Inquiry to assess sex change concerns The Weekend Australian 17.08.19

The original article is here.

A national inquiry into the safety and ethics of medical treatment for the rising number of trans­gender-identifying children and adolescents will go ahead with the backing of Health Minister Greg Hunt.

Mr Hunt’s office said yesterday he had referred concerns ­reported exclusively in The Weekend Australian this month to the Royal Australasian College of Physicians as “the ­expert clinical body”. The independent RACP has agreed to do the inquiry and said it had­ ­“received correspondence in relat­ion to treatment of gender dysphoria (discomfort in biological sex) in children and adolescents, and we are seeking advice from our relevant expert groups to inform our response”.

NSW Health Minister Brad Hazzard has flagged the possibility of national standards to guarantee consistent quality of care when young people identify as the opposite sex and are given treatment such as puberty blocker drugs at around 10-12 years of age, cross-sex hormones at 14-16 and, in rare cases, surgery to ­remove breasts at under 18.

NSW will go to the federal health department to ask “whether clinical guidelines for gender dysphoria should be developed at the national level”, Mr Hazzard’s office said.

It has emerged that the “Australian standards” document for treatment in this contentious field — issued by Melbourne’s Royal Children’s Hospital gender clinic — has uncertain status across the country and does not carry endorsement as a national standard from the National Health and Medical Research Council.

The Weekend Australian reported two weeks ago that Mr Hunt and the RACP had been alerted to the child-welfare concerns of a group of clinicians and researchers including Western Sydney University professor of paediatrics John Whitehall, clinician and former Sydney University psychology professor Dianna Kenny and health sociologist Geoff Holloway with support from paediatrician and 2019 ­Senior Australian of the Year Sue Packer. A little-understood surge in adolescent girls suddenly ­declaring they are boys is causing growing international disquiet.

Critics say the 2018 standards encourage risky medical treatment without properly considering safer therapies such as counselling for problems such as depression, anxiety, autism spectrum disorder, bullying and family conflict. The RCH standards overplay evidence for medical treatment and downplay risks, say “dissident” clinicians.

The first national figures, ­obtained under FOI legislation, show 2415 children and adolescents were seen from 2014-18 at the main gender clinics at RCH in Melbourne (the pacesetter in treatment), Perth Children’s Hospital, Westmead Child­ren’s Hospital in Sydney and Queensland Children’s Hospital.

Westmead, which said it did not provide irreversible cross-sex hormones or surgery, had 50 ­referrals last year and its overall caseload was 61 per cent biological female. RCH refused a request for a sex breakdown.

In a rare case, the Family Court in January approved a double mastectomy for a 17-year-old girl who identified as the boy “Ryan”. His mother and experts supported “top surgery” but his father was against it.

The judge said: “It is possible, as the father fears, that Ryan will regret his decision, although on the evidence it seems highly ­unlikely. It is part of the human condition to regret decisions taken at earlier stages of life.”

The Melbourne RCH caseload of young patients rose 41 per cent to 228 referrals last year.

Asked about practices at RCH, Victorian Health Minister Jenny Mikakos said: “The (RCH) nat­ional standards ensure that children who are treated at gender clinics are protected by the most stringent safety standards.”

The RCH standards cham­pion the internationally dominant “affirmation model”, in which the trans self-identification of young people is readily ­accepted by health and medical staff, who set them on the path to “social transition” and in some cases medical treatment.