Medical misinfo
An Australian inquiry into gender clinics should scrutinise their unreliable treatment guide
Treatment guidelines used by gender clinics in Australian children’s hospitals falsely claim a medical consensus and mislead parents, distressed young people and health professionals in the wider community.
This claim has been put to Australia’s Health Minister Mark Butler by the National Association of Practising Psychiatrists (NAPP), which is calling for an independent federal inquiry, an audit of gender clinic medical records and a centralised registry tracking all minors treated for gender dysphoria.
NAPP president Dr Philip Morris wrote to Mr Butler on August 2, and also sent him a 19-page overview of the gender clinic debate written by Melbourne psychiatrist and researcher Dr Alison Clayton. These two documents went to state and territory health ministers across Australia’s federation on August 12.
This initiative emerged from the NAPP’s July 2 webinar with British paediatrician Dr Hilary Cass on the relevance to Australia of her 2020-24 review of youth dysphoria care.
“While we note that [England’s National Health Service] and the Australian health system are different, the clinical issues regarding gender identity concerns and gender dysphoria in young people are very similar in our two countries,” Dr Morris’s letter to Mr Butler says.
“We consider the general recommendations about the assessment and treatment of youth with gender incongruence and dysphoria by the Cass review are applicable to Australia.”
The national inquiry requested by the NAPP would cover—
“the most appropriate and ethical management of gender dysphoria in young people (age 18 and under) in Australia in the light of the Cass review findings and recommendations
“the number and experiences of detransitioners and the care they require
“and the longitudinal follow-up of young people experiencing gender dysphoria focusing on long-term outcomes”
Video: British detransitioner Ritchie Herron on gender surgery and regret
Untrustworthy guide
In her overview brief for Minister Butler, Dr Clayton says an independent federal inquiry should also scrutinise the “Australian standards of care” treatment guidelines issued in 2018 by the gender clinic at the Royal Children’s Hospital (RCH) Melbourne and used across the country.
“The [RCH] Australian guidelines misrepresent and overstate the evidence base in support of the gender-affirming treatment model,” she says.
“They inaccurately claim clinician consensus, cherry-pick studies that appear to support their favoured model of care, do not reference the findings of systematic reviews (including one done contemporaneously and overlapping in authorship with the Australian guidelines), do not mention possible psychological treatment approaches (such as exploratory psychotherapy) for gender dysphoria, and are out-of-date.”
Dr Clayton, who is affiliated with the Society for Evidence-based Gender Medicine, says those relying on Australia’s treatment guidelines include general clinicians in the community, public sector health policymakers and benchmarking reviewers, young people who identify as transgender or non-binary and their parents.
“This means that, on the lead of Melbourne’s RCH, gender-affirming interventions without robust evidence for the claimed benefits and with more risks than acknowledged are being routinely implemented across Australia,” she says.
“This risks the health and well-being of vulnerable young people and their families. Furthermore parents, young people, and [generalist] clinicians are not being adequately informed of the current state of professional opinion and medical knowledge.”
Dr Clayton observes that the Australian guidelines make no mention of the international scientific debate about paediatric gender medicine, nor do they include any reference to the phenomenon of detransition.
Not Cass-compliant
Dr Clayton challenges the activist claim that Australia’s gender clinics already represent the safer, reformed approach recommended by Dr Cass in her final report released in April.
She notes the UK decision to restrict puberty blockers to clinical trials, whereas these drugs used to interrupt normal puberty remain “a standard treatment option” in Australia.
While Dr Cass discourages “full social transition, especially for prepubertal children, and notes the lack of evidence of benefits”, the Australian treatment guidelines recommend child-led social transition with no minimum age—“I have personally seen this happening for 5-year-olds,” Dr Clayton says.
Most fundamentally, she points out, the Cass report does not endorse the gender-affirming model followed by Australia’s clinics.
Dr Clayton highlights the fact that Australian health professionals who criticise the dogmatic gender-affirming model have been the subject of complaints to the regulator, attempts to shut down their conference presentations and in one case, suspension from a senior hospital role.
“I also know of Australian youth gender clinic clinicians who have raised concerns within their clinic regarding what they consider as unsafe and unethical gender-affirming care being practiced,” she says.
“They report their concerns have been ignored, and they have subsequently left the service.
“All this has a silencing effect on other concerned clinicians and suggests a culture of fear amongst concerned Australian clinicians.”
GCN has sought comment from Mr Butler’s office and RCH Melbourne. GCN does not dispute that gender-affirming clinicians believe their interventions benefit vulnerable youth
Someone will eventually have to write an entire book about the experiences of clinicians who called foul on the child-sterilizing cult.
Our Federal Minister for Health and Aged care, Mark Butler, has been asked establish an independent inquiry into the ‘gender clinic medical records and a centralised registry tracking all minors treated for gender dysphoria’ as proposed by the National Association of Practising Psychiatrists (NAPP).
I am not optimistic that he will comply with such a request given Labor’s ‘stand’ on issues that might upset the electorate.
That aside, it interesting to note that the ‘Parliamentary website which cites ‘Qualifications and occupation before entering Federal Parliament’ references the only job Mr Butler has ever held a was as a Union Official from 1992 to 2007.
His qualifications would mirror those in the ‘chook raffle’ analogy.