Clear rules needed on surgery

Within the bounds of respectful debate, it is reasonable that surgeons are calling for the national medical regulator to step in to set clear and specific guidelines on gender-affirming surgery. That includes the issue of whether the age at which transgender adolescents legally are allowed to undertake procedures such as double mastectomies should be raised to 18.

Such operations, which only a handful of Australian surgeons are willing to perform, are rare, but their incidence appears to be increasing, Natasha Robinson reported on Sunday. The case of a 15-year-old child in Queensland having “top surgery” prompted Mark Ashton, a plastic surgery specialty elected counsellor to the Royal Australasian College of Surgeons and University of Melbourne professor of surgery, to question the lack of regulations. Gender-affirming surgery was becoming more mainstream but regulation had not kept up, he said. Most Australians would agree with Professor Ashton that, because of their permanency, elective double mastectomies should be delayed at least until patients are 18.

The federal government’s nat­ional public health information service Healthdirect says “top surgery” can be performed with parental consent on minors over 16, but “some surgeons will provide surgery to younger people in very specific situations”.

Three breast reconstruction surgeons have confirmed to The Australian that as the medical transition of young people has grown more common, surgeons are being approached by people who want surgical procedures reversed.