Trans therapy law ‘may harm child patients’

Treatment that could sterilise kids may be entrenched if Qld criminalises ‘conversion therapy’.

Health Minister Steven Miles says the government was proud to lead the fight against ‘gay conversion therapy’ by health providers, rejecting ‘the notion that LGBTIQ people are broken or sick’. Picture: Steve Pohlner

Unproven hormone treatment that potentially sterilises children “born in the wrong body” may be entrenched if Queensland becomes the first state to criminalise so-called anti-transgender “conversion therapy.”

This is the warning from health practitioners who say the threat of 18 months in prison will scare away the cautious therapists needed to unravel the reasons for a puzzling post-2000 epidemic in teenagers, mostly girls, wanting to change gender.

Conversion therapy normally refers to attempts, sometimes coercive and using electric shocks, to change the fixed sexual orientation of adults, mostly associated with the US decades ago.

In line with global trans activist tactics, the Queensland bill expands the definition to include changing the still-developing “gender identity” of under-18s but gives a green light to the gender shift of “transition”.

Health Minister Steven Miles said the government was proud to lead the fight against “gay conversion therapy”, rejecting “the notion that LGBTIQ people are broken or sick”.

The ban is expected to apply not only in clinics but also in schools and religious settings — anywhere a health service is offered, even if no fee is charged.

“There is overwhelming evidence that conversion therapy is harmful and that it correlates with high rates of suicide,” the minister said when introducing the mostly uncontroversial, multi-part Health Legislation Amendment Bill in late November.

But an unlikely coalition of doctors, Christians and women’s groups has accused the government of following an activist template that exploits revulsion at past conversion therapy as a cover to freeze out psychotherapists who are worried some of today’s teenage trans declarations mask underlying issues and social pressures.

These gender clinic patients, chiefly girls, often have a range of problems including autism, mental illness, awkward same-sex attraction, child abuse, harassment, bullying and family trauma.

Some clinicians say if those issues are explored and treated, bodily distress may fade away. However, they stress that the recently dominant pro-trans “affirmative” care approach frames this as “conversion therapy”.

Key mainstream bodies appear to have been blindsided by the Palaszczuk government’s attempt to rush the bill through, with consultations staged during the summer holidays.

The deadline for comment was January 6 but the Australian Medical Association Queensland and the Royal Australasian and New Zealand College of Psychiatrists both want the chance to make a submission.

‘No data’

Queensland Law Society president Luke Murphy said the government had no “cogent data” on conversion therapy to justify a new criminal offence, and the bill’s “extremely broad” definition could prohibit legitimate treatment.

The bill’s backers include Queensland’s Human Rights Commission, the Queensland AIDS Council and the Australian Psychological Society, all echoing the government’s reliance on the 2018 Preventing Harm, Promoting Justice report of the La Trobe University sex research centre behind the pro-trans Safe Schools program.

Veteran psychiatrist Cary Breakey, founding director of Queensland’s first inpatient mental health unit for adolescents, said the law in effect could impose the pro-trans “gender affirming” model “as the automatic treatment pathway for all children reporting gender issues”.

In the past, typical cases of feeling “born in the wrong body” involved a small number of pre-school boys and the vast majority grew out of it, following psychotherapy or cautious “watchful waiting”, with many emerging as young gay or bisexual adults.

Asked if those approaches could become crimes, a spokeswoman for the minister said the bill would not “not apply to or change the current way clinicians treat children who are considering gender transition”.

Current practice at the Queensland Children’s Hospital gender service is “affirmative” treatment, including puberty blocker drugs to stop the “distressing” growth of breasts in “trans boys”, and cross-sex hormones to mimic the opposite-sex body.

Some researchers and practitioners, including former gender clinic staff overseas, say the evidence is so weak, the treatment must be regarded as “experimental”, with side-effects including infertility, impaired sexual function and life-long dependence on the medical system.

There are no rigorous studies confirming the superiority of the affirmation model over other kinds of treatment for gender dysphoria, the unsettling conflict between biological sex and an inner feeling of gender identity.

Green light for transition

The Queensland bill includes “counselling” as potentially criminal conversion therapy but exempts the “affirmative” approach that “assists” children thinking about or undergoing gender transition.

University of Queensland law dean Patrick Parkinson, making a personal submission on the bill, said it would be “almost impossible” to draw a line between a counsellor “changing” the inherently changeable identity of young people and ethical, compassionate exploration of the underlying reasons for a mistaken feeling of being “born in the wrong body”.

Explanatory notes for the bill use the word “torture” six times, but at a public briefing last month Queensland Health’s director-general John Wakefield admitted data on conversion therapy in Australia was by its nature “very scant”, although he cited the 2018 La Trobe report as the “most detailed work”.

That report, co-authored by the Human Rights Law Centre, focuses mainly on religious “gay conversion” stories, going back as far as the 1980s, as told by 15 interviewees recruited through social media, newspapers and LGBT networks. Only two of them were transgender, one was non-binary and none was under 18.

The report admits: “Without further research, it remains unclear where and to what extent trans conversion therapy is actually promoted and practised in Australia.”

The affirmative model claims children are “experts” in the “inner truth” of their gender identity and promotes hormone treatment, and sometimes under-18s surgery, such as a double mastectomy. Families say they are offered a simple choice between “life-saving” affirmative care and suicide risk.

There has been a surge in pro-trans publicity online, together with an uptake of “gender diverse” school policies, but affirmative clinicians deny any social contagion. They insist the exploding caseload simply reflects a more welcoming society, although they also blame “transphobia” in the community for the poor mental health of young patients.

