Youth welfare demands clarity

 

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.

The coronavirus pandemic has been an all-consuming challenge, but other health issues also require vigilance. Earlier this month federal Health Minister Greg Hunt revived debate about medical treatments at children’s hospital gender clinics. Mr Hunt is right that this issue demands careful attention because it involves vulnerable minors. Unfortunately, his intervention has sown confusion. He has ruled out a national inquiry but would not explain why when asked by The Australian, and so the government’s position is unclear. This is a global debate, with official reviews and landmark litigation overseas, and it is not going away.

Cautious advocates for these “affirmative” medical treatments admit the supporting evidence is short-term and low quality at best. That is why this newspaper has reported professional concerns — and calls for an inquiry — since August last year. There has been a surge in teenagers, many mentally ill or with autism, wanting irreversible changes to the body that they may regret. Everyone is entitled to better information about these treatments and rival, less invasive responses such as psychotherapy. This is true not only for families wary of gender clinics but also for those who see them as saviours. Parents and clinicians wanting the best care for young people can disagree profoundly about this complex issue.

In August last year, Mr Hunt gave the job of vetting these trans youth treatments to a medical college that immediately protested it did not do inquiries. This newspaper’s reporting revealed the college had joined gender clinics in lobbying to extend these treatments with more public money and less judicial oversight. Last month, the college admitted to Mr Hunt there was only patchy evidence for these treatments, which include powerful hormone drugs and surgery. Yet the college focused not on the harm that might be done by the treatments but on the “further harm” that an inquiry supposedly would do to suicide-prone trans kids. The source of this harm, according to the college, is media and public interest. In a debate that ought to turn on evidence, the college failed to back up this claim, which clearly was targeted at the activist caricature of The Australian’s coverage. This was a worrying sign in a fraught issue marked by years of mostly uncritical pro-trans media coverage and often opaque policymaking involving lobby groups.

For seven months, in the face of questions from this newspaper, Mr Hunt had kept silent on the call for a broad parliamentary inquiry from a petition of 200-plus doctors. Then, 10 days ago, The Age quoted him saying he opposed an inquiry and repeating the college’s “further harm” warning. His stance on this important question of public policy remains unclear, despite our requests for clarification.

The precise nature of an inquiry is open to debate but what’s vital is rigorous scrutiny of evidence with respect for all involved and no more smearing of informed critics as bigots. The Royal Children’s Hospital in Melbourne, home to Australia’s biggest gender clinic, claims our coverage is “inflammatory”. The articles are available for anyone who wants to test that claim, but where are RCH’s answers to multiple questions about medical ethics and evidence? The hospital pleads a “dignified silence” but does not disclose it refused requests for interviews with clinicians and detailed data before this newspaper published its first report last August. Every gender clinic in Australia knew that sooner or later local media would pick up the global medical debate raging overseas.