I wonder at the feasibility of influencing and initiating change at the political level?

In Australia the targets would presumably be Albanese and Mark Butler (Minister for Health). Albanese has only ever had one job in his life, as a bank teller for a year and Butler’s only job prior to entering parliament was working with the Unions for fifteen years. Neither of these senior politicians are likely to commit to anything that might upset their electorate.

I believe that change, if it is to come, must evolve at the coal-face, the medical profession. Those directly involved in addressing and treating children as well as the large cohort who merely support ‘affirmation’.

It is clear that this subject is receiving ever more introspection and doubt in the public space. There may well be a tipping point where the ethical considerations take centre stage. If that were to occur the protagonists would be in a vulnerable place:

Dispensing off-label hormonal therapies to children with unknown long-term effects, mutilating, irreversible, sterilising genital surgery, all without any formal studies to confirm efficacy and safety.

The status quo has violated virtually all of the long-established principle in medicine that demands ‘do no harm’.

Medical defence organisations are already beginning to address the inherent risks. Enough pressure and exposure and the specialist medical colleges will flick the switch.

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“ I believe that change, if it is to come, must evolve at the coal-face, the medical profession “ yes Vincent , but how to implement this strategy ( to protect future vulnerable children from medical intervention) via feasible tactics? Intuitively an overwhelming majority of the key clinicians ( child and adolescent psychiatrists, paediatricians, paediatric endocrinologists) providing this medical support have remained silent out of fear of career retribution. If legislators could be made aware of the quiet level of disagreement, they might be persuaded to act appropriately? How might the voice of majority of the profession be obtained? All the key players i.,e., the relevant colleges, AHPRA, appear to have been essentially bluffed by the activists within the profession, who likely are a relatively small , but powerful, subset. So, yes, the “ change” must come from the medical profession, via tactics which convince lay legislators who are the ultimate setters of the goal posts.

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I think that if change comes it will involve pressure on the political system from various points -- litigation, rethink by medical bodies, better media coverage, also from social connections of individual MPs. It's also possible that politicians may lead. Let's say Queensland's next government is the Coalition. By now there are a number of opposition MPs who have a good enough understanding of the problem, thanks to the individuals and groups that have lobbied them & when possible talked to them face-to-face.

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As you intimate Bernard, it will need to be on a State by State basis, Health being a sovereign State responsibility. Queensland LNP parliamentary ranks contain one medical practitioner ( Dr Christian Rowan, my own State opposition member) and Ros Bates, an ex nurse and current opposition Health spokesperson, both of whom are aware of what, let’s say, needs to be done in terms of garnering support for appropriate legislation in the next parliament. However for as long as the ALP hold the Federal benches, the various State ALP governments ( potentially, a clean sweep Nationally if Tasmania joins their ranks soon!) are committed , as under ALP rules, to follow the policy of Obligatory Affirmation treatment protocol for minors with GD , as agreed policy at their 2018 Federal conference, which,I understand, continues to pertain following their more recent Brisbane Federal conference, so , Nationally, the task is ahead

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