Do No Harm

A child-safeguarding case for caution in youth gender dysphoria

Photo by Etienne Girardet on Unsplash

What follows is, in my opinion, a well-articulated and moderate case for restricting further use of puberty blockers and cross-sex hormones with gender-distressed minors.

Cory Bernardi, a minority party member in the Upper House of South Australia’s Parliament, delivered on Wednesday the second reading speech for his Health Practitioner Regulation National Law (South Australia) (Childhood Gender Dysphoria) Amendment Bill.

Mr Bernardi, a representative of the One Nation Party, may not get the numbers for his Bill to pass the Upper House, unless the governing Labor Party allows a conscience vote, which in the recent past it has refused to do on the issue of the gender medicalisation of minors. In the Lower House, Labor has a huge majority.

Even so, Mr Bernardi’s speech deserves a wide readership. August 19 is the earliest date for a second reading debate and a vote on the Bill in the Upper House.

Bernard Lane

Cory Bernardi, 17 June 2026, second reading speech, Health Practitioner Regulation National Law (South Australia) (Childhood Gender Dysphoria) Amendment Bill—

This Bill seeks to place into legislation a prohibition on the prescription and administration of puberty blockers, cross-sex hormones and other prescribed drugs for the primary purpose of treating gender dysphoria in persons under the age of 18 years.

This Bill is about safeguarding children.

It recognises that children experiencing distress regarding their sex and identity deserve counselling and support.

Irreversible or life-altering medical interventions should not be undertaken in circumstances where the evidence base remains uncertain, and the long-term consequences may be profound.

This legislation reflects the precautionary approach recently adopted in Queensland through a Ministerial Direction issued in 2025, which prohibited the prescription of puberty blockers and hormone therapies to new patients under the age of 18 diagnosed with gender dysphoria within the public health system. The difference is that this Bill provides certainty through legislation rather than an administrative direction.

The Bill does not affect treatment already commenced prior to commencement of the Act. Nor does it interfere with the legitimate use of puberty suppression for conditions such as precocious puberty, treatment relating to medically verifiable disorders of sex development, or the use of medications for purposes unrelated to gender dysphoria.

The Bill makes it an offence for a registered health practitioner to prescribe or administer a prescribed drug to, or for, a minor under 18 years for the treatment of gender dysphoria.

The Women’s and Children’s Hospital Gender Diversity Service accepts referrals from across South Australia for children and young people up to the age of 17 years who have concerns regarding their gender identity.

Approximately 160 referrals were reportedly made to the service during 2024.

Despite the significant increase in presentations across Australia over recent years, there remains a troubling lack of publicly available information regarding the number of South Australian children receiving puberty blockers and cross-sex hormones.

Six of Australia’s eight states and territories have refused to release data relating to the number of children prescribed puberty blockers for gender dysphoria.

This lack of transparency would not be tolerated in relation to almost any other emerging area of medical practice involving children.

This Bill is informed by international developments that have occurred over recent years.

Countries once regarded as leaders in what has been termed “gender-affirming care” have fundamentally reassessed their approach.

In the United Kingdom, the independent Cass Review found that the evidence underpinning the use of puberty blockers for gender dysphoria in children was weak and insufficient to justify routine clinical practice. Importantly the review emphasized psychological support over early medical interventions.

Following that review, the National Health Service ended the routine prescription of puberty blockers for children outside formal clinical research settings.

Finland revised its treatment guidelines to prioritise psychosocial support and psychological interventions as the first-line treatment for minors experiencing gender-related distress. This change was prompted by a systematic review of evidence that found inconclusive results regarding the benefits of medical transition for minors.

Sweden similarly restricted the use of puberty blockers and cross-sex hormones to exceptional circumstances, citing concerns regarding uncertain benefits and potentially serious risks. The Swedish National Board of Health and Welfare has updated its guidelines, prioritising psychotherapy and supportive care over medical interventions.

The debate has not been confined to Europe.

Across the United States, numerous states have enacted legislative restrictions on the prescription of puberty blockers and cross-sex hormones to minors.

Queensland has taken its own steps within Australia.

These changes are in line with the fact that the evidence does not support the confidence with which these treatments were once promoted.

Members [of the Upper House] should also consider the developmental stage of the patients involved.

It is well established that adolescence is a period of profound emotional, psychological and neurological development.

Research consistently demonstrates that the human brain continues to mature well into early adulthood, with development of areas associated with judgment, impulse control, future planning and risk assessment continuing into the mid-twenties.

This reality should give Parliament pause before endorsing medical interventions that may permanently alter a young person’s reproductive capacity, sexual function and physical development.

The risks associated with these treatments cannot simply be dismissed.

Evidence points to concerns regarding reduced bone density during critical developmental periods.

Questions remain regarding impacts on cognitive development and psychosocial growth.

There are concerns about cardiovascular risks associated with cross-sex hormones.

Of particular significance is the fact that the overwhelming majority of children prescribed puberty blockers for gender dysphoria proceed to cross-sex hormone treatment and often surgery with irreversible consequences.

International studies have suggested that this figure exceeds 90 per cent.

Children experiencing gender distress frequently present with co-existing mental health challenges.

Many experience anxiety, depression, autism spectrum conditions, trauma histories, social isolation or other psychosocial difficulties.

These young people deserve counselling and evidence-based psychological care.

Questions must be asked regarding the extent to which broader mental health supports are available to children awaiting appointments through South Australia’s Gender Diversity Service.

The Women’s and Children’s Hospital itself acknowledges the existence of significant delays between acceptance of referrals and initial consultation due to high demand.

What counselling services are available during these waiting periods?

What interventions are being offered to address underlying mental health concerns?

Are families being provided with sufficient support and information regarding all available treatment pathways?

These questions warrant answers.

The Parliament should also be concerned by reports that, between July 2023 and July 2024, 22 South Australian children received gender-affirming treatment from a doctor without prior psychiatric assessment.

If accurate, such reports raise serious concerns regarding safeguards and oversight in what remains a contested field of medicine.

The first duty of medicine is to do no harm.

Where the evidence is uncertain, where the long-term consequences are significant, and where the patients involved are children who cannot fully appreciate those consequences, Parliament has both the authority and the responsibility to act.

This Bill establishes clear legal standards, promotes accountability and places the welfare of children above ideology.

Future generations may well ask whether governments exercised appropriate caution at a time when evidence remained limited and uncertainty persisted.

This Parliament has an opportunity to ensure that South Australia takes a careful, measured and child-centred approach.

Members may hold differing views about the broader social and political debates surrounding gender identity.

However, we should all be united in one principle: children deserve the highest standard of evidence before they are exposed to medical interventions with potentially lifelong consequences.

This Bill reflects that principle.