Judge who approved puberty blockers for minors calls for urgent government rethink

Australia has reached what should be a significant turning point in our medical approach to vulnerable, gender-distressed children and teenagers. In Monday’s paper, the former judge who led the Family Court in 2013 when it green-lit liberalised access of puberty blockers to minors revealed she now has doubts about the landmark ruling. Former Family Court chief justice Diana Bryant now says it may be better for parliaments to step in and regulate the field of pediatric gender medicine rather than rely on whatever disputes come before judges, Bernard Lane reported.

The time is ripe for a change of direction, led by elected governments stepping up to represent voters rather than leaving it to the medical or legal professions to lead decision-making on the issue. In August, Health Minister Mark Butler ordered the National Health and Medical Research Council to review pediatric gender medicine, with interim advice on puberty blockers expected by mid-2026, to “ensure states are acting on the best possible advice”. It is vital that the new national treatment guidelines, to be developed by the council, be rigorous and free of activist influence. Mr Butler has sent mixed messages on gender clinics. The review comes as the subject is increasingly controversial in different states.

Queensland has paused the process of new patients accessing hormonal puberty blockers in the state health system, pending an independent review of evidence, to report to the Crisafulli government by the end of this month. In Victoria, in contrast, gender medicalisation of minors continues without constraint. As we reported a month ago, the Allan government is riding roughshod over parental rights, with official policy enabling opposite-sex “social transition” of children in state schools, without the knowledge or approval of parents. That approach increases the likelihood that minors will go down the path to irreversible hormonal and surgical interventions, with potential harms including cardiovascular disorders, infertility and sexual dysfunction.

Ms Bryant, wisely, is opposed to excluding parents from decisions about their children’s health. “If a child, for example, has cancer and there is to be treatment, you’d certainly hope that they’d be involved (in the decision), but it’s highly unlikely that their parents are going to give them complete autonomy to decide what to do,” she said.

Ms Bryant’s change of heart came about earlier this year after she chaired the World Congress on Family Law and Children’s Rights in Cambridge, England. There she was struck by a presentation on teenagers, their immature brains and risky decision-making. Adolescents and young adults, University College London professor of clinical neuropsychology Sallie Baxendale told the conference, are more prone to impulsive, peer group-pleasing decisions.

That concern stands in stark contrast to Ms Bryant’s view 12 years ago when, under her leadership, the Family Court accepted evidence from an endocrinologist, known only as “Dr G”, that puberty blockers were reversible, safe and a no-regrets option to give children time to explore their gender identity. She wrote the key decision abolishing the rule that, even if parents agree, court approval is necessary before a child with gender dysphoria can start on puberty blockers. At the time the decision was hailed as a human rights victory.

But “things have absolutely moved on since 2013”, as she says. The UK’s 2024 Cass report undermined the confident claims of beneficial outcomes by gender clinics. Dr Hilary Cass led the world’s most thorough review of youth gender dysphoria care, finding that social transition carries the possibility of locking in gender distress, which would otherwise resolve as the young person matures. Concern about puberty blockers is growing, with Nordic countries leading the way with evidence reviews and more cautious treatment policies since 2020. The UK has a politically bipartisan, indefinite ban on routine prescription of puberty blockers. Governments in Australia cannot dodge responsibility indefinitely.