Health Minister Mark Butler shows the way in gender treatment guideline review
It’s getting hard to keep track of gender clinic news. The latest is that Australia’s Health Minister, Mark Butler, has decided to seek a new national treatment guideline for the care of young people with gender distress. This is a breakthrough, potentially.
Guidelines are not technical trivia. The guideline that Mr Butler has asked the National Health and Medical Research Council to review is nothing less than the blueprint for activist “gender-affirming” medicine in Australia.
This guideline, issued by the gender clinic at the Royal Children’s Hospital Melbourne and used across the country, promotes the chemical disruption of normal puberty, advises high-dose testosterone drugs for teenage girls, and argues that even minors with psychosis can be good candidates for an irreversible medical transition.
The RCH guideline suggests a double mastectomy at age 16 is routine. The word “detransitioner” does not appear; nor anything from the scientific literature since 2018.
Note that Mr Butler has turned the RCH guideline into a lame-duck document. He did not rest content with subjecting it to NHMRC; he has already decided there must be new national guidelines and these are to be developed by the NHMRC in concert with an expert committee.
It’s worth reflecting on those who have used the RCH guideline as a shield to deflect questions about the safety and evidence for gender medicalisation of minors as young as 10. The culprits include politicians, bureaucrats, medical colleges, regulators, judges – even our human rights commission.
As a Laborite Mr Butler has done away with the progressive excuse that any scrutiny of gender medicine must be opposed as a right-wing culture war. With his federal intervention, might he even enable the national co-operation necessary for a return to evidence-based medicine and the safeguarding of vulnerable young people?
In his statement, Mr Butler acknowledges health is a state responsibility but emphasises the expert national role of the NHMRC and its “statutory responsibility for developing and supporting high-quality guidelines for clinical practice”.
Mr Butler says the new national guideline will be put together using NHMRC standards and the international GRADE system for assessing the quality of evidence claimed to underpin treatment recommendations.
We already know the low-quality RCH guideline could not satisfy this test.
A precondition for the new NHMRC guideline would be a systematic review of the evidence base. And we know the likely result. Since 2019, in jurisdictions as different as Finland, the UK, Florida and Sweden, systematic reviews have found the evidence for hormonal treatment of gender-distressed minors to be very weak and uncertain.
But will the NHMRC process be insulated from the gender ideology that has distorted many of our institutions? If the gender medicine lobby has its way – and it has a voice in government through the LGBTIQA+ health advisory group chaired by Assistant Health Minister Ged Kearney – the expert committee for guideline development will be stacked with gender-affirming dogmatists.
In the UK, pediatrician Hilary Cass was chosen as lead reviewer precisely because she was not a gender clinician who comes with a conflict of interest. Such clinicians were consulted during her review but not allowed to dictate.
The NHMRC was party to a recent statement on sex and gender in research complete with gender studies jargon and a mechanism whereby ideology can be smuggled into science as “lived experience”. The council and other federal agencies also have potential conflicts arising from multimillion-dollar research grants awarded to gender clinicians, including one of the authors of the discredited RCH guideline.
But let’s wait and see what happens. For now, Mr Butler deserves credit for showing some leadership.
Bernard Lane, a former journalist with The Australian, publishes Gender Clinic News.
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