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

Dr. Barrett’s second report dated 15^th January 2021

Dr. Barrett’s second report recorded that the Applicant “presented in a male role” and “was enthusiastic to receive the first of 2 opinions in connection with phalloplasty”. He stated (“Mental Health History”):

“This patient is about to undergo IVF fertility treatment with the aspiration of becoming pregnant and for this reason has stopped all hormone treatment. He is allowed 3 cycles, as I understand it, and should he become pregnant no further treatment will be possible until the baby is born and things are once again stable.”

Consistently with the Applicant’s evidence that he intends to resume treatment after he conceives, the report stated:

“In a sense, this patient is in a situation where everything is on hold until his current fertility issues have been resolved by either the birth of the baby or the abandonment of fertility treatment. If the first of these is the case, which I hope, it would not be sensible for him to consider moving forward until he is able to both look after the child and himself.”

The phrase “everything is on hold” does not strike me, with respect to Dr. Barrett, as entirely apposite, but it does broadly resonate with the concept of the disagreeable “intermediate zone” between two genders, first termed in Goodwin. The matrix here is plainly different, though the experience must surely be similar. The Applicant’s strong gender identity is not discarded, or put on ice, but is navigated alongside his equally strong reproductive instincts.