The affirmative model faces intensifying global scrutiny from practitioners, young adult “detransitioners” who regret gender change as harmful and misconceived, “gender critical” women’s groups, and some trans adults.

(Watch Stella O’Malley’s documentary Trans Kids: It’s Time to Talk.)

Texan trans man Scott Newgent, who has begun an online petition to stop medical transition of children, said the risks of surgery going wrong were being downplayed.

“I do think there are people who need to transition, but not kids,” he said. “Transition (with hormones) is brutal on the mind, body and soul. I was absolutely flabbergasted (when I found out) that they were doing this to kids.”

Federal Health Minister Greg Hunt is awaiting urgent expert advice on the best way to treat young people with gender dysphoria.

The affirmation model in Australia has been spearheaded by the Royal Children’s Hospital in Melbourne gender clinic, which issued 2018 treatment guidelines promoted as “Australian standards”.

Last September, following critical coverage in this newspaper, the RCH guidelines were quietly disendorsed, pending “further review” of their evidence base, by the RANZCP.

‘Cannot consent’

Last week in the UK, court action began against the NHS Tavistock youth gender clinic, with former staffer Sue Evans and the mother of a troubled, “gender-confused” 15-year-old girl arguing that minors cannot give informed consent to puberty blocker treatment with long-term effects unknown to experts.

In stark contrast to Queensland, legislators in several US states are preparing bills to make it a criminal offence to transition under-18s with hormone treatment or surgery.

On Wednesday, a South Dakota legislative committee will hear evidence in favour of a ban from witnesses including “a progressive feminist, a middle-aged trans man, a young de-transitioner female, a mental health counsellor, and three physicians,” Republican politician Fred Deutsch told The Australian.

He said he had come across “so many horror stories from kids dealing with transition and detransition”.

Many US states already have “conversion therapy” laws, leaving clinicians little choice but to “affirm” a child’s stated “gender identity”, and parents fear being reported to authorities and losing custody of their children if they resist transition.

On Saturday, there was a launch in Scotland of what is believed to be the world’s first LGB organisation willing to openly challenge the self-identified trans project. The LGB Alliance is calling for an open, respectful debate about the clash between trans rights and the risk to the welfare of lesbians, gays, bisexuals, women, and children who don’t fit stereotypical gender roles.

Same-gender attraction

Radical trans ideology redefines homosexuality as sexual attraction between people of the same “gender identity”, meaning men can “identify” as lesbians with a “female penis”. Not all trans people agree with this, and “gender identity” activists include gay men and feminists influenced by academic “queer theory” that sets out to destabilise “normality”.

Bev Jackson, a founder of the LGB Alliance, said the Queensland bill sounded “shocking.”

“This is the (trans activist) script,” she said. “You sneak policy in without public knowledge, you hitch your policy goal to something more popular, like same-sex marriage, you try to limit media coverage and instead do your lobbying behind the scenes ... the public is completely unaware of what’s happening.”

University of Melbourne philosopher Holly Lawson-Smith, a “gender critical” lesbian feminist, said the Queensland bill promoting uncritical affirmation put clinicians in a double bind.

“You might affirm a young ‘trans man’ who turns out to actually be a lesbian. You might affirm a young ‘gay man’ who turns out to actually be trans,” she said.

Queensland Health’s Dr Wakefield cited APS support for the government approach.

The APS, which calls itself Australia’s “premier professional association for psychologists”, said it “strongly opposes any form of mental health practice that seeks to change a person’s sexual orientation or gender identity” and claimed “the research evidence clearly shows that conversion practices are harmful”.

This claim is also made by affirmative advocates overseas, and critics say it is misleading when linked to the unfamiliar, expanded definition of conversion therapy.

“There are no studies of conversion therapy for gender identity,” said the renowned Canadian psychologist and sex researcher James Cantor.

“Studies of conversion therapy have been limited to sexual orientation, and, moreover, to the sexual orientation of adults, not to gender identity and not of children in any case.”

In a 2019 peer-reviewed paper, Dr Cantor cast a critical eye over the recent policy of the American Academy of Pediatrics, which endorses the affirmative treatment model as the only way to help gender-questioning children.

He said the AAP had cited but misrepresented key studies which, contrary to its new policy, had “repeatedly endorsed watchful waiting”.

“The AAP told neither the truth nor the whole truth, committing sins both of commission and of omission, asserting claims easily falsified by anyone caring to do any fact-checking at all.”

The AAP refused to comment.

‘Captured’ institutions

Affirmative model sceptics say it has been embraced by small committees of mainstream medical bodies, with busy practitioner members outside this niche field unaware that the claims of treatment safety and mental health benefits are weak or untested.

Critics say this model is entangled with identity politics, frames “trans” medical intervention as a human right, campaigns against safeguards as “unnecessary gatekeeping”, and pushes for intervention at ever-younger ages.

In a Tasmanian law reform submission last year, the APS gave advice on what rules should apply in the case of doctors seeking to go ahead with “trans” surgery when a patient under 16 gives consent but parents are opposed.

The society argued it might unduly restrict such children’s access to surgery if it required sign-off from two independent medical practitioners (who could also be clinical psychologists).

The stated reason of the APS was a shortage of specialists and a “bottleneck” in youth access to surgery.

Rejecting the idea of mandatory pre-operative counselling for these under-16s, the APS said “affirming” mental health support should be on offer, but “whilst some oversight is required in terms of medical treatment, such oversight should not serve to gatekeep or prevent access to services”.

After controversy about its submission, the APS issued a statement saying that if minors sought surgery without parental approval, they “should have the right to access the opinion and guidance of suitably qualified medical professionals, including psychologists.”