“(1) A person of either gender who is aged at least 18 may make an application for a gender recognition certificate on the basis of – (a) living in the other gender… (2) In this Act “the acquired gender”, in relation to a person by whom an application under subsection (1) is or has been made, means – (a) in the case of an application under paragraph (a) of that subsection, the gender in which the person is living… (3) An application under subsection (1) is to be determined by a Gender Recognition Panel.” (ii) Section 2 provides: “(1) 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…” (my emphasis) (iii) Section 3 provides: “(1) An application under section 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 made by another registered medical practitioner (who may, but need not, practise in that field), or (b) a report made by a registered psychologist practising in that field and a report made by a registered medical practitioner (who may, but need not, practise in that field) … (4) An application under section 1(1)(a) must also include a statutory declaration by the applicant that the applicant meets the conditions in section 2(1)(b) and (c) … (6) Any application under section 1(1) must include – (a) a statutory declaration as to whether or not the applicant is married [or 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 ... (8) If the Panel which is to determine the application requires information or evidence under subsection (6)(c) it must give reasons for doing so.” (a) a report made by a registered medical practitioner practising in the field of gender dysphoria and a report made by another registered medical practitioner (who may, but need not, practise in that field), or (b) a report made by a registered psychologist practising in that field and a report made by a registered medical practitioner (who may, but need not, practise in that field) … … (a) a statutory declaration as to whether or not the applicant is married [or 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 ... (iv) Pursuant to Section 4(1): “If a Gender Recognition Panel grants an application under section 1(1) it must issue a gender recognition certificate to the applicant.”
“61. The statutory basis for the grant of a gender recognition certificate is that the applicant is ‘living in the other gender’ [s 1(1)(a)]. By s 2(1)(a) the Panel ‘must grant the application’ if satisfied that the applicant has, or has had gender dysphoria and ‘has lived’ in the acquired gender for the past two years (and intends so to live for the rest of their lives). In addition the evidential requirements of s 3 must be complied with. In order to be satisfied that an applicant has lived, and will continue to ‘live’ in the acquired gender, a Panel must take account of all of the available and relevant evidence. The medical evidence required by s 3 from a registered doctor or psychologist practising in the field of gender dysphoria must include ‘details of the diagnosis of the applicant’s gender dysphoria’. Whilst information in any medical report will sit alongside all of the other evidence in the case which must be considered on the question of whether the applicant has been ‘living in the other gender’ [s 1(1)(a)], that issue, in contrast to the diagnosis of gender dysphoria, is not to be determined by considering the medical evidence alone.”
“63. At paragraph 7 of the decision letter, the Panel states: ‘Even if [Dr Longworth’s] reports are accepted as confirmation of gender dysphoria for the purposes of theGender Recognition Act 2004 , they are far from providing a firm diagnosis’ [emphasis added]. That statement is at odds with the clear conclusions of both Dr Longworth and Dr Lorimer, who were both clear that the appellant was suffering from gender dysphoria and that was their diagnosis. It is not the role of the medical witness to go further and to ‘diagnose’ whether or not an individual is ‘living in the other gender’, that is a matter of fact for the Panel on the basis of the totality of the evidence.(my emphasis) Whilst what is said in a medical report may detract from a finding that a person is living in one gender or another, that is not a matter for medical diagnosis as the Panel’s statement appears to suggest.”
“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).”
“The fact that a person’s gender has become the acquired gender under this Act does not affect the status of the person as the father or mother of a child.”
“(1) An applicant to a Gender Recognition Panel under section 1(1) ... may appeal to the High Court or Court of Session on a point of law against a decision by the Panel to reject the application. (2) An appeal under subsection (1) must be heard in private if the applicant so requests.”
“93. I agree with Ms McCann's central submission that the GRA is a statue designed to facilitate gender recognition, that the statutory regime is permissive rather than restrictive, and that the evidential requirements are ancillary to the statutory criteria and any directions made by the panel must not be elevated to a status which sideline or undermine the statutory criteria or frustrate the process.”
