A young woman who began treatment to change gender as a teenager said on Sunday that she should have been challenged about her wishes by the NHS before she began transitioning.
Keira Bell is bringing a landmark case that could see the NHS stopped from using controversial puberty blockers on children who say they want to change sex.
Campaigners claim children as young as 12 should not be given the powerful drugs because they are too young to weigh up the impact of such a momentous decision on their future.
Miss Bell began hormone treatment to become a boy after being referred to a gender identity clinic at the Tavistock and Portman NHS Foundation Trust in north London when she was only 16.
Miss Bell, who is now 23 and has stopped hormone treatment after deciding to live as a woman, spoke on Sunday of her anger over what she had gone through. "I should have been challenged on the proposals or the claims that I was making for myself," she told the BBC.
Miss Bell, from Cambridge, said she was a tomboy at school, where she asked to be called by a boy’s name. After suffering from depression she was referred by her GP to the clinic – the trust runs the NHS’s only child gender identity development service.
She said she was prescribed puberty blockers, which delay the development of signs of puberty such as periods or facial hair after just three one-hour appointments, and that "one step led to another".
She said that within a year she was prescribed the male hormone testosterone, causing her to develop characteristics such as facial hair and a deep voice.
Then three years ago she had an operation to remove her breasts. "Initially I felt very relieved and happy about things, but I think as the years go on you start to feel less and less enthusiastic or even happy about things," she said. She claims children are too young to give informed consent to such treatment – for example to consider the long-term consequences of treatment on a girl’s fertility.
Lawyers for Miss Bell and a second claimant, the mother of an unnamed 15-year-old girl being treated at the clinic, argue that there needs to be more assessment of children with so-called gender dysphoria before they are prescribed the powerful drugs.
The case was given the green light last week by High Court judge Mr Justice Supperstone, who said it was "plainly arguable" that the clinic was acting unlawfully when it referred children to receive drugs to arrest puberty.
It was originally also brought by Susan Evans, who used to work at the clinic as a psychiatric nurse, but Miss Bell replaced her as a claimant in January. NHS England has announced a review of its policies on the use of puberty blockers and cross-sex hormones.
Dr Polly Carmichael, the consultant clinical psychologist who runs the Tavistock clinic, insisted it already had a thorough assessment process, with fewer than half the children referred to it going on to have such treatment.
The Tavistock and Portman NHS Foundation Trust said: "We welcome the opportunity to talk about the service and to stand up for our dedicated staff who put the best interests of the young people and families at the heart of their practice."
The full trial is expected to take place this summer.