Why children need ‘protection’ from zealous use of puberty blockers and hormone therapy
As the government investigates controversial ‘gender-affirming’ treatments, parents and critics claim children need ‘protection’ from the zealous use of puberty blockers and hormone therapy.
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Newcastle mum Jude Hunter says medical professionals failed her child – and shattered her entire family – after the teenager was prescribed cross-sex hormones following a one-hour appointment.
“My daughter suffered three years of precarious mental health before announcing at 17 that she was transgender and identified as a boy,” she said.
“Yet the only issue the clinicians explored at the time was gender. I will never understand how the medical profession ever gave a disturbed teenager access to irreversible hormones.”
Sydney mother Melissa, who does not want to be identified to protect her child, said she was called a “transphobe, non-inclusive, a bigot and more” when she asked psychiatrists to delve into her son’s background – rather than focus solely on his gender confusion.
“He’d shown no signs of divergence of identity until he was 16 and several of his friends announced they were transgender … then one day he told me he didn’t identify as a male and eventually wanted to be castrated,” she said.
“The (gender clinicians) didn’t want to listen to his history. What system wants to take a healthy person and give them hormones or, worse, remove healthy body parts, and make them dependent on medication for life?”
Meanwhile, South Coast father Jake, who cannot speak publicly, felt ostracised by gender clinicians when he disagreed with them – and their daughter’s mother – over the best course of treatment.
“I cannot believe how many lies they tell to parents and children, and how quick they are to hurt and damage children for the rest of the child’s life as if it’s OK,” he said.
LANDMARK REVIEW
Gender-affirming treatment in Australia is in the spotlight, with the federal government announcing late last month it would conduct a landmark review into the prescription of puberty blockers and cross sex hormones for children and adolescents.
The government has tasked the independent National Health and Medical Research Council to develop new national guidelines for the treatment and care of trans and gender diverse youth. Interim advice on the use of puberty blockers will be completed mid next year.
The announcement came just days after Queensland Health Minister Tim Nicholls’ controversial suspension of hormone therapies for new patients under 18 with gender dysphoria, amid a review of that state’s public gender services.
Transgender advocates have criticised the ban as a “politically motivated attack”, with thousands marching in rallies across the country on February 8, including Brisbane, Sydney and Melbourne.
Jackie Turner, director of the Trans Justice Project, said the ban undermined the right of trans youth to grow up “happy, healthy, and with the freedom to be themselves”.
STRICT LAWS
NSW Health operates three gender clinics, with the Sydney Children’s Hospitals Network service and Maple Leaf House operated by the Hunter New England Local Health District supporting referrals of patients under 16.
A third clinic operated by the South East Sydney Local Health District called True Colours was opened in December last year targeting patients between 16 and 24. And last week NSW Health referral figures for 2024 obtained by the Telegraph revealed the number of children and young people referred to one of the three clinics has risen to 571.
Not all referrals result in puberty blockers or Stage 2 hormone therapies being given. There were 61 children receiving puberty blockers from the Westmead service in 2023 – up from only eight in 2014. Another 91 children received puberty blockers from the Maple Leaf service in 2023. Figures for True Colours were not available.
A spokesman for NSW Health Minister Ryan Park welcomed the development of national guidelines. He said NSW clinicians were already required to operate within stringent national and state laws, with a range of safeguards in place, including appropriate consent procedures to ensure young people and families could make informed decisions.
“I want to reassure families that there will be no interruption to services in NSW, and we remain committed to providing healthcare for young people that is tailored, best-practice, multidisciplinary and age appropriate,” the spokesman said.
“In 2024, the Sax Institute undertook a review into the latest national and international evidence on effective interventions for children and young people with gender dysphoria.
“The review found that puberty suppression, gender affirming hormones and psychological therapies can be beneficial for young people who are trans and gender diverse. The review reaffirms our current approach to providing care to these young people.”
A NSW Health spokesperson said any developments in the evidence in the “constantly evolving research field” were monitored closely.
“Puberty suppression treatment is clinically appropriate for a minority of clients (in state gender clinics),” the spokesperson said.
“If gender affirming medical treatment is considered, multidisciplinary diagnosis and assessment is required over time.
“This occurs in close consultation with the patient, parents and carers, and clinical teams, who must all agree treatment is in the patient’s best interest.”
PROTECTING CHILDREN
However Queensland psychiatrist Jillian Spencer said children needed to be protected now from the harms of puberty blockers or cross-sex hormones.
“These medications can result in infertility, a lack of sexual function and long-term physical health problems,” she said.
Dr Spencer was removed from clinical duties at Queensland Children’s Hospital in April 2023 after voicing concerns about the gender affirming care model for minors there, and is one of 100 prominent Australians who had recently called on the federal government to initiate a review.
Yet she said the planned national inquiry may be too little, too late, with an “unnecessarily long time frame” and lack of associated action to protect young people immediately.