“6(4)A Panel must determine an application without a hearing unless the Panel considers that a hearing is necessary.”
“DIRECTIONS: 1. We need your full birth certificate, or a certified copy of it. 2. We see from Dr Barnes’ letter that you are hoping to conceive a child with your partner. We would like you to tell us more about this, because we wonder if it is incompatible with your declaration to live as a man for the rest of your life. You can write us an email, or you can ask for an oral hearing on a secure online platform if you prefer to explain to us in person. If you do, you would be asked for some convenient dates/times. It may help you to know that if you wanted to tell us in person, we think this would take no more than half an hour. Please think about this, and let the Team know what you prefer within a month of these directions.8/8/2024 ”
“If possible I'd like to book an in person appointment to explain more about my desire to have children as well as the fact I have been living as male for the past 8.5 years. Could I also bring my birth certificate to this appointment or does that have to be submitted separately? I am available at any time and on short notice too.”
“Before we start, I just want to let you know that I’m neurodivergent so I’ve written down everything I want to say and I was hoping you’d let me read this and then answer any questions that arise after. Just because I know otherwise I’ll lose my train of thought and I want to make sure you have all the information you need from me. I suppose I should go back to the start a little bit. I knew from a very, very young age that I wanted to be a boy, I thought that everyone felt that way so it wasn't really different to me. I only discovered what being transgender meant at around 11 but got scared out of coming out. When I did eventually come out at 17, I immediately changed my name, pronouns, and the way I presented. When I went to my doctor to get referred to the GIC, they told me that testosterone is permanently gonadotoxic, and that if I did want children I needed to start trying straight away, especially as having pre-existing fertility issues was going to make it a little more difficult. For me, I've also always known I wanted to be a parent, it was never a question of if, it was always a question of when. Obviously the waiting list to see the GIC is really long so I thought I had more than enough time. I suffered a miscarriage 17 and again at 19. I then discovered that actually testosterone doesn't make you permanently infertile so I took a break and started testosterone and had top surgery. I only took testosterone for 6 months before a relationship breakdown and I decided to seek IVF as a single person. I'm still on the IVF journey 4 years and another miscarriage later but the plan with my GIC has always been to restart testosterone as soon as I give birth. I toyed with the idea of surrogacy, but the cost is so prohibitive and it is not supported by the NHS. My only real option is to carry a child by myself. I plan to stick to he/him pronouns and present as male throughout my pregnancy and everyone is aware of this. As my pregnancy is so high risk with my previous miscarriages and medical history, I have actually already met my pregnancy team. The midwife deals specifically with transgender men who carry a pregnancy themselves so it's actually very common for transgender men to take this path. There's actually a whole network of us that I have reached out to. The McConnel case ruled that giving birth is not a female only thing. That it is possible to be a male mother, as the term is no longer gendered. I've spoken to lots of other trans men and have discovered that being rejected a GRC based on the desire to have children is becoming more common. I'm actually quite alarmed about this entire process because as far as I know there is no requirement for even medical transition in order to gain a GRC, much less a requirement for sterilisation. So I'm a little bit confused and worried that this is affecting my application despite living as male for almost 9 years now. I know it said that this is incompatible with my declaration to live as male for the rest of my life but I intend to give birth as a man and be known as dad by my child, despite being down as mother on their birth certificate.”
“Practically speaking, [W] has transitioned to the male social gender role full-time. He changed his name by deed poll in April 2016 and has lived full-time since then. He is known in all contexts as male and as [W], including on his UK driving license, UK passport, with his university and with his GP surgery. With respect to taking steps toward physical gender change, [W] wears a binder, has started with testosterone therapy and generally presents as masculine. In future, he plans to undertake gender confirming genitoplasty. [W] wishes now to move forward with bilateral mastectomy with the view to achieving a more naturally masculine appearance and sense of self.”
