HEALTHCARE

Re J  (Transgender: Puberty Blocker & Hormone Replacement Therapy)  [2024] EWHC 922 (Fam)

Paul Conrathe acted on a case concerning a dispute over transgender medical treatment for a young person who had been treated by GenderGP, an overseas online gender clinic.  CONCLUDED

​

Bell & another v The Tavistock and Portman NHS Foundation Trust [2021] EWCA Civ 1363

​

Paul Conrathe represented Keira Bell in a landmark legal challenge to the lawfulness of the practice of prescribing puberty blockers to under 16 years olds at the Gender Identity Development Service at the Tavistock and Portman NHS Trust. The case was initially successful before the Divisional Court with that ruling ultimately being overturned on appeal. Nonetheless the case had a very significant impact upon the development of paediatric gender services in the NHS.  CONCLUDED

 

Evans and XX v Care Quality Commission [2025] EWHC 2015 (Admin)

​

Judicial review challenge against the Care Quality Commission, Britain’s independent regulator of health and adult social care, regarding the registration of the first private paediatric gender clinic in the UK.  A case on behalf of a mother (anonymous) and Sue Evans, a Tavistock whistleblower, challenging the decision of the CQC to register the first private paediatric clinic. The claimant claimed that the CQC had acted beyond the scope of its powers by approving a clinic which is run by a trans activist and does not conform to the NHS regime put in place after the Cass Report. In response to our client’s challenge, the CQC hurriedly conducted a thorough inspection of the clinic based on the grounds raised in the legal case.  Subsequently the Court found in favour of the defendant.   CONCLUDED

​

Bell & The Bayswater Support Group v Sec of State for Health and Social Care

 

A challenge to the failure of the Secretary of State for Health and Social Care to ban the prescribing of cross-sex hormones to children in the private sector, brought on behalf of a young woman who transitioned to male and later regretted that course of treatment. Following an earlier judicial review, the Secretary of State agreed to investigate the issue, but no investigation was undertaken despite the Divisional Court having emphasised that the matter required "urgency and intensity". A further judicial review claim was therefore issued by two claimants, including Bayswater Support Group, challenging the continuing delay.  Mr Justice Sheldon refused permission on the papers but the claimants have sought an oral renewal hearing. Our clients remain concerned that private gender clinics continue to offer cross-sex hormones to children, with some advertising access within a matter of weeks.  ONGOING

​

ATT v Wellbn Surgery

 

A significant judicial review challenge to the practice of a GP surgery in Brighton prescribing hormonal medication to teenagers with gender dysphoria.  The case has already resulted in a rapid investigation by the NHS into the conduct of the WellBN clinic, the results of which were published in June 2026: a damning report.  In the light of this report, permission to proceed to judicial review was not granted and the case has been closed.  CONCLUDED

​

Bell & Esses v The HRA and The MHRA (Pathways 1)

​

This case concerns the government's plans for a multi-year, publicly funded trial of puberty blockers on children which was undergoing regulatory approvals prior to being launched. On behalf of our clients we made extensive demands for information concerning the trial, but the Health Research Authority and the Medicines & Healthcare products Regulatory Agency have refused to comply. In this regard they failed to fulfil their duty of candour as public bodies. Our clients threatened judicial review but this challenge was superseded when the PATHWAYS trial was launched. CONCLUDED.  

​

The Bayswater Support Group, Bell & Esses v The HRA and The MHRA
(Pathways 2)

​

We acted for three claimants, Bayswater Support Group, Keira Bell and James Esses, in a challenge to decisions of the Health Research Authority and the Medicines and Healthcare products Regulatory Agency approving the PATHWAYS clinical trial of puberty blockers for children and young people with gender incongruence. The trial is recruiting up to 226 participants, including children as young as 10. The proceedings raised issues of considerable public importance concerning the safeguards that apply to clinical trials involving children, the assessment of risks and benefits, and the responsibilities of regulators when approving experimental treatments. The litigation attracted significant national and international attention.

The claimants contended that the regulators had failed properly to apply the statutory safeguards governing clinical trials involving minors. Among other matters, they argued that the regulators had failed adequately to consider evidence concerning potential harms associated with puberty blockers, that relevant information had not been properly presented to decision-makers, and that the regulators had not lawfully satisfied themselves that participation in the trial offered the degree of benefit required by the applicable legal framework. The claimants also raised issues concerning uncertainty about treatment pathways following completion of the trial.

A two-day permission hearing took place before Mr Justice Chamberlain on 27 and 28 July 2026. In a judgment handed down on 31 July 2026, the Court refused permission for judicial review. The Court concluded that none of the grounds of challenge had a realistic prospect of success and held that many of the issues raised involved matters of scientific, clinical and regulatory judgment which Parliament had entrusted to specialist regulators.

The claimants respectfully disagree with the Court's conclusions and remain concerned about the adequacy of the safeguards applied in relation to the trial and about broader questions regarding the protection of children participating in clinical research. The case nevertheless provided an important opportunity for public scrutiny of the PATHWAYS trial, generated extensive disclosure of regulatory material, and raised significant issues about the approach of courts to decisions made by specialist regulators. Recruitment to the trial has now commenced.
CONCLUDED

​