“77. … serious interference with private life can arise when the state of domestic law conflicts with an important aspect of personal identity. The stress and alienation arising from a discordance between the position in society assumed by a post-operative transsexual and the status imposed by law which refuses to recognise the change of gender cannot, in the Court’s view, be regarded as a minor inconvenience arising from a formality. A conflict between social reality and law arises which places the transsexual in an anomalous position, in which he or she may experience feelings of vulnerability, humiliation and anxiety. 78. In this case, as in many others, the applicant’s gender re-assignment was carried out by the National Health Service, which recognises the condition of gender dysphoria and provides, inter alia, re-assignment by surgery, with a view to achieving as one of its principal purposes as close an assimilation as possible to the gender in which the transsexual perceives that he or she properly belongs. The Court is struck by the fact that nonetheless the gender re-assignment which is lawfully provided is not met with full recognition in law, which might be regarded as the final and culminating step in the long and difficult process of transformation which the transsexual has undergone. The coherence of the administrative and legal practices within the domestic system must be regarded as an important factor in the assessment carried out underarticle 8 of the Convention . Where a State has authorised the treatment and surgery alleviating the condition of a transsexual, financed or assisted in financing the operations and indeed permits the artificial insemination of a woman living with a female to male transsexual, it appears illogical to refuse to recognise the legal implications of the result to which the treatment leads.”
“In this Act “the acquired gender”, in relation to a person by whom an application under sub-section 1 is or has been made, means - (a) in the case of an application under paragraph (a) of that sub-section, the gender in which the person is living…” (a) in the case of an application under paragraph (a) of that sub-section, the gender in which the person is living…”
“An application under subsection (1) is to be determined by a Gender Recognition Panel.”
“In the case of an application under section 1(1)(a), the Panel must grant the application if satisfied that the applicant (a) has or has had gender dysphoria; (b) has lived in the acquired gender throughout the period of two years ending with the date on which the application is made; (c) intends to continue to live in the acquired gender until death; and (d) complies with the requirements imposed by and under section 3.”
“The Panel must reject an application under s.1(1) if not required by [s.2(1)] … to grant it.”
“If a Gender Recognition Panel grants an application under s.1(1), it must issue a gender recognition certificate to the applicant.”
“(1) An application under s.1(1)(a) must include either: (a) a report made by a registered medical practitioner practising in the field of gender dysphoria and a report by another registered medical practitioner (who may, but need not, practice in that field), or (b) a report made by a registered psychologist practising in that field and the report made by a registered medical practitioner (who may, but need not, practice in that field). (2) But subsection (1) is not complied with unless a report required by that subsection and made by (a) a registered medical practitioner, or (b) a registered psychologist practising in the field of gender dysphoria includes details of the diagnosis of the applicant’s gender dysphoria. (3) And subsection (1) is not complied with in a case where (a) the applicant has undergone or is undergoing treatment for the purpose of modifying sexual characteristics, or (b) treatment for that purpose has been prescribed or planned for the applicant unless at least one of the reports required by that subsection includes details of it. (4) An application under s.1(1)(a) must also include a statutory declaration by the applicant that the applicant meets the conditions in s.2(1)(b) and (c). … (6) Any application under s.1(1) must include (a) a statutory declaration as to whether or not the applicant is married or has a civil partner, (b) any other information or evidence required by an order made by the Secretary of State, and (c) any other information or evidence which the Panel which is to determine the application may require, and may include any other information or evidence which the applicant wishes to include.” (a) a report made by a registered medical practitioner practising in the field of gender dysphoria and a report by another registered medical practitioner (who may, but need not, practice in that field), or (b) a report made by a registered psychologist practising in that field and the report made by a registered medical practitioner (who may, but need not, practice in that field). (a) a registered medical practitioner, or (b) a registered psychologist practising in the field of gender dysphoria includes details of the diagnosis of the applicant’s gender dysphoria. (a) the applicant has undergone or is undergoing treatment for the purpose of modifying sexual characteristics, or (b) treatment for that purpose has been prescribed or planned for the applicant unless at least one of the reports required by that subsection includes details of it. (a) a statutory declaration as to whether or not the applicant is married or has a civil partner, (b) any other information or evidence required by an order made by the Secretary of State, and (c) any other information or evidence which the Panel which is to determine the application may require, and may include any other information or evidence which the applicant wishes to include.”
“Where a full gender recognition certificate is issued to a person, the person’s gender becomes for all purposes the acquired gender (so that, if the acquired gender is the male gender, the person’s sex becomes that of a man and, if it is the female gender, the person’s sex becomes that of a woman).”
“Where there is a UK birth register entry in relation to a person to whom a full gender recognition certificate is issued, the Secretary of State must send a copy of the certificate to the appropriate Registrar General.”
