Gender care for minors in England has recently been scrutinised by the courts and is currently undergoing significant transformation, shifting away from the long-standing centralised service provision model. Alongside this change, the World Professional Association for Transgender Health has recently published Version 8 of its Standard of Care, which introduces radical changes that shift away from age restrictions on medical interventions. This article considers what role judicial decision-making could, or should, play in this new era of healthcare provision for adolescent gender care, especially since Bell v. Tavistock. Despite Bell seemingly returning decision-making to clinicians, patients, and their families, we argue that the decision has left the door open in a way that threatens the autonomy and rights of gender diverse children. Through a comparative analysis with Australian case law, we demonstrate how and why uncertainties left by Bell may in fact lead to continued court involvement. Finally, we suggest several pragmatic responses that may mitigate the risk of unnecessary and time-consuming court involvement.

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