Immediate restrictions on hormone therapy for young people in Queensland

Queensland has become the first state to restrict hormone therapy for young people, ordering public health facilities cease offering such interventions to new patients with gender dysphoria.

Health Minister Tim Nicholls on Tuesday said the immediate “pause” was justified on safety grounds, due to allegations around the authority for services provided to 17 young people in far north Queensland.

But Nicholls said the restrictions would also allow Queensland to conduct its own review of the medical evidence around puberty blockers and gender-affirming hormone therapy provided to people under the age of 18.

Health Minister Tim Nicholls (left) and Premier David Crisafulli (right) want to examine the evidence behind hormone therapy for young people with gender dysphoria.Credit: Matt Dennien

Nicholls said an external evaluation of the statewide Queensland Children’s Gender Service, completed last year under the former Labor government, had wrongly set out to determine “how is the service delivered, not whether the service ought to be delivered”.

He said a reviewer had yet to be appointed, but would be consulted on the terms of reference and be required to report back within 10 months.

The Queensland LNP last year joined Pauline Hanson’s One Nation Party in adopting a policy to ban puberty blockers.

The WA Liberal Party wants to follow Queensland’s lead if it wins the state election in March, promising to ban puberty blockers while awaiting the findings of a review to determine whether the ban is warranted.

Other states also offer hormone therapy as part of gender-affirming healthcare, with some variation in the consent and approval processes.

Before the Queensland election in October, LNP leader David Crisafulli called for an evidence-based approach while at the same time claiming Queensland was out of step with the rest of the world.

The UK government banned the routine use of puberty blockers in December.

In announcing the review, Nicholls said there was “widely contested international evidence” around the use of hormone therapy for young people with gender dysphoria.

The Queensland Children’s Gender Service is based in South Brisbane but offers services across the state.

“Queensland has not yet undertaken its own considered review of that evidence,” he said, noting that France, Finland, Norway, Denmark and Sweden had also imposed restrictions.

However, Equality Australia CEO Anna Brown on Tuesday declared Queensland “an outlier state”, while Eloise Brook from the Australian Professional Association for Trans Health (AusPATH) warned the LNP government was putting young people at risk.

“Hormone treatments for the small number of young people who need them are essential health care,” Brook said.

“The evidence shows that denying access to this care will cause young people immeasurable trauma, contributing to depression, anxiety and in some cases self-harm.”

The federal Labor government and Coalition opposition said it was a matter for the states.

But, with an election due within months, and an apparent lack of national consensus, Queensland-based Deputy Nationals Leader Matt Canavan called for a federal ban.

“The drugs they use have not been tested and approved for gender transition services and young children are not mature enough to make such life-changing decisions,” Canavan said.

“We should not treat our kids as guinea pigs.”

The evaluation of the Queensland Children’s Gender Service heard patients and their families “reported the care is extremely comprehensive, considered, safe, and evidence-based,” and staff did not coerce or rush decisions.

The incoming Queensland LNP government put a stop to work implementing the recommendations from the evaluation – which had highlighted “long waitlists and demands from consumers to access the service” – and the further expansion of the service.

The local allegations around the “apparently unauthorised” provision of services in Cairns will be the subject of two separate investigations, Nicholls said, with those findings also to be considered in the broader review.

Nicholls said the allegations were raised in May 2024, investigated locally, and relayed to him in December.

“While this review is taking place, there is a need to maintain confidence in the public health services … so today I am also announcing an immediate pause on new public patients receiving hormone therapy for those who are under the age of 18,” he told reporters.

Nicholls said patients already receiving hormone therapy would be able to continue – there were 547 in mid-2024 – and other services would still be available to young people with gender dysphoria.

A spokesman for the state’s Labor opposition said the government’s decision “impacts some of our most vulnerable”.

“Ultimately, it should be a medical discussion and decision between an individual and their doctors, not one made by politicians,” the spokesman said.

It is not the first time the Queensland LNP has been criticised for its health policies. After a campaign mired by debate over abortion laws, Crisafulli took the extraordinary step of banning parliament from discussing the issue.

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