“A panel must determine an application without a hearing unless the panel considers that a hearing is necessary." Under subparagraph (5): “the President [of Gender Recognition Panels] may give directions about the practice and procedure of panels.”
“3. It is the responsibility of the panel to decide whether the applicant has satisfied all of the s.2 requirements by considering the evidence provided in support of each of the four requirements. In the case of s.2(a) [sic – presumably s.2(1)(a)], the panel must therefore examine the medical evidence provided in order to determine whether it is satisfied that the applicant has or has had the diagnosis of gender dysphoria. In order to do so, the panel requires more than a simple statement that such a diagnosis was made. The medical practitioner practising in the field who supplies the report should include details of the process followed and evidence considered over a period of time to make the diagnosis in the applicant’s case. Nor is it sufficient to use the broad phrase ‘gender reassignment surgery’ without indicating what surgery has been carried out. Nor should relevant treatments be omitted, such as hormone therapy. These requirements are particularly pertinent in assisting the panel to be satisfied not only that the applicant has or has had gender dysphoria but also has lived in the acquired gender for at least two years and intends to live in that gender until death. 4. On the other hand, doctors need not set out every detail which has led them to make the diagnosis. What the panel needs is sufficient detail to satisfy itself that the diagnosis is soundly based and that the treatment received or planned is consistent with and support that diagnosis. 5. It would be impossible to set out precisely what should be provided in all cases. Each will have its own individual facts and the detail which might be sufficient in one case may be inadequate in another. The panels perform a judicial function. In the ultimate analysis it is for each panel to determine precisely what is required. At the same time, doctors and applicants need to know in broad terms what is expected of them and what detail is likely to satisfy a panel. The burden upon them of providing the evidence should not be such as to deter applicants from applying in the first place or to deter doctors from supporting them. 6. The detail required should normally be no greater than can be set out in the space provided in the medical report pro forma.”
“It is not the role of the panel to impose unnecessary or excessive evidential burdens on applicants. However the Act does place on panels the responsibility of ensuring that the requirements of sections 2 and 3 are complied with before an application is granted.”
“5.27 Paragraph 5.28 to 5.30 apply where the appeal is brought under s.8(1) of the [GRA] on a point of law against a decision by the Gender Recognition Panel to reject the application under s.1(1) … of the [GRA]. The appeal is to the High Court or to the family court. However, FPR 5.4 provides that where the family court has jurisdiction to deal with a matter, the proceedings relating to that matter must be started in the family court except where the court otherwise directs, any rule, other enactment, or Practice Direction provides otherwise or proceedings relating to the same parties are already being heard by the High Court. Most appeals under s.8(1) of the [GRA] are therefore likely to be to the family court and be heard by a judge of High Court Judge level sitting in that court …. 5.28 Where the appeal is to the High Court, the appeal notice must be (a) filed in the PRFD [the Principal Registry of the Family Division], and (b) served on the Secretary of State [i.e. for Justice] and the President of the Gender Recognition Panels. 5.28A Where the appeal is to the family court the appeal notice must be served on the Secretary of State and the President of the Gender Recognition Panels 5.29 The Secretary of State may appear and be heard in the proceedings on the appeal. 5.30 Where the High Court issues a gender recognition certificate under s.8(3)(a) of the [GRA], the court officer must send a copy of that certificate to the Secretary of State.”
“I have lived full time as a female for 6 years [sic] since I transitioned in 12/2008. I intend to live full time as a female until death”
“since then various documents have been supplied, but none deal with the essential legal difficulty, which is that the [GRA] requires a diagnosis of gender dysphoria from a registered medical practitioner, who practices within the field. Accordingly there has been nothing to persuade the panel not to dismiss the application and it is hereby dismissed.”
“Separately, and recently, she reports gender identity problems. Her history, if taken at face value, is reasonably consistent with this diagnosis but the difficulty is that other aspects of that history are rather directly at odds with the documentary records leading me to have doubts about the veracity of her whole history – which would include a reasonably consistent history of gender identity problems. This aspect might be made clearer if a source other than [Ms Jay] could be interviewed …. If collateral collaboration is elicited I would reach an additional diagnosis of some sort of gender identity disorder. Whether the intensity of gender dysphoria caused by that disorder is great enough to merit or require a change of gender role might be explored in the setting of a gender identity clinic; it might be sufficiently intense in a prison but not so outside one and in civilian life, for example. If collateral corroboration is not convincingly elicited I would have grave doubts and wonder whether [Ms Jay]’s somewhat dependent personality had caused her to unwisely latch onto a change of gender role as a seemingly universal solution to both why her life had gone wrong and how it might be rectified.”