“[W]’s presentation is consistent with a diagnosis of gender dysphoria (302.85) / female to male transsexualism (F64.0) according to DSM-5 and ICD-10-CM criteria. … It is my opinion that [W] has met the guidance criteria for gender confirming surgery outlined by the World Professional Association for Transgender Health (WPATH): (1) [W] has a persistent and well-documented history of gender dysphoria, present for longer than two years; (2) [W] possesses the capacity to consent to treatment; (3) [W] is of the age of majority for the United Kingdom; and (4) [W] reported no disqualifying health concerns and presented with no disqualifying psychiatric history. In sum, I support [W] in going forward with bilateral mastectomy under your care.”
“This patient is about to undergo IVF fertility treatment with the aspiration of becoming pregnant and for this reason has stopped all hormone treatment. He is allowed 3 cycles, as I understand it, and should he become pregnant no further treatment will be possible until the baby is born and things are once again stable.”
“In a sense, this patient is in a situation where everything is on hold until his current fertility issues have been resolved by either the birth of the baby or the abandonment of fertility treatment. If the first of these is the case, which I hope, it would not be sensible for him to consider moving forward until he is able to both look after the child and himself.”
“The last consultation in the core side of the clinic here was with Dr J Barrett, January 2021: there was a supportive first opinion for a referral for genital surgery. It was noted that [W] was about to undergo IVF so was off testosterone therapy. … As above, [W] tried IVF twice, using sperm donors (once privately in the UK, once in [abroad], not able to secure on the NHS “on the basis of being trans”, which seems worrying), he is aiming to try again in [abroad] around October 2022, focusing on optimising diabetes control between now and then.”
“[W] was endorsed for testosterone therapy by Dr Barrett in 2019. He took Testogel 2 pumps between November 2019 and April 2020, but reported that he did not notice any significant masculinising changes. He then stopped it in order to try to conceive. He does not anticipate that being pregnant will make him significantly dysphoric. Since stopping testosterone therapy he has completed 3 full rounds of IVF and a frozen transfer. He sadly had a miscarriage in January 2024. (He reported that he also previously had 2 miscarriages in 2016 and 2018, at a time when he had been to conceive via artificial insemination.) He currently has one frozen embryo and is considering his options, including surrogacy. He reported that it is not clear why he is struggling to conceive… He is not sure when he will restart testosterone therapy. He wants to have at least 2 children and he may restart testosterone therapy temporarily when he has had 1 child, or may wait until he has completed his family.”
“[W] had privately funded chest surgery in 2020… Once he has finished IVF he intends to seek privately funded revision surgery. In the longer term he thinks that he will ‘definitely’ want genital surgery and is leaning towards metoidioplasty. He also thinks that he is likely to want a hysterectomy and oophorectomy. However, he would not seek these surgeries until he has completed his family in a few years’ time.”
“(ii) Your declared intention to live in the male gender for the future: Dr Barnes’ report of22 February 2024 led to the Panel’s directions on8 August 2024 . The Panel wanted your input on whether your wish to conceive a child was incompatible with your declared intention to live as in the male gender for the rest of your life. The Panel Directions offered you the opportunity to explain either by email, at a face to face or via a secure video hearing why you thought it was not incompatible to live as a man when trying to conceive and carry a pregnancy. You did not take up any of these options but did send further medical evidence.”
“5. In your further medical evidence, the practitioners who were aware of your medical history and continuing intentions for conceiving a baby did not question their diagnoses of gender dysphoria. This is not surprising since gender dysphoria and its more up to-date wording of ‘gender incongruence’ are broad umbrellas. Given the scope of gender dysphoria/gender incongruence, it is rarely necessary to doubt a specialist’s diagnosis and we do not do so here, but it is still necessary to decide whether, in the circumstances of your application, you have lived throughout the period in the other gender and intend to do so.”
