The decision of Re: Imogen (No. 6) is the most recent development of the legal system’s understanding and treatment of gender dysphoria.

Imogen, aged 16 years and 8 months and formerly known as Thomas, was diagnosed with gender dysphoria. She wished to progress to stage 2 gender affirming treatment after having undergone stage 1 puberty suppression medication. Her father and treating doctors assessed Imogen as capable of consenting to this treatment (Gillick competence). However, her mother disputed Imogen’s diagnosis and her Gillick competency based on her own medical evidence. Therefore, Imogen’s mother did not provide parental consent to the treatment.

As there was a dispute about Imogen’s diagnosis, competence, and treatment, the matter required court intervention. The court determined that Imogen was Gillick competent and that this was a factual consideration. Therefore, Gillick competence does not require determination based on the best interests of the child.

The court was also asked to consider approving treatment, and granting Parental Responsibility to Imogen for her future medical treatments. The court found that these matters warranted determination on best interest principles. The court approved for Imogen to progress to stage 2 treatment. As to allocating Parental Responsibility, the court denied this application and found that treatment disputes were best dealt with by the court as it eliminates any uncertainty for medical practitioners regarding future treatments.