84. So far as the medical reports required by section 3 are concerned, the President of the Panel issued guidance in 2005 pursuant to paragraph 6(5) of Schedule 1 (as amended) as to how panels should consider the medical evidence. The guidance states:
“3. … 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 supports that diagnosis.”
85. In Carpenter v Secretary of State for Justice [2015] EWHC 464 (Admin), [2015] 1 WLR 4111 a trans woman challenged the requirement under section 3(3) of the GRA 2004 that she had to provide details to the Panel of the surgical treatment she had undergone for the purpose of modifying her sexual characteristics. She argued this infringed her article 8 rights because applicants could be issued with a certificate without having undergone surgery and without therefore having to provide such details. The challenge was rejected. Thirlwall J accepted that the requirement to provide medical details engaged the article 8 right to respect for private life. However, where an applicant had undergone surgery, or planned to do so, that fact was highly relevant, if not central, to the application and was plainly necessary to the Panel’s consideration of the criteria in section 2(1)(a) to (c) of the GRA 2004. Thirlwall J said at para 23:
“Undergoing or intending to undergo surgery for the purposes of modifying sexual characteristics is overwhelming evidence of the existence now or previously of gender dysphoria and of the desire of the applicant to live in the acquired gender until
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