Schtum
Australia’s national regulator of health practitioners is refusing to identify which clinical guidelines it uses to detect misinformation and distinguish between truth and falsity in the contested domain of gender medicine.
Doctors have been warned by the Australian Health Practitioner Regulation Agency (Ahpra) and the Medical Board that they may face disciplinary action if their social media posts spread “false or misleading information”. After an Ahpra investigation, the Board can refer doctors to a tribunal with the power to cancel their registration.
In one instance, the Board used its emergency powers to suspend a primary care doctor for his social media use, including one post which the board judged harmful because it was “likely to arouse contempt towards practitioners enabling gender-affirming care”.
The former general practitioner, Jereth Kok, was suspended for seven years before a penalty of 12 months’ further suspension was imposed in October 2026.
In overlooked remarks in the Senate earlier this year, Ahpra’s chief executive Justin Untersteiner said the regulator relied on “existing clinical guidelines” in healthcare, as well as the facts in a given case, when detecting misinformation about gender medicine.
Yet, through its spokesman, the regulator has refused to answer GCN’s request that it name the clinical guidelines alluded to by its own chief executive in a public parliamentary hearing.
At the same time as it imposes secrecy, Mr Untersteiner has complained about “selective media”, a reference to The Australian newspaper’s coverage exposing his organisation’s ties to ACON, a former AIDS council that now functions as a gender medicine lobby.
In minutes from Ahpra’s own workforce diversity project, obtained under Freedom of Information law, it is claimed that if the regulator’s officials “get the standards right, and ensure more identity-affirming care, we won’t receive the complaints in the first place”. This suggests an institutional bias reaching beyond Ahpra’s internal diversity regimen to distort its regulatory function. The shortcomings of gender-affirming care, a form of identity medicine, are central to the public debate over youth gender clinics.
What is truth?
Mr Untersteiner’s reference to reliance on clinical guidelines came in response to One Nation Senator Malcolm Roberts, who had asked him in a June 3 estimates hearing how Ahpra staff “acquire the capacity to know what is true or false information in this highly contested area”.
Senator Roberts also wanted to know what Ahpra would consider “misinformation” in a social media post about paediatric gender medicine.
During the hearing Senator Roberts and Liberal Party Senator Sarah Henderson raised with Mr Untersteiner the case of psychiatrist Dr Andrew Amos, a critic of the gender medicalisation of minors who was ordered by Ahpra to cease social media posting about transgender issues including gender medicine. (The regulator used its emergency powers for this purpose.)
Mr Untersteiner told senators that practitioners had a right to engage in public debate about the gender-affirming treatment model, but the regulator would intervene if this went “beyond a debate about clinical pathways and treatments and moves into a place of hate or discrimination against individuals or groups”.
Senator Roberts asked: “How can a doctor fulfil their ethical obligation to inform the public of potential harms of gender interventions and gender ideology without being accused of discrimination against LGBTIQA+ people?”
“Is it discrimination for a health practitioner to refer to a person’s biological sex?”
The line between legitimate debate and alleged discriminatory targeting of trans people is in practice “not a boundary”, according to Dr Gary Geelhoed, a retired paediatrician who served as Chief Medical Officer of Western Australia and Assistant Director General of Clinical Services and Research for the Western Australian Department of Health.
“Almost any serious criticism of a treatment model [such as gender-affirming care] can be redescribed as targeting the patients who receive it,” Dr Geelhoed said in a recent article for GCN.
“A psychiatrist who questions whether every trans identification is distinguishable from other psychopathology; a paediatrician who says a girl cannot consent to mastectomy; a researcher who cites the Cass Review: each can be cast as making a class of people feel unsafe.
“The test is no longer falsehood, incitement or a refusal to treat. It is the anticipated feeling of a hypothetical patient who has not been seen.”
Following a Freedom of Information request by GCN, Ahpra released a redacted briefing note used to prepare Mr Untersteiner for the June 3 Senate estimates hearing.