“6. The Gender Recognition Act sets out rigorous conditions to ensure that a certificate is granted only where an applicant is securely set in their acquired gender. The Act gives a straightforward choice: male or female. Some aspects biological sex (sic) such as childbearing and associated reproductive issues will, in the Panel’s view, almost certainly be relevant in assessing an individual’s genuine and enduring adoption of their new gender. In this area, gender and biological sex remain entwined.”
“sex is now more properly understood to refer to an individual's physical characteristics, including chromosomal, gonadal and genital features, whereas gender is used to refer to the individual's self-perception”
“The term “gender” is used in this context to describe an individual’s feelings or choice of sexual identity, in distinction to the concept of “sex”, associated with the idea of biological differences which are generally binary and immutable.”
“We do not draw any inference from this as to the intended breadth of the rule set out in section 9(1). In our judgment, the words in parenthesis are more likely to be intended to forestall any argument that might have arisen if the rule referred only to gender and not to sex (or only to sex and not to gender) and to reflect the fact that the words “gender” and “sex” were used interchangeably in legislation at the time the GRA 2004 was introduced.”
“In this case the court is required to define the term ‘mother’ under the law of England and Wales. Down the centuries, no court has previously been required to determine the definition of ‘mother’ under English common law and, it seems, that there have been few comparable decisions made in other courts elsewhere in the Western World. Hitherto, a person who has given birth to a child has always been regarded as that child’s mother. The issue arises in modern times where an individual, who was born female, undergoes gender transition and becomes legally recognised as male before going on to conceive, carry and give birth to a child, with the result that the parent who has given birth is legally a man rather than a woman. The question posed to this court is: Is that man the ‘mother’ or the ‘father’ of his child?”
“139. It is pertinent to ask whether the role of ‘mother’ is as entirely gender specific as Miss Markham’s assumption requires. It is undoubtedly the case that throughout history the role of being a gestational mother has been undertaken by females, but is being female the essential or determining attribute of motherhood? There is a strong case to be made for the role of ‘mother’ being ascribed to the person, irrespective of gender, who undertakes the carrying of a pregnancy and who gives birth to a child. In that regard, being a ‘mother’ is to describe a person’s role in the biological process of conception, pregnancy and birth; no matter what else a mother may do, this role is surely at the essence of what a ‘mother’ undertakes with respect to a child to whom they give birth. It is a matter of the role taken in the biological process, rather the person’s particular sex or gender. 140. The law has, in recent times, readily recognised mothers, who are to be regarded as male, and fathers, who are to be regarded as female. Long before the GRA 2004, transgender parents were accepted in the family courts in their acquired gender. 141. On the facts of [JK, R (On the Application of) v The Secretary of State for the Home Department & Anor[2016] 1 All ER 354 ], the transgender woman who was the father of the two children, and who remained registered as ‘father’ following the court’s ruling, was, by a time soon after the second child’s birth, to be recognised for all purposes as female. It is accepted in these proceedings that the effect of GRA 2004, s 12 was that JK’s GR certificate did not affect her status as ‘father’ to those children; JK is thus a female father. The same would be true had it been the other way around and a mother had subsequently been granted a GR certificate recognising an acquired male gender, that person would be a male mother.”
