Children aged under 16 will need court approval in England and Wales to access puberty blockers after a landmark ruling on Tuesday amid a global debate about the age at which a child can choose to transition gender.

Three High Court judges said it was "highly unlikely" that a child of 13 or under was "competent to give consent" to puberty blockers, and it was "doubtful" that 14- and 15-year olds could "weigh the long-term risks and consequences".

Following the ruling, the National Health Service (NHS) England updated its guidelines to state that a court order must be sought for any new referral for such medication. But the Tavistock and Portman NHS Foundation Trust, which runs England's only youth gender identity clinic, vowed to appeal, setting the stage for a Supreme Court showdown.

Keira Bell, 23, brought the action against the Tavistock and Portman NHS Foundation Trust after regretting taking puberty blockers at the age of 16 that she feared may have damaged her ability to have children. Bell, who "detransitioned" in her early 20s and now lives as a woman, had argued for puberty blockers to only be prescribed for under-18s with a court order.

The judges said 16 and 17-year-olds were presumed to be able to consent to medical treatment, but doctors may want to seek court orders before prescribing them puberty blockers due to the "experimental" nature of the treatment. Read more via Openly/Reuters