That document is headed “Discrimination—LGBTQIA+” and states that the right to free speech is “constrained if a practitioner comments, or supports comments, that can cause harm to groups or individuals … Harm is caused when some members of the community fear seeing a medical practitioner and do not access the healthcare they need.” This presupposes that gender medicine is healthcare.
The redacted briefing note makes no mention of “existing clinical guidelines” used by the regulator to police misinformation by practitioners.
The note does mention the January 2025 announcement by federal Health Minister Mark Butler that the National Health and Medical Research Council would develop new national guidelines for youth dysphoria care.
The note for Mr Untersteiner also cited Mr Butler’s statement that there would be a comprehensive review of the de facto national guidelines promoted as “Australian Standards of Care and Treatment Guidelines for Trans and Gender-Diverse Children and Adolescents”. These guidelines were first issued by the gender clinic of the Royal Children’s Hospital Melbourne in 2018.
This contentious document is the only Australian-authored clinical guideline on paediatric gender medicine available to Ahpra for its regulatory functions.
RCH gender clinician Dr Michelle Telfer is the first author of this gender-affirming guideline, which advises that psychosis in a minor is not necessarily an obstacle to medical transition with powerful hormones.
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Singing the same song
Children’s hospital gender clinics in Australia also cite international gender-affirming guidelines issued by the World Professional Association for Transgender Health (WPATH) and the Endocrine Society. These guidelines recommend puberty blockers and cross-sex hormones.
The WPATH guidelines, a key influence on the RCH Melbourne document, are also contentious. In preparing the current 2022 guidelines, WPATH allegedly suppressed systematic evidence reviews with inconvenient results, and gave into political pressure when abruptly abandoning minimum age thresholds for surgery on minors.
The US Federal Trade Commission has begun court action against WPATH, alleging that “its guidelines provide the means for medical providers to repeat misleading, false, incomplete, or unsubstantiated information when persuading parents to purchase medical transition services for their children”.
In defending the action, WPATH says its guidelines, previously promoted as the “gold standard”, represent mere opinions which cannot be empirically verified and which constitute just “one side” of the debate over paediatric gender care.
In Australia, apart from the WPATH document, the local guideline for adult patients is a fast-track “informed consent” document issued by another gender medicine lobby, the Australian Professional Association for Trans Health.
By contrast, Australia’s National Association of Practising Psychiatrists has declared that the best response to youth gender dysphoria is “a contested area of medical practice”. NAPP’s guide, which is not a fully developed clinical guideline, says the first-line treatment for minors should be psychological, warning that blockers and hormones are “potentially harmful” and rest on “very limited” evidence of benefit.
Ahpra has also refused to tell GCN its policy for handling a complaint against a doctor who is an author of a guideline on which the regulator relies when investigating.
In September last year Ahpra dismissed a complaint against RCH Melbourne’s Dr Telfer, citing her side of the story, including her “approach to providing informed consent for puberty blockers”. The regulator found she was “meeting accepted standards of practice”, but made no reference to any clinical guideline establishing those standards.
The complaint drew on adverse findings against Dr Telfer in a landmark 2025 Family Court case involving a 12-year-old boy, “Devin”, whose parents disagreed about whether their son should be given puberty blockers at RCH.
In court Dr Telfer testified that medical interventions for minors would be carried out in accordance with the RCH guideline. Justice Andrew Strum concluded that a gender non-conforming boy such as Devin would be offered no alternative treatment but puberty blockers and made orders protecting the boy from hormone suppression at RCH.
The judge also criticised the RCH treatment guideline as taking a concerning and “oddly binary” approach to children with its advice “to affirm unreservedly those [minors] who present with concerns regarding their gender, brooking no questioning thereof”.
He suggested the RCH guideline was misleadingly badged as “Australian Standards” when in fact this document had no “approval or imprimatur of the Commonwealth or any State or Territory Government, including any such government Minister for, or Department of, Health”.
