Clock ticking on gender clinics

 

EDITORIAL: We will not shy away from uncomfortable topics that deserve attention. This is particularly so when the health and wellbeing of vulnerable children are at stake.

Children and teenagers can be deemed competent to consent to medical treatment without parental approval under the common law Gillick rule. With minimal court supervision, that rule applies to life-altering medical treatments for under-18s in children’s hospital transgender clinics. In England, use of the Gillick rule in gender clinics faces a challenge, with a High Court judge granting a full hearing for a “plainly arguable” case that minors cannot give informed consent to treatments such as puberty blockers with unknown long-term risks. That challenge is relevant to Australia, and similar litigation here is inevitable. The same hormone drugs used in Australia are being scrutinised for safety and evidence by international experts and research groups.

This means policy-makers in Australia cannot indefinitely operate in a vacuum with little transparency. On Friday, federal Health Minister Greg Hunt sent the gender clinic controversy back to the states via a COAG health officials council, urging them to come up with consistent and safe clinical standards for their children’s hospital clinics. Amid uncertainty about his reasons, Mr Hunt ruled out a national inquiry, which would put this child welfare issue in the public spotlight.

The states have a chance to preside over a thorough and independent review. But there are grounds for scepticism. Victoria is the key state, having lobbied for the contentious “gender-affirmative” treatment model with easier access to irreversible hormone drugs and under-18 surgery. So far, the Andrews government and its Royal Children’s Hospital gender clinic have refused to engage with informed critics. And the COAG review starts not with a blank slate but with questionable advice from a medical college that had promoted the affirmative treatments it was later called upon to assess. That advice focused on the “harm” done by media coverage of this health debate, not the harm that might be done by treatments it admits are based on patchy evidence. The information and expertise for a rigorous COAG review are available. It’s up to state ministers — and Mr Hunt as Australia’s health minister — to supply the essential integrity and determination.