Who will drive gender inquiry?

The British health system’s adoption of more cautious advice for under-18s and parents contemplating “transgender” medical treatments is a significant development in a global debate about medicalisation, ethics and informed consent. As Australia’s Health Minister, Greg Hunt has put this on the agenda for a gender clinic review by his state and territory counterparts. So, too, he has asked them to investigate the overrepresentation of teenagers with signs of autism in the clinics. He stresses state responsibility for children’s hospitals and has already set in train a review by a COAG council of health officials. As we report in Tuesday’s paper, Mr Hunt says he will ensure that concerns are “expressly and clearly addressed” by state bodies.

The risk is one of political ownership. It’s not a matter of prejudging the outcome of an inquiry but of political leadership reassuring the public that serious questions about the welfare of vulnerable young people will be pursued with rigour and determination. It’s not clear yet how the review mandated by Mr Hunt will be handled under national cabinet. The COAG council to discuss gender clinics on June 24 makes decisions by consensus. The states with big clinics are Western Australia, Queensland and Victoria, with the last the pacesetter. None of their health ministers has displayed any grasp of the debate. Queensland and Victoria would like to shut it down with spurious bans on “conversion therapy”. In August, when The Australian started reporting this issue, Mr Hunt asked a medical college for urgent advice but the brief response that turned up seven months later cannot be regarded as useful.

So, who or what will drive the cause of a proper inquiry when powerful interests oppose it? In Britain, litigation is clearly a factor in the government flagging changes to protect minors from medical interventions they may come to regret. Trouble is, those who champion these treatments frame them as a human rights imperative and portray prudent scrutiny as a bigoted attack on at-risk youth. Nobody disputes that many of the trans-identifying teens of the post-2000s wave suffer from multiple problems. That is precisely why we have a duty to make expert and compassionate efforts to understand what it is that causes their distress and make sure that any medical treatments do good, not harm.