would not seek these surgeries until he has completed his family in a few years’ time.”

Dr. Barnes referred the Applicant to local NHS clinics for egg freezing and recommended speech and language therapy while he paused testosterone therapy.