Memory holes and insider rules

One threat to parents is withdrawn, but it looks like business as usual for Australia's puberty blocker dispensaries

Photo by sarandy westfall on Unsplash

The human rights commission in Australia’s state of Victoria has quietly disappeared its public claim that a parent refusing to support a child’s request for puberty blocker drugs is breaking the law.

Until recently, the website of the Victorian Equal Opportunity & Human Rights Commission stated that such a refusal would be illegal under the state’s draconian Change or Suppression (Conversion) Practices Prohibition Act 2021.

Asked about the unannounced removal of the claim, the commission’s spokesman said it was done as part of a review of website material about how the 2021 Act applied to parents and children.

The list of “illegal practices” still includes other examples involving parents and children. The spokesman did not answer GCN’s question whether the commission stood by its claim about the legal peril of parental opposition to puberty blockers.

In June 2022, emeritus professor of law Patrick Parkinson stated his opinion that the commission’s claim was “extraordinary” and legally incorrect.

A mother from Victoria, who spoke to GCN at the time, said she believed the commission was “attempting to force parents to permanently sterilise their children and damage their sexual function before they reach a level of maturity sufficient to understand what is being done to them.”

The commission is given a central role in enforcing the Act—which includes a maximum 10-year prison sentence for criminal offences prosecuted by police—and is also tasked with educating the public about this legislation. The commission is empowered to investigate illegal practices under the civil scheme of the Act.

With no compelling evidence, LGBTQ lobbies internationally are claiming an urgent need for laws prohibiting practices deemed to be attempts to change the nebulous concept of someone’s “gender identity.” (The same lobbies have campaigned for laws allowing gender identity in official records to be changed once a year.)

The concern is that punitive exercises of state power against “conversion therapy” will have the effect of entrenching medicalised gender change for minors, and depriving confused young people of the help of ethical psychotherapists, who will decide to avoid such clients in fear that their exploratory interventions may be misrepresented.

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Screenshot: What the commission used to say (captured by the sharp eye of Twitter account MS Catty)

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Video: What is the real conversion therapy? A large proportion of the minors in the original Dutch research on puberty blockers and also at the London-based Tavistock gender clinic were same-sex attracted or bisexual

Tectonic shifts

Earlier this month, England’s National Health Service (NHS) announced an end to routine prescription of experimental puberty blockers for gender-distressed minors, while leaked files from the World Professional Association for Transgender Health (WPATH) showed clinicians in doubt about the capacity of children to give informed consent to treatments likely to damage future fertility.

Last year, Victorian independent politician Moira Deeming wrote an article for the UK Telegraph warning the British government against adopting an activist-driven ban on “conversion therapy” similar to her state’s law.

Mrs Deeming, who has called for a moratorium on medicalised gender change for minors in her state followed by an independent inquiry, urged the UK’s ruling Conservative Party not to enact a law that would frustrate and punish “the instinct of loving parents and ethical clinicians to divert gender distressed young people away from irreversible interventions like puberty blockers, cross-sex hormones and surgeries.”

Also last year, UK Equalities Minister Kemi Badenoch said she believed the hormonal and surgical interventions