Luke was a teenager, but sometimes he suffered from hot flashes so intense he felt faint. His bones ached. Sitting on the edge of his bed, he twisted repeatedly to relieve the pain in his back, which “feels like it could snap in two.” The discomfort was like having an illness, he says, except he was not sick. Instead, he was suffering from the side effects of puberty blockers—a drug that suppresses the estrogen his body would otherwise naturally produce. Luke was supposed to be on the blockers for a year, part of a mandatory thinking period for minors before they can be prescribed gender-affirming hormones through the United Kingdom’s National Health Service. That deadline, like others before it, had passed. When I first met him, he was 17, and he had been waiting six years for care.
Luke is one of the thousands of young people in the U.K. living in limbo, casualties of a battle being waged in the media and the court system over the Gender Identity Development Service, a division of the NHS that performs psychological assessments for gender-diverse youth. The fight has divided British mental-health professionals: On one side are clinicians who believe if a child says they’re trans, they’re trans—and they have the right to puberty blockers and hormones.
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