Calls for Australian review of gender services as rigour questioned

A senior psychiatrist says an overhaul is needed to stop a repeat of UK systems, which were found to have failed young people questioning their identities.

Andrew Amos is an academic psychiatrist and has written a paper challenging the evidence base of gender affirmative medicine. Picture: Peter Eve

A senior Australian psychiatrist has called for a complete overhaul of gender services to prevent Australia from replicating the British systems, which were found to have “let down” young people who were questioning their identities.

Andrew Amos, academic at James Cook University, believes the treatment of people under 18 who are reporting gender dysmorphia is not being put under the same scrutiny as other medical practices, putting them at risk of over­treatment and detrimental, long-lasting health outcomes.

“There is no question that in order to have high quality medical services, you need to be doing adequate oversight,” Dr Amos told The Australian.

“We call it clinical evidence and the first step is to record what you’re doing, report what you’re doing, and then review what the results have been.

“None of that’s happening with gender services in Australia.

“A lot of patients are going to be harmed. If the federal government doesn’t implement a review similar to a case review, we’ll continue on this path … it’s absolutely needed.”

The findings of the UK’s four-year-long Cass review into gender services found the entire field of medicine aimed at enabling children to change gender was “built on shaky foundations”.

The number of children under 18, particularly young girls, reporting gender dysmorphia in Australia is rising exponentially, Dr Amos said.

A similar spike in the number of children being referred to Eng­land’s National Health Service for gender treatments sparked the review in 2020.

In response to the interim findings of paediatrician Hilary Cass, which offered an extensive examination of the care being provided to children at London’s Tavistock clinic, the associated Gender Identity and Development Service (Gids) was closed in March after being deemed “inadequate” by inspectors.

England's first gender identity development service for children, run by the Tavistock and Portman NHS Trust, closed last month. Picture: Henry Nicholls / AFP

British health authorities in March announced a ban on the routine prescription of puberty blockers to young teens – a treatment that “pauses” development prior to cross-sex hormones to transition sex.

Associate professor Gemma Sharp, who leads the Body Image and Eating Disorders Research in the Department of Neuroscience at Monash University, endorsed the use of puberty blockers for children on a case-by-case basis, but acknowledged the need for greater rigour to ensure children were achieving appropriate levels of care. “Obviously, we shouldn’t be handing out puberty blockers without absolutely comprehensive assessments but honestly, if we didn’t have gender-affirming care, I think we’d lose a lot of ­people to suicide,” Professor Sharp said.

Associate Professor Gemma Sharp. Picture: Ben Searcy

In response to the British review, Queensland Health Minister Shannon Fentiman has stood by the state’s Gender Services, which she said “continually reviews” care models based off the best available evidence.

“All trans young people deserve access to high quality and timely healthcare, and that is something we are committed to continue providing,” Ms Fentiman.

Dr Amos said activist doctors had hijacked the treatment of children and young people who chose to detransition and revert to their birth gender were being dropped from services.