Clash of convictions

A national inquiry into the safety and ethics of transgender medicine will be conducted by the Royal Australasian College of Physicians with the backing of Federal Health Minister Greg Hunt.

At the moment there are no nationally agreed standards, although guidelines issued by Melbourne’s Royal Children’s Hospital gender clinic have been referred to as the “Australian standards”. However, this document, which has been described as the “most progressive” in the world by Victoria’s Minister for Health, has not been approved by the National Health and Medical Research Council.

The RCH model commits doctors to the controversial policy of reducing“mental illness in trans and gender diverse children by affirming and protecting their identity in a world where many judge and hurt them”.

According to an exclusive article in The Australian about the inquiry, “Critics say the 2018 standards encourage risky medical treatment without properly considering safer therapies such as counselling for problems such as depression, anxiety, autism spectrum disorder, bullying and family conflict. The RCH standards overplay evidence for medical treatment and downplay risks, say ‘dissident’ clinicians.”

The opposing sides of the debate over transgender Australian youth differ on fundamental issues.

Michelle Telfer, director of the Royal Children’s Hospital Gender Service in Melbourne, told The Australian that commencing medical intervention as young as 13 or 14 was “not at all controversial within those with expertise because we all know that we have been doing this for years”.

Critics question whether gender dysphoria is really understood.

“Far be it from anybody to say that there are absolutely no people in the world who are genuinely gender dysphoric and who find it impossible to live in their biological sex,” said Dr Dianna Kenny, a psychologist. “What I’m saying is it’s been massively and irresponsibly over-diagnosed … (these children and teens) are going to be irrevocably damaged by the treatment they received.”

And the ethics of irreversible medical treatment have not been settled. “Who gave ethics approval for this treatment (at children’s hospitals) when it lacks any scientific basis and therefore is an experiment?” asks Prof John Whitehall, of Western Sydney University. “We should give the psychiatry and psychology a full run before we start castrating children.”

Michael Cook is editor of BioEdge

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Michael Cook

Michael Cook edits BioEdge, a bioethics newsletter, and MercatorNet, an on-line magazine whose focus is human dignity. He writes from Sydney, Australia.

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