Dr Spencer supports the “watchful waiting” therapeutic model where children and young people receive treatment for the issues that might be driving their gender distress – such as trauma, autistic traits, depression or anxiety. The NSW system – like her home state – was not evidence-based, she maintained.
“I’m very concerned about the NSW system of care for children with gender distress because the model being used is being determined by government policy rather than by research evidence on what is safe and effective,” Dr Spencer said.
“It is important for parents to realise that within state government funded children’s gender clinics, all the clinicians are mandated to provide ‘gender-affirming care’.
“This is a very dangerous model where the child is assumed to be naturally trans or gender diverse and they are placed on a pathway of social transition, puberty blockers, cross-sex hormones and gender surgery.”
Dr Spencer said reputable systematic reviews of global research literature showed that these interventions do not improve a child’s mental health and do not lower the child’s risk of self-harm or suicide.
“Puberty blockers do not give a child ‘time to think’ as originally claimed. Instead they lock-in the gender distress so that the child doesn’t recover as most children naturally do if they are allowed to go through adolescence.”
As well as protecting children, Dr Spencer stressed the need to have careful processes in place to protect vulnerable young adults, up to the age of 25, from being able to rush into irreversible interventions which they might regret.
“Gender interventions are being sold to people as a solution to their complex problems but we are finding more and more young people getting to the end of the gender affirming pathway, which is surgery, and finding that they feel no better and they regret it.”
DETRANSITION
That includes a growing number of destransitioners, such as Mel Jefferies who recently shared her journey with the Telegraph, claiming she spent a decade “going down the wrong path”.
The Melbourne woman spent over a decade as “Mason” after she was diagnosed with gender dysphoria in her late teens, accessing testosterone to deepen her voice, grow facial hair and form muscles, and undergoing a double mastectomy at 25.
Ms Jefferies has trans friends who’ve transitioned well, she’s happy for them, but she regrets her decision and is detransitioning – yet she said the support from peers and gender clinicians that was there for her to transition has all but disappeared.
Perth woman Courtney Coulson, also detransitioning after taking testosterone, concurred: “Detransitioning was very lonely,” she said.
NSW gender clinician Alex – who is concerned about using his surname due to backlash from transgender groups – treats kids with gender dysphoria without hormones or surgery.
Alex said the Albanese government review was desperately needed, however, the findings of the UK’s Cass Review had already found “a lack of robust evidence on the long-term benefits and outcomes of these (puberty blocker) interventions” which led to the UK banning them for under-18s last year.
Other European countries, including Sweden, Denmark and France, have also moved to limit their use to research settings or in exceptional circumstances.
“It is well established, all around the world, that uninterrupted puberty is the most effective way to resolve gender dysphoria and distress from feelings of incongruity or dysmorphia,” Alex said.
“In contrast, so-called ‘affirming care’ neither helps resolve mental distress nor leads to a person’s comfort with their body’s natural biology. Legitimate care does not entrench a person’s dissatisfaction with their body, or force dependence on lifelong medicalisation.”
They criticised the “coercion” of many Australian parents into supporting treatments that they were not comfortable with.
“NSW gender clinicians have driven a wedge between many children and parents I know by seeking to force agreement from parents who have well founded reservations about gender interventions,” they said.
PARENTS’ ANGUISH
It’s been a devastating journey for Jude Hunter, who helped establish Genspect Australia after her personal experience – to help support other families and individuals navigating questions of sex and gender.
“These gender clinics prioritise gender above all other health considerations,” she said.
“My daughter was 17 … they immediately affirmed her and we were told we were bigoted parents for not getting on board. They said to us ‘Would you like a live son or a dead daughter?’.”
Ms Hunter said her daughter is now struggling more than ever after using testosterone – which she’s now stopped, but the effects are irreversible.
“It significantly changed her physical appearance in such a short time – including a redistribution of fat and the growth of facial hair and her voice deepened – and she suffered medical issues too,” she said.
It’s “broken” Ms Hunter too – and she and her daughter move “in and out of estrangement”.
Sydney mum Melissa’s son took a dangerous mix of pills and alcohol after he’d been dumped by his girlfriend and “had a mental breakdown”. He has since been diagnosed with autism.
“We just wanted the psychiatrists he was referred to to look at him with a wider lens – they just wanted to explore gender.
“We were able to break free and our son slowly came back to us … he still identifies himself as being part of the queer community, he was able to get into uni and he’s living life.”
South Coast dad Jake said: “My oldest daughter has expressed gender confusion since around Year 5, and her younger sister followed suit. Their mother has supported that, and I was alienated by the gender clinic my oldest was referred to.
“My position is that children should have a right to grow up protected and be able to choose when they’re adults. I have a good relationship with both my kids, and I’m happy for them to make their own decisions – but I don’t believe children have the capacity to critically engage with endocrinologists and other specialists. I just feel powerless right now.”
Do you have a story for The Telegraph? Email lisa.wachsmuth@news.com.au
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