“I can confirm that [Ms Jay] has been seen in the Nottingham Centre for Gender Dysphoria this year and [Ms Jay] is living as a female. I believe that female orientation is permanent or very likely to be permanent and formal gender reassignment is taking place.”
“In my opinion, [Ms Jay] fulfils the criteria for gender dysphoria, i.e. a person has an overpowering wish to live as a member of the gender group opposite to their anatomical sex and seeks to alter their bodily appearance and genitalia. Gender dysphoria is the distress associated with the experience of one’s personal gender identity being inconsistent with the phenotype or the gender role typically associated with that phenotype. Those with gender dysphoria have a strong conviction of belonging to the sex opposite to that which they were assigned, usually starting before puberty. I note that in [Ms Jay]’s case, she gave an account of having these beliefs and convictions since an early age but struggled to express this due to a fear of shame and ridicule by others. It appears [Ms Jay] was greatly distressed by her predicament and on various occasions [sic] and this resulted in displayed episodes of low mood and also self-harm attempts. I note that [Ms Jay] has expressed openly her desire to become female, following the death of her father in January 2012. [Ms Jay] has also changed her name and passport and has also sought help in terms of becoming female from a gender dysphoria clinic in Nottingham and subsequently on a private basis from a specialists [sic] with expertise in gender dysphoria. I note [Ms Jay]’s features of personality disorder have resulted in escalation of her risk behaviours. She has poor ability to cope with feelings of frustration and this led to considerable distress leading to utilising maladaptive coping strategies such as self-harm and suicidal attempts. [Ms Jay]’s gender dysphoria has complicated her presentation. She continues to be considerably distressed as a result of her gender dysphoria and feels very uncomfortable being male. [Ms Jay] is extremely conflicted in her mind as a result of gender dysphoria and this has complicated her presentation including escalating her risks. [Ms Jay] is also distressed there has been lack of progress in terms of treatment of gender dysphoria. She is unhappy in relation to not being prescribed medication i.e. hormone supplements that she has been taking as part of gender reassignment process. In my opinion, it is likely [Ms Jay]’s features of personality disorder are likely to worsen and would result in more risk behaviours if she does not receive further specialist input in relation to her gender dysphoria ….”
“Transsexualism: A desire to live and be accepted as a member of the sex opposite of that which was assigned at birth. This is usually accompanied by a sense of discomfort with, or inappropriateness of, one’s anatomic sex and a wish to have hormonal treatment and/or surgery to make one’s body as congruous as possible with the experienced gender identity, i.e. as male or female. Diagnostic Guidelines: For the diagnosis to be made, the cross-sex gender identity should have been present persistently for at least two years, and must not be a symptom of mental illness such as psychosis. [Ms Jay]: [Ms Jay] is a 39-year-old natal male who has lived in the female gender role since 2013. In this time, she has lived continuously and in all contexts as female, has undertaken laser hair removal, breast augmentation, feminising hormone therapy and feminising body sculpting procedures. Furthermore, to my knowledge, [Ms Jay] has never been diagnosed with disqualifying psychiatric illness. With respect to identification, [Ms Jay] changed her name by statutory declaration in the UK on5 September 2012 and followed with the changes in identification on all relevant documentation including bank accounts/statements, utility accounts, UK driving licence and UK passport. She now wishes to obtain a gender recognition certificate to complete the process of gender change in the UK. After specialist assessment by me carried out over three sessions on 24.6.16, 19.7.16 and 25.8.16, I can confirm that [Ms Jay] continues to live successfully in the female gender role and should do so for the foreseeable future.”
“My impression is that [Ms Jay] is a gender dysphoric individual with a long history of cross-gender ideation. [Ms Jay] presented as relatively stable, reported no contributory psychiatric history and gave a detailed account of herself. [Ms Jay] presents with male to female transsexualism according to ICD 10 F 64.0 criteria. [M Jay] presented to me in female role, was dressed appropriately and had a remarkably feminine appearance and demeanour. Her mood was euthymic and she showed no outward signs of atypical anxiety, agitation or aggression. The history of self-harm and depressed mood notwithstanding, there was no current suicidal ideation or perceived risk to the self or others. Thought processes and speech appeared normal. [M Jay] appeared to have a reasonable degree of insight and showed recent improvements in social and occupational functioning.”
“You keep altering directions after directions making things old. I’m sick to death of this ridiculous process. Do you have any idea what all this keep denial of my right to be recognised by law is doing to me? It’s one thing after another. I have a gender specialist Vickie Pasterski. I have an endocrinologist Dr King. I have a GP. What the hell more do you want I’ve been female all my life I’ve been out fully since 2008 !! Why are you constantly messing me around for !!!”
