Rights of the Child

Other countries have undertaken investigations into the evidence base for gender “affirmation” treatments including use of puberty blockers, hormonal treatments and gender surgery. They have discontinued such treatments for minors because the evidence that it is effective care is so poor.

Instead, countries including Sweden and Finland, along with the NHS in the UK, have moved to a less radical approach to the treatment of children and adolescents experiencing a disconnect between their natal sex and their “gender”.

Rather than utilising a medical pathway deemed “experimental” because of the paucity of information on the short- and long-term effects of these treatments, these countries have adopted the more cautious “watch and wait” approach. In these countries appropriate mental health support is provided to guide and support children and adolescents seeking treatment for gender dysphoria.

Research shows the vast majority of children and adolescents who experience gender dysphoria find it resolves post-puberty, when most realise they are gay, lesbian, bisexual or heterosexual rather than trans.

With this more cautious approach children and adolescents are protected from the unnecessary medicalisation of a condition that most grow out of. With “watchful waiting” therapies, any unknown and irreversible side effects of “gender affirmation” treatments, along with transition regret, are avoided.

Despite the lack of evidence in support of “gender affirmation”, Victoria has introduced legislation that provides heavy penalties for parties including parents, schools and medical and health professionals who fail to support “gender affirmation” treatments.

We call on the Australian government to meet its obligations under Article 3 of the Convention of the Rights of the Child by immediately introducing a ban on gender affirmation treatments for minors to ensure the best interests of children are protected.

In making this call, we note the research that indicates significant numbers of children and adolescents presenting as gender dysphoric are girls on the autism spectrum, or are gay or lesbian, or present with a history of trauma or other mental health conditions or a combination of several of these. Mental health issues are not always satisfactorily addressed prior to puberty blockers, hormonal treatments or surgery being prescribed.

We further note that many trans-identified people report experiencing difficulty forming and maintaining relationships, including intimate relationships. A top gender surgeon in the USA, Marci Bowers (a trans woman) has acknowledged that children who undergo surgical treatments prior to puberty are unlikely to ever experience orgasm.

Some effects of the use of puberty blockers and hormonal treatments are already known (and are warned about on the websites of companies that produce them). However the full impacts of gender affirmation treatments on brain and physical development, health and longevity on children and adolescents are not known due to poor monitoring, poor data collection and very limited longitudinal studies having been undertaken.

Research shows that many children and adolescents presenting for treatment for gender dysphoria also experience poor mental health. It is already questionable as to what age a child or adolescent can give “informed consent”. It is questionable whether anyone can give “informed consent” when treatments are deemed “experimental” because of the absence of research into side effects and long-term health. But when a patient is experiencing untreated mental health issues it is even less likely they will be capable of exercising the judgement required to provide genuine consent or to understand the potential ramifications of a medicalised “gender affirmation” pathway, even if these risks are outlined by a treating professional.

For example, governments have been slow to ensure that misinformation in relation to gender affirmation practices provided to the public through the social media and mainstream media, including the ABC, (Australia’s public broadcaster) is challenged.

The impact of this is that the medicalised treatment of gender dysphoria is viewed as “safe”, “life-saving” and “reversible”, by many Australians, despite other countries acting to suspend such treatment because the evidence does not support these claims.

Laws enforcing Gender Affirmation have been introduced, with provisions that run counter to Article 18. Article 18 states that parents “have the primary responsibility for the upbringing and development of the child” yet this right can be removed by the State if a parent objects to a medicalised pathway for the treatment of their child’s gender dysphoria.

Article 29 states that education should be directed to: “The development of the child's personality, talents and mental and physical abilities to their fullest potential”.

Yet programs such as “Safe Schools” in Victoria promote unscientific teachings that lead children to believe that they can be “born in the wrong body”, that sex exists “on a spectrum” and in effect, that gender affirmation treatments including medications and surgery are necessary in order for many children to live their “authentic lives”.

Article 29 also says that education should be directed to “The development of respect for the child's parents, his or her own cultural identity, language and values, for the national values of the country in which the child is living, the country from which he or she may originate, and for civilizations different from his or her own”.

The current approach to “gender affirmation” creates situations where many Australians are expected to accept practices that they consider contrary to their own beliefs and values, and the safety, dignity and privacy of their children and themselves.

In many cases, gender affirmation means girls cannot participate fully in activities like school camps, Girl Guides, swimming and other sports. Potential exposure to male bodies in sleeping facilities and change rooms creates a risk that girls and their parents are not prepared to accept; the prosect of fair sporting competition is significantly reduced or eliminated should a biological male identify as female and chose to compete in girls sporting competitions; safety, privacy and dignity are compromised in “gender neutral” toilet facilities, for example.

The alternative is acceptance that unfair/unsafe practices must be tolerated, or withdrawal of participation. Either way, the aim of Article 29 that “The development of the child's personality, talents and mental and physical abilities to their fullest potential” is affected.

Article 33 “States Parties shall take all appropriate measures, including legislative, administrative, social and educational measures, to protect children from the illicit use of narcotic drugs and psychotropic substances”.

While puberty blockers and opposite sex hormones are not necessarily “psychotropic substances”, the intention of article 33 is to restrict the use of substances known to have potential to cause harms. 

Puberty blockers are used off-label for treatment of gender dysphoria – they are not tested or approved for use to delay puberty in children.  Many of the risks are unknown, due to poor monitoring and inadequate short- and long-term studies. Efficacy of such treatments is questionable.  

Opposite sex hormones are life-long medications, and like puberty blockers, there is no research that shows the short- and long-term impacts on the health of people who commence these treatments in childhood or adolescence. 

Until there is evidence that clearly demonstrates the benefits of these treatments available, Australia should place them under the same restrictions as the UK’s NHS, Finland and Sweden