Last week in the United Kingdom, a momentous judgement with international implications was handed down by the High Court. The court found in favour of the arguments put forward by the mother of a child with gender dysphoria and Keira Bell, a brave 23-year-old woman who had at 16 been prescribed puberty blockers after three short appointments with the Tavistock youth gender clinic.
The judges in this case observed that prescribing puberty blockers to children with gender dysphoria is an experimental treatment with real uncertainty over the short- and long-term consequences of the treatment and with very limited evidence as to its efficacy. Given the potential lifelong effects on fertility, sexual function, bone density and development of these treatments, as well as a lack of evidence of their full long-term impacts, the court found that children are very unlikely to be able to adequately understand and give informed consent to these experimental treatments.
This judgement has profound implications for Australia, not that you would know it from the muted — in some cases, non-existent — coverage by many Australian media outlets. Let’s look at what’s happening right now in Australia and how out of step it is with what has been found in the UK High Court.
Last month Bernard Lane, in The Australian, reported on the Family Court removing an Australian child from its parents because they wanted psychologists to consider other possible factors in their child’s gender dysphoria and the potential for other non-invasive treatments. The parents told the Weekend Australian that state authorities had said it was dangerous for their child to come back to their house because they want a thorough assessment by an independent psychologist and they hadn’t consented to testosterone treatment. The parents know their child needs help and support, and they want it to be provided by medical experts in an evidence based way. For this, the child has been taken away from them by the state. The mother told The Australian newspaper that their family and friends were shocked at their story. They just can’t believe it had happened in Australia.
Last week, just as the UK High Court was finalising its findings that puberty blockers are an experimental treatment for which young children are unable to give informed consent, the Victorian government introduced legislation which criminalises discussion of the very same issues highlighted by the court. The Victorian legislation makes any conduct or practice that is not seen as gender affirming potentially illegal. The definition is so broad that it includes conversations and online discussion.
Under this bill, Keira Bell, a woman who has been through the transition process and had a court uphold the legitimacy of her concerns regarding the process, could be charged with a crime if she were to discuss her experience with a young Victorian experiencing gender dysphoria.
If the bill passes, the Victorian human rights commission will be given extraordinary powers to launch investigations into people questioning gender change practices and to “take any action it considers appropriate after conducting an investigation”. They will also offer education to persons and organisations engaged in change or suppression practices — practices which, as the bill makes clear, can include conversations about gender identity theory and the risks of experimental medical treatment on children.
Everyone familiar with how these commissions operate around Australia can foresee how these powers will be used and abused. Another round of guidance will be issued, threatening that it is against the law to question unproven medical practices such as puberty blockers. Investigations will be launched into parents and medical experts who question the single focus on gender-affirming medical interventions. More pressure will be applied to media not to report on any debate that questions medical interventions in children who have nothing medically wrong with their bodies.
If this legislation isn’t Orwellian and dangerous enough on its own, it has been introduced by the Victorian government at the exact time that the states are supposed to be working together to develop a service model for safe and appropriate care and treatment of children and adolescents with gender dysphoria.
How can the Victorian government play a central role in developing an evidence based model of care whilst simultaneously introducing a law criminalising any treatment that is not gender affirming? How can they take this position when the UK High Court has just handed down findings that puberty blockers are an experimental treatment for which children are unable to give informed consent? The same questions, frankly, have to be asked of the Queensland and ACT governments, who have also forced through similar laws in the past year.
In Australia, just as in the UK, the number of children and adolescents being treated for gender dysphoria with gender-affirming medical interventions has skyrocketed in recent years. Patient numbers at the Tavistock clinic in the UK rose from 97 in 2009 to 2,519 in 2018. We know from FOI data that referrals to Victoria’s Royal Children’s Hospital gender clinic rose by more than 1,700 per cent between 2012 and 2019. We have no idea what the national figures are, because states do not release the data on how many children have been given puberty blockers, hormone treatment and surgery. In fact, we don’t even know if this data is kept. If states do have this data, then they need to release it publicly now so that we can get a full picture of what’s happening.
The UK High Court in their judgement expressed extreme surprise the Tavistock clinic was not able to produce data on the treatment provided to their own patients, including the proportion of those on puberty blockers who move on to receive cross-sex hormones. Surely state governments have an obligation to find out if their own clinics are operating with the same absence of data.
We all want the best possible care for all children and adolescents who are suffering from any form of emotional distress. This care must be based on the most thorough evidence based approach so that mistakes aren’t made which have longer term consequences for these young people, consequences which Keira Bell and so many detransitioners have bravely detailed on the public record at great personal cost.
It’s clear from the Keira Bell judgement that there are many valid concerns about medical interventions on children experiencing gender dysphoria, yet for many years people raising those exact concerns, both here in Australia and around the world, have been labelled as hateful and transphobic and been accused of pushing children towards self-harm, just as those with legitimate evidence based concerns about women’s sport and women’s services have been defamed as transphobic and ignored by the mainstream media.
Thanks to the bravery of Keira Bell and the efforts of her supporters, the world can now see that silencing and pushing aside these concerns does not guarantee better outcomes for children who need care, support and the best possible medical assistance. This must be a turning point for Australia, away from silencing and slurs and towards proper evidence based outcomes and proper public discussion.
Republished from the Parliament of Australia’s Hansard.