“The panel finds that it cannot entirely rely on all the evidence of [Ms Jay], which places doubt in the panel’s mind about what can and cannot be accepted. Evidence has been produced with deletions and editing which has not been explained. There have been a number of inconsistencies in her evidence which have not been adequately explained. The evidence she has provided has often been vague and unclear. The panel has at times found [Ms Jay] evasive in her response to directions ….”
“I wish to have contact details of your legal team please so I can send them a letter of claim and let a judge see how your requests are relevant. If it’s not granted this time. Please destroy all my applications as I will not be carrying on with any [sic].”
“The main reason was that the panel could not be confident about the evidence provided by Dr Pasterski was reliable [sic]. She appeared not to be aware of significant features about [Ms Jay’s] circumstances and recent background. Some of those matters might have influenced the assessment made by Dr Pasterski. The doctor needed to know those circumstances to decide whether the findings of her report … were sound and she stood by them. This is particularly relevant in this case because, in respect of the previous application, Dr Barrett from the Charing Cross Hospital had declined to give a diagnoses [sic] of gender dysphoria and both previous applications had been refused. Since the directions of17 November 2016 , the only written communication from [Ms Jay] has been a letter dated6 April 2017 in which she indicates that she was unwilling to comply with the panel’s directions. The panel seeks to respect the privacy and rights of [Ms Jay], as with all applicants. However sufficient evidence has to be produced to satisfy the panel that the requirements of the [GRA] are met. The uncertainty in this case about the reliability of the medical evidence meant that the panel had to ask for further clarification. The aim of the panel is to assist anyone who is entitled to a gender recognition certificate to achieve that aim to be legally recognised in their acquired gender. Granting directions on six occasions was intended to assist and support [Ms Jay] in her aim of achieving a gender recognition certificate. The evidence provided in respect of the two previous applications could not be ignored when considering the present application, because of the questions raised about a diagnosis of gender dysphoria in respect of the previous applications.”
“69. As the Court has had previous occasion to remark, the concept of ‘private life’ is a broad term not susceptible to exhaustive definition. It covers the physical and psychological integrity of a person. It can sometimes embrace aspects of an individual’s physical and social identity. Elements such as, for example, gender identification, name and sexual orientation and sexual life fall within the personal sphere protected by article 8. Article 8 also protects the right to personal development and the right to establish and develop relationships with other human beings and the outside world. Likewise, the Court has held that though no previous case has established as such any right to self-determination as being contained in article 8, the notion of personal autonomy is an important principle underlying the interpretation of its guarantees. Moreover, the very essence of the Convention being respect for human dignity and human freedom, protection is given to the right of transsexuals to personal development and to physical and moral security. 70. The Court further reiterates that while the essential object of article 8 is to protect the individual against arbitrary interference by the public authorities, it does not merely compel the State to abstain from such interference: in addition to this negative undertaking, there may be positive obligations inherent in an effective respect for private or family life….”
“21. The notion of the personal autonomy of every individual marches with the presumption of liberty enjoyed in a free polity: a presumption which consists in the principle that every interference with the freedom of the individual stands in need of objective justification. Applied to the myriad instances recognised in the article 8 jurisprudence, this presumption means that, subject to the qualifications I shall shortly describe, an individual’s personal autonomy makes him – should make him – master of all those facts about his own identity, such as his name, health, sexuality, ethnicity, his own image, of which the cases speak; and also of the ‘zone of interaction’ (the Von Hannover case 40 EHRR 1, para 50) between himself and others. He is the presumed owner of these aspects of his own self; his control of them can only be loosened, abrogated, if the state shows an objective justification for doing so. 22. This cluster of values, summarised as the personal autonomy of every individual and taking concrete form as a presumption against interference with the individual’s liberty, is a defining characteristic of a free society. We therefore need to preserve it even in little cases. At the same time it is important that this core right protected by article 8, however protean, should not be read so widely that its claims become unreal and unreasonable. For this purpose I think there are three safeguards, or qualifications. First, the alleged threat or assault to the individual’s personal autonomy must (if article 8 is to be engaged) attain ‘a certain level of seriousness’. Secondly, the touchstone for article 8(1)’s engagement is whether the claimant enjoys on the facts a ‘reasonable expectation of privacy’ (in any of the senses of privacy accepted in the cases). Absent such an expectation, there is no relevant interference with personal autonomy. Thirdly, the breadth of article 8(1) may in many instances be greatly curtailed by the scope of the justifications available to the state pursuant to article 8(2)….”
“it goes to the heart of how [she], and others in her situation, relate to the world and the world relates to them.”
“The enjoyment of the rights and freedoms set forth in this Convention shall be secured without discrimination on any ground such as sex, race, colour, language, religion, political or other opinion, national or social origin, association with a national minority, property, birth or other status.”