He took a cautious view of Dr Telfer’s testimony in which she praised her own guidelines as the “most progressive and trans-affirming guidelines”, suggesting she had a conflict of interest “akin to being the proverbial ‘judge, jury and executioner’.”
As for her claim that the RCH document represented “best practice”, Justice Strum said Dr Telfer had conceded under cross-examination that this endorsement was “essentially tantamount to her agreeing with herself”.
After this judicial criticism of Dr Telfer, RCH issued a statement in her defence, describing her as “a highly respected paediatrician, expert in adolescent medicine, and fierce advocate for the health and wellbeing of all children and young people”.
Whose experts?
In written responses to some of Senator Roberts’s questions from June this year, Ahpra said: “All regulatory decisions are made impartially, based on evidence, public safety, risk and in accordance with the Health Practitioner Regulation National Law … Ahpra obtains clinical input on matters, including independent expert opinion, as appropriate.”
Ahpra refused to tell GCN whether this clinical input includes experts critical of the gender-affirming model.
In a 2025 tribunal ruling, some social media posts by Melbourne GP Jereth Kok were found to have “denigrated, demeaned and slurred” doctors who “recognise that people who identify as transgender are not suffering from a mental health condition”.
Treatment of a mental disorder is an essential element of the Family Court’s jurisdiction to approve the hormonal or surgical interventions for a gender-distressed minor whose parents are in dispute over the issue, according to Emeritus Professor of Law Patrick Parkinson.
In Mr Kok’s case, the Medical Board used its emergency powers to suspend him in 2019.
The tribunal found he had engaged in professional misconduct.
The Board, which makes decisions following an Ahpra investigation, used its emergency powers to suspend Mr Kok seven years ago. In the resulting case, the tribunal agreed with the Board that gender-affirming care involving hormonal treatment and surgery was “accepted medical practice”.
Mr Kok’s offending posts included sharing a meme stating that, “Being one sex but thinking you’re the other is a psychological disorder” and “Mandating a widespread enabling of a psychological disorder is sociopathy”.
The tribunal upheld the Board’s view that the “word sociopathy was a highly emotive and inappropriate term, as it has connotations of mental illness and bad faith. It is likely to arouse contempt towards practitioners enabling gender-affirming care.”
Mr Kok had also reposted, “If you’re 18 and think you’re the opposite sex, you have a mental illness. If you’re 8 and think you’re the opposite sex, your mother has a mental illness.”
And: “Transgenderism is the only mental illness demanding that the rest of society adopt the patient’s delusion as part of the patient’s treatment.”
Suspended as a doctor since 2019, Mr Kok subsequently found a new career, ending his 16-year term as a GP.
None of the complaints against Mr Kok or Dr Amos came from patients.
On 12 October 2026, the tribunal handed down a penalty decision, setting a one-year period before he could apply for reinstatement. The Board had asked for a three-year term.
In the case against Mr Kok, the Medical Board relied partly on expert evidence from endocrinologist Professor Jeffrey Zajac, who is included in a directory of gender-affirming clinicians maintained by the Australian Professional Association for Trans Health.
That directory gives his pronouns as “They/Them”. Professor Zajac told GCN his preferred pronouns were in fact He/Him.
He is a co-author of a 2019 position statement for adults published by the Medical Journal of Australia. This document claims that, “Gender‐affirming hormone therapy is effective and, in the short term, relatively safe with appropriate monitoring.”
Asked if he was capable of giving objective expert evidence in a case such as Mr Kok’s, Professor Zajac told GCN that, “Any evidence I give as an expert witness is as accurate as I can make it and is evidence based whenever possible.”
GCN does not suggest any wrongdoing by Professor Zajac or Dr Telfer, just that there are serious questions about the impartiality of institutions including Ahpra.
It is particularly concerning that Mr Untermeier speaks at Senate Estimates with the tone and content of a political advocate and not a strictly impartial bureaucrat, which is what he is required and employed to be.