Queensland freezes hormone therapy, launches three-part investigation and review
An immediate statewide freeze on hormone therapy for new patients under 18 has been ordered in Queensland, after it was discovered a 12-year-old was allegedly given puberty blockers without parental consent.
An immediate statewide freeze on hormone therapy for new patients under 18 has been ordered in Queensland after it was discovered a 12-year-old in Cairns was allegedly given puberty blockers without parental consent or appropriate medical guidance.
The extraordinary action was taken after a whistleblower made a complaint to Queensland Health in May 2024, which triggered an internal investigation into the Cairns Sexual Health Service.
It was revealed that 42 patients aged between 12 and 18 were treated outside of best practice guidelines, with 17 prescribed stage one (puberty blockers) or stage two (gender-affirming hormones) therapy.
Health Minister Tim Nicholls on Tuesday announced a three-part investigation and review into the facility and medical gender dysphoria treatments across the state.
In an Australian first, the Queensland government will establish an independent review into the delivery of stage one and stage two hormone therapy for patients under the age of 18 in light of emerging international research into the efficacy of treatments.
“As parents, as communities, as a state, we owe it to children to ensure that care is grounded on solid evidence and that we act in this contested area and this developing area with caution,” Mr Nicholls said
A dual clinical review and health service investigation into the Cairns Sexual Health Service will examine how and why the treatments were delivered to the 42 children, including legal issues regarding the absence of parental approval and governance of the facility. Quality of care will also be assessed, looking at delays in essential blood and bone mineral density tests.
Patients already receiving hormone treatment will be unaffected by the statewide freeze.
Mr Nicholls said a 2024 review by the former Miles government of the state’s gender clinics focused solely on the delivery of gender treatments rather than the efficacy of services being delivered.
Psychiatrist Jillian Spencer, who was suspended by Queensland Health for her outspoken views, said she saw the action as vindication of her stand against the gender-affirming care model.
“I’m absolutely thrilled that, finally, some members of the government have shown courage and are leading the way.” Dr Spencer said.
“It’s so well-known that this needs to change.”
Dr Spencer was stood down following a patient complaint in 2023, and she alleges she was prevented from adopting a gender-neutral approach to patient care.
She said she believed a greater focus needed to be placed on the often complex mental health needs of a patient.
“There’s been a series of systematic reviews of the research literature that shows that both puberty blockers and cross-sex hormones don’t lead to any benefit in mental health for children,” she said.
“Originally, it was sold as reducing suicide risk but it’s become very clear that that’s not the case.
“We know that they have their very serious risks and harms, things like infertility and lack of sexual function and long-term physical health problems, as well as the risk of regret with distress.
“You just can’t hurt all these children in order to try to help this one in 10,000 boy or one in 30,000 girl … it’s just unethical to be hurting all these kids to try and find this one kid who would have wanted it (gender-affirming care) to have occurred.”
The use of hormone treatments for young people reporting gender dysphoria has been put under scrutiny in recent years following a spike in the number of teen patients requesting affirming care.
Britain’s 2024 Cass review, led by paediatrician Hillary Cass, found that the framework of the medical field designed to allow children to change gender had been “built on shaky foundations” and led to British health authorities banning the routine prescription of puberty blockers.
Governments in France, Finland, Norway, Denmark and Sweden have also in recent years tightened regulations around the prescription of hormone therapy to children and adolescents.
Researchers commissioned by the Cass review found that Australia’s guidelines on gender-affirmative medicine lacked rigour and independence and had also failed to screen children for complex issues that might also influence their dysphoria, such as autism spectrum disorder, sexual orientation and body-image issues.
Equality Australia chief executive Anna Brown slammed Queensland’s decision to ban hormone treatments as “catastrophic” for young trans people and their families
“Governments should stay out of these deeply personal decisions and leave it to young people, their parents and the expert doctors treating them,” Ms Brown said.
“This move is at odds with the current evidence base, expert consensus, health services in all other Australian states and territories and the majority of clinical guidelines around the world.”
The clinical review will be completed by April 30.
The health service investigation report to follow on June 30.
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