The pattern in the US seems to be that many tras claim that any age restriction on puberty blockers, wrong sex hormones, surgery etc. is anti-trans and an attack on trans rights. Most of the so-called anti-trans bills are age restrictions. Unfortunately, if the age is reduced to 16, the next step will be to get it lowered to 14, then lower. I hope it doesn't get passed.

Expand full comment

It doesn’t take a great deal of insight to come to the conclusion that the ‘affirmative’ management of gender dysphoria in children (puberty blockers > cross sex hormones > surgical mutilation/sterilisation) is a dreadful idea.

That our major paediatric teaching hospitals are actually implementing and promoting it requires that a higher authority intervene.

I have written to the Coalition shadow Minister for Health, Senator Anne Ruston on a number of occasions suggesting that the Coalition commit to a ‘thorough review’ of the matter but have received no response.

Perhaps others could write her?

Expand full comment

Vincent , we can agree that legally obligatory “ gender affirmative care” deserves challenging. I thought that was we had a statuary regulatory body for. Such bodies are instruments of government and will function under current legislation. The status quo of our State legislation leaves the said body to be operating lawfully in not acting proactively to “ protect the public “ , as sited in its charter, unless there be a “ notification “, as it’s role is basically a reactive one. Rather than wait for a change of government, who might change legislation, if a “ higher authority “ than , say, a body representing professional leadership, say, the RANZCP, continues to sit on their hands, then what is to stop another group of individuals to instigate a “ notification “?

Our regulatory body, AHPRA, should prove an ally to challenge what has been progressively discredited wherever it has gained dominant clinical roles.

Expand full comment

Good points Andrew.

I wouldn't hold my breath on AHPRA doing anything useful.

The 'regulatory bodies' aside, it seems that the Affirmative model of 'gender care' has run its race, from a high point of acclaim in the heady days when RCH physicians were lauded for saving so many young lives by their affirmative interventions it now largely discredited globally. I believe (hope) that the tide will be turning here in Australia.

Expand full comment

I agree Vincent, there was never any likelihood of any spontaneous challenge to have eventuated from AHPRA, given its statuary function being that of a reactive one to complaints .

If a , say ,group of concerned clinicians was prepared to take up a complaint to AHPRA perhaps they might find , in AHPRA, an ally to challenge the status quo?. If such a challenge ( to the appropriateness of legally obligatory “ gender affirmative care” for minors) was to be successful it would make for a powerful case for legislation recalibration. Perhaps a high profile clinician such as Jillian Spencer might join with a number of senior colleagues who share her concern and present those concerns to AHPRA? What is the worst that could happen? The longer the beast is unchallenged, the stronger it has become. Future vulnerable children will require their cause to be championed for anything to change and AHPRA could / should be convinced to become a central player in a tactical response to the status quo on behalf of future children, and clinicians who risk punitive “ anti conversion “ legislation.

Expand full comment

I have come across Benjamin's substack which has some great analysis of the silly disinformation being spread about the Cass report. Unfortunately, when a strongly held view is challenged, some people will attack the new point of view, rather than question their own. The more immature, the more likely they will do this.

Expand full comment