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"An educated guess at best": x-raying children to determine their age  

Kamena Dorling
In its attempt to clamp down on the exaggerated problem of ‘adults pretending to be children’ while seeking asylum, the government has been pushing the use of X-ray and MRI scans to find out their ‘real’ age. NGOs and medical bodies have raised serious concerns that these so-called ‘scientific methods’ are not just inaccurate but potentially harmful.    

The Nationality and Borders Act 2022 (NABA) allowed the government to introduce regulations specifying scientific methods to be used to assess age, including ‘examining or measuring parts of a person’s body’ and the analysis of saliva, cell or other samples and the DNA within them.  

The use of scientific methods to assess age has long been the subject of debate and professional medical bodies have been unequivocal in their rejection of use of dental x-rays, bone age and genital examination as being unethical and extremely imprecise as methods for assessing age.  

The government has repeatedly claimed that scientific methods are widely used in some European countries, but in reality there have been significant legal decisions in Europe finding that scientific methodology is not sufficiently sound to be relied upon. Furthermore, the Council of Europe has highlighted the “broad consensus that physical and medical age assessment methods are not backed up by empirically sound medical science and that they cannot be assumed to result in a reliable determination of chronological age...[they are] at best an educated guess” 

At what cost? 

The Home Office received advice from its own Interim Age Estimation Science Advisory Committee (IAESAC) which found that “biological age assessment can be carried out using an appropriate combination of dental and skeletal methods; assessment of development of the third molar using radiography, radiography of the hand/wrist or MRI of the knee, and MRI of the clavicle”. However, the IAESAC also made very clear that “if biological age assessment is implemented it should be used to assess whether the age claimed by UASC is possible” (emphasis added) and should only be used as part of a wider social work assessment that is compliant with existing guidance and case law.  

Social work assessments are already detailed and should include a wide range of evidence. So, if scientific methods can only ascertain whether an age might be possible, is there any real benefit of adding another, costly and time-consuming, element to an existing system that is already lengthy and onerous? Despite having not produced an impact assessment, nor any outline of what the use of x-rays and MRIs would cost, the government clearly thinks so. The Justification Decision (Scientific Age Imaging) Regulations 2024 and Immigration (Age Assessments) Regulations 2024 have been introduced to implement the changes set out in NABA, despite widespread concerns and many unanswered questions.  

Forced ‘consent’  

A further key concern is that children who refuse to undergo x-rays or MRIs will be threatened with being identified as over 18 by default. Section 52 of NABA outlines that if a child decides not to consent to the use of a scientific process, this should be seen as ‘damaging’ their credibility. Clause 58 of the Illegal Migration Act 2023 goes further, allowing for an automatic assumption of adulthood if a person refuses to consent. The government’s intended approach is not consistent with IAESAC’s recommendation that “no automatic assumptions or consequences should result from refusal to consent”.  

Earlier this year we showed that the issue of ‘adults pretending to be children’ is not nearly as widespread as the Home Office claims because its statistics are flawed and misleading. Instead of wasting money and resources on x-raying children for no real benefit, the Home Office should urgently address its flawed decision making at the border which is resulting in hundreds of children wrongly assessed to be over 18. Placing them in adult accommodation or detention has been putting them at significant risk and this must stop.  


  • Evidence from HBF and the Refugee Council, Royal College of Paediatrics and Child Health, and Refugee and Migrant Children’s Consortium to the Secondary Legislation Scrutiny Committee can be found here 
  • The regulations were debated in the House of Commons on Monday 20th and were debated in the House of Lords  on Monday 27th November 2023, during which Peers voted in favour of a regret motion tabled by Baroness Brinton  – click on the arrow below for our briefing for that debate.