Britain’s Court of Appeal ruled Friday that doctors can prescribe puberty-blocking drugs to children under 16, overturning a lower court’s decision that a judge’s approval should be needed.

Appeals judges said the High Court was wrong to rule last year that children considering gender reassignment are unlikely to be able to give informed consent to medical treatment involving drugs that delay puberty. The December 2020 ruling said because of the experimental nature of the drugs, clinics should seek court authorization before starting such treatment.

The Tavistock and Portman NHS Trust, which runs the U.K.’s main gender identity development service for children, appealed against that ruling.

On Friday the Court of Appeal agreed with the trust. The judges said it was “inappropriate” for the High Court to have given the guidance and said it was up to doctors to “exercise their judgment” about whether their patients can properly consent.

The trust welcomed the decision, saying it “affirms that it is for doctors, not judges, to decide on the capacity of under-16s to consent to medical treatment.”

Hormone blockers are drugs that can pause the development of puberty, and are sometimes prescribed to help children with gender dysphoria by giving them more time to consider their options.

The lawsuit against the Tavistock clinic was brought by two claimants including Keira Bell, who was prescribed hormone blockers at 16 and argued that the clinic should have challenged her more over her decision to transition to a male.

Lawyers for Bell and the other claimant argued that children going through puberty are “not capable of properly understanding the nature and effects of hormone blockers.”

Bell, now 24, said she was disappointed by the court of appeal ruling and would seek permission to appeal to the Supreme Court.