“279. The principal conclusion at the centre of this extensive judgment can be shortly stated. It is that there is a material difference between a person’s gender and their status as a parent. Being a ‘mother’, whilst hitherto always associated with being female, is the status afforded to a person who undergoes the physical and biological process of carrying a pregnancy and giving birth. It is now medically and legally possible for an individual, whose gender is recognised in law as male, to become pregnant and give birth to their child. Whilst that person’s gender is ‘male’, their parental status, which derives from their biological role in giving birth, is that of ‘mother’. (my emphasis) 280. At paragraph 149, I set out my preliminary conclusions with respect to domestic law, these can now be firmly stated as: a) At common law a person whose egg is inseminated in their womb and who then becomes pregnant and gives birth to a child is that child’s ‘mother’; b) The status of being a ‘mother’ arises from the role that a person has undertaken in the biological process of conception, pregnancy and birth; c) Being a ‘mother’ or a ‘father’ with respect to the conception, pregnancy and birth of a child is not necessarily gender specific, although until recent decades it invariably was so. It is now possible, and recognised by the law, for a ‘mother’ to have an acquired gender of male, and for a ‘father’ to have an acquired gender of female; (my emphasis) d) GRA 2004, s 12 is both retrospective and prospective. The status of a person as the father or mother of a child is not affected by the acquisition of gender under the Act, even where the relevant birth has taken place after the issue of a GR certificate.” a) At common law a person whose egg is inseminated in their womb and who then becomes pregnant and gives birth to a child is that child’s ‘mother’; b) The status of being a ‘mother’ arises from the role that a person has undertaken in the biological process of conception, pregnancy and birth; c) Being a ‘mother’ or a ‘father’ with respect to the conception, pregnancy and birth of a child is not necessarily gender specific, although until recent decades it invariably was so. It is now possible, and recognised by the law, for a ‘mother’ to have an acquired gender of male, and for a ‘father’ to have an acquired gender of female; (my emphasis) d) GRA 2004, s 12 is both retrospective and prospective. The status of a person as the father or mother of a child is not affected by the acquisition of gender under the Act, even where the relevant birth has taken place after the issue of a GR certificate.”
“I'm actually quite alarmed about this entire process because as far as I know there is no requirement for even medical transition in order to gain a GRC, much less a requirement for sterilisation. So I'm a little bit confused and worried that this is affecting my application despite living as male for almost 9 years now. I know it said that this is incompatible with my declaration to live as male for the rest of my life but I intend to give birth as a man and be known as dad by my child, despite being down as mother on their birth certificate.”
“The Panel erred in concluding that the desire to become pregnant, the taking of steps to facilitate a pregnancy, or becoming pregnant was “inconsistent with living in the male gender” for the purposes of s.2(1)(b) and (c) (§7). The effect of that interpretation was to require the Appellant – and other transgender persons – to abandon the right to choose to conceive biological children (or take steps to conceive) as a precondition to obtaining a GRC. Such an interpretation is inconsistent with the State’s obligations underArticle 8 of the ECHR (Ground 1).”
“8. The evidence before the Panel leads us to make the following findings of fact: As to question (i), prior to the two year period of living in the male gender, you took steps to achieve a pregnancy, though your pregnancies resulted, sadly, in miscarriage. Certainly by 2021, you were again taking active steps to conceive a baby with a view to carrying it to term while presenting as living in the male gender. Although your IVF treatments in January and June 2022 were unsuccessful, the latter attempt was within the statutory period. In early 2024, you sadly had had another miscarriage. This pregnancy was within the statutory two year period. You still hoped to conceive and carry a baby yourself, and you were to be referred for further egg storage on the NHS. There is no indication that you have, or had abandoned your hope to conceive and carry a baby at that time. As to (ii) your statutory declaration dated21 March 2024 stated that you had lived in the male gender for seven years and intended to live the rest of your life in the male gender. During that period you had three rounds of fertility treatment including IVF and unsuccessful pregnancies. Your application was made on 22 March.”
“9. On these facts the Panel concludes on balance of probabilities that you were not living in the male gender throughout the period of two years down to the date of your application. For the same reasons, we are unable to accept that you were living in your acquired gender throughout the 7 years stated in your Statutory Declaration. In so far as those professionals practising in the field of gender dysphoria consider you to be living in your acquired gender in the circumstances as we find them, we reject their views. The medical practitioners and psychologist practising in the field of gender dysphoria are tasked with diagnosing and treating gender dysphoria. They may offer opinions on matters such as whether a patient is living in their acquired gender and on the patient’s future intentions, but their opinions are just that. The Panel considers their opinions when assessing all the evidence, but our task is to find whether the statutory conditions for granting a Gender Recognition Certificate are satisfied. Medical opinion and legal analysis may yield different results and do so on these facts.”
“10. Pregnancy is a fundamentally female biological function and we find it to be inconsistent with living in the male gender. The Panel accepts that you have changed important documents to reflect a male identity and have had a bilateral mastectomy but while these provide some evidence that you were living in the acquired gender, they do not outweigh the combination of other factors identified in paragraph 9.”
“...in AP sterility was, in effect, a precondition for a GRC. However, in C’s case, he can (on the GRP’s reasoning) in principle complete his family planning efforts and obtain a GRC two years later. Further or alternatively, C can have a child by some other arrangement than his own pregnancy, e.g. potentially adoption or surrogacy (subject to the practicalities of being able to do so, noting that C has said he cannot do so).”
“(i) Physical / physiological features. Gender dysphoria is, in its essence, an incongruence between a person’s sense of self and their biological features (see C at [2] above). Accordingly, some trans people make changes to their bodies through surgery or medical treatment such as hormone treatment. This is politically controversial because some people may argue that sex/gender is purely a matter of identity and does not require any bodily modification at all. Others may argue that no amount of bodily modification can alter someone’s underlying biological sex.”
“(ii) Self-identification. This might be evidenced by changing one’s sex designation on various documents (such as a passport or driving licence). It might also be evidenced by using facilities and services ordinarily designated for those of their acquired sex (such as a trans man using the men’s lavatories). The subjects of self-identification and facilities use are also matters of political controversy. For example, the question of whether trans people can, under theEquality Act 2010 , use the facilities aligned with their acquired sex is the subject of a judicial review recently brought by the Good Law Project and others (permission hearing pending).”
“(iii) Behaviours. This might include doing activities, or presenting in a way, that is more typically associated with one sex than another. An example might be a trans person’s choice of clothing or makeup or a trans person adopting a name typically regarded as feminine or masculine (or at least adopting a neutral name which dissociates from a clearly gendered birth name). Again, this category of evidence is controversial; both sides of the political debate might argue that this reduces sex into a series of stereotypes, none of which are intrinsically linked with sex and the perpetuation of which may be argued to be damaging.”
“17. After I have had children, I plan on restarting testosterone therapy and to seek referral for bottom surgery (likely metoidioplasty, hysterectomy and oophorectomy). I definitely want bottom surgery and sought a referral for that surgery previously. Given that the NHS waiting list for bottom surgery is around 6 years, I had hoped to get that referral and then have enough time to have children before I reached the front of the queue, but my fertility issues have meant that it has taken longer than I expected. 18. I recently finished a course of speech and language therapy that began in December 2024 to learn techniques to make my voice sound deeper and more masculine in delivery.”
“20. I had always dreamt of having a big family. I would like at least two children, but I would of course also be happy with just one. My ideal situation would be to have one child and then continue trying for a second. To do this, I would need to have a caesarean section (because of my disabilities) and then wait 12-18 months before immediately having another. Thereafter I would want to restart testosterone therapy and seek referral for bottom surgery. 21. I have considered, and reflected on, how conceiving and carrying a child would affect my decision to live in the male gender. I expect that being pregnant will cause me some dysphoria, but I believe experiencing a level of dysphoria for nine-months will be worth it for a lifetime of love having a family. I have also of course considered other options but have always concluded that carrying my own children is the only achievable and affordable option for me. 22. I have considered surrogacy as a means to have children, and I was a part of the Surrogacy UK Facebook group for a while. I understand that finding a surrogate is not straightforward. I do not have a family member or friend who would be willing and able to be a surrogate. I also understand that, while you do not technically pay a surrogate, you have to pay their expenses, which can total up to£50,000 . That is far beyond my means and always will be.”