In the U.K., the NHS-run transgender-youth clinic is now facing a class-action lawsuit on behalf of some 1,000 families who allege the clinic’s “failures in their duty of care toward young children and adolescents.” In the U.K., the doctor’s duty to the patient (as opposed to the patient’s “right” to obtain certain services) is the guiding principle. This may seem paternalistic, but when dealing with a vulnerable patient population — children, adolescents, or adults in mental distress — surely paternalism is warranted.

Whatever its faults, doctor accountability is baked into the British health-care system. The General Medical Council, founded in 1858, oversees the registration and education of doctors. Some of this is obviously burdensome. Since 2012, NHS doctors have been required to undergo “revalidation” every five years, which means they must show that their knowledge is up to date, that there are no concerns about their work, and that they provide a “good level of care.” Nevertheless, a doctor who exhibits recklessness or who acts “outside the limits of his expertise” can be banned from practicing, such as in the case of the husband-and-wife team Michael and Helen Webberley, who prescribed puberty blockers to minors through their private online clinic.