It’s time to restore professional practice in gender clinics

It’s time to restore professional practice in gender clinics

As a child psychiatrist, I was both relieved and saddened to read Natasha Robinson’s report in The Weekend Australian (“Plea for answers on trans treatment”, 15-16/7). Relief because you presented a balanced, updated review. And saddened as the unfolding crisis erodes delicate trust between my chosen profession and families who entrust us to make ethically informed decision. Over four decades I have spoken with many families and colleagues, and written clinical and research papers. The last three years my focus shifted to the “gender affirmation” debate, noting the dramatic change in the risk-benefit ratio in treatment. In that context your article noted last week’s RANZCP’s Faculty of Child and Adolescent Psychiatry meeting.

In response, I raise the following concerns: If clinical and research experts in the gender field conclude clinical decision-making competence is influenced more by gaps in knowledge than evidence-based facts, are ethically informed health professionals duty-bound to share this knowledge with families when asked to give “informed consent”? Furthermore, should this lack of evidence-based facts – if shared with families during assessment – be in writing? If not, why not?

As child psychiatrists we have a duty of care to offer effective treatment. The current evidence suggests we have gaps in knowledge so we do not know what is, and what is not, effective in each clinical case. The gender dysphoria/incongruence condition is too complex simply to be “affirmed”. In view of the emerging evidence we can no longer say, “business as usual”. Such critical issues demand urgent updates to professional practice guidelines to restore the broken trust between a new generation of young people, their parents and professionals at specialist gender clinics in Australia and overseas.

Dr George Halasz, Armadale, Vic

Fadden victory

Admittedly a by-election win in a safe, blue-ribbon seat does not indicate a turnaround for the Coalition, but here’s hoping the herculean mountain Scott Morrison left for Peter Dutton to climb is ascendable. As Dutton said in his congratulatory speech to Fadden’s new MP, Cameron Caldwell, our country is going in the wrong direction under Labor. Mapping out an alternative energy policy, Dutton was spot-on to call out the government’s weather-dependent policies that are antithetical to the mission-critical provision of energy security, affordability, reliability and sovereignty.

While on the voice, Dutton has put a trio of commonsense recommendations to Anthony Albanese. One, delay the referendum; two, legislate an advisory body, and; three, pursue constitutional recognition separately. Good on him.

Mandy Macmillan, Singleton, NSW

Perfect verse

I always read Caroline Overington’s column in The Weekend Australian’s Review, and I couldn’t agree with her more this week. I read the poem by Claire Watson, Man at work, and loved it. I even said to my husband to read it, when I don’t usually point something out before he reads that section of the paper. But I couldn’t resist. It was a treat to read and just wonderful words. A perfect celebration of masculinity.

Jennifer Johnson, Melbourne, Vic

Tassie parliament

With the decision of independent Rob Valentine not to recontest his seat – and the possibility of being replaced by Greens member Cassy O’Connor – this once again raises the possibility of losing Tasmania’s present bicameral system of parliament.

Hypothetically, if one party gains a future majority, or if both major party members in the upper house decide to vote for the abolition of the Legislative Council, which does not require a state referendum, Tasmania’s parliament will become a unicameral system. This was advocated by former premier Robin Gray, and which already exists in the past troubled state of Queensland.

Kenneth Gregson, Swansea, Tas

Sub facts

Paul Monk should beat a retreat from commentary on foreign policy given his grasp on the facts is so feeble. He wrote last month that Tony Abbott, in a captain’s call as prime minister, asked Japan to build us “eight nuclear-powered” subs. This must have been a revelation to Abbott who, of course, did no such thing. In 2014 he was exploring purchase of Soryu-class subs powered by diesel-electric systems. None of Japan’s 22 subs is nuclear. Monk says he was conducting briefings for the Submarine Institute on submarine policy. This unforgivable sloppiness might leave clients asking for their fees back. Incidentally, we would have been better off with off-the-shelf Soryu-class subs, and have them patrolling our waters now, as opposed to the 2040s high-risk grandiosity of AUKUS.

Bob Carr, Sydney, NSW