FD25P00172 and FD25P00173 - [2025] EWHC 1325 (Fam)

Having considered carefully the written and oral submissions, I am satisfied that it is necessary for the court to give permission to instruct an expert endocrinologist, and that the expert instructed should be Dr Cotterill. I am further satisfied that the endocrinologist should be instructed by way of a single joint instruction on the basis of the questions I set out below. I am not satisfied that it is necessary to instruct an expert psychiatrist on either the issue of capacity or the issue of best interests. My reasons for so deciding are as follows.

In determining whether it is necessary for this court to give permission to instruct a consultant psychiatrist and / or a consultant endocrinologist in order to resolve the proceedings justly, it is important to maintain a careful focus on the issue that this court is required to decide.

It is readily apparent from the material before the court that the applicants wish the court to examine wider questions of policy with respect to gender affirming treatment, including those they contend arise from the Cass Review and the “implementation” of the recommendations in that Review. That is not the role of this court. As confirmed by the Court of Appeal in O v P, matters of policy concerning gender affirming treatment are the province of the NHS, the medical profession, the regulators and Parliament. This case is not a forum for determining wider political, social or philosophical questions arising from such treatment, nor will it be permitted to become such a forum. This court is concerned only with the best interests of B, in so far as they are engaged by the applications made by the parents.

The issue that this court is required to decide is whether it is in B’s best interests to continue, or to stop, receiving the HRT treatment currently prescribed to her by her General Practitioner, the latter decision involving overriding B’s consent to such treatment given under s.8 of the 1969 Act. In determining the issues before it, the court will ask itself whether B’s best interests require the court to intervene to protect B from “grave and irreversible mental or physical harm”. It is this question that informs the extent to which it is necessary to instruct a consultant psychiatrist and / or a consultant endocrinologist in order to resolve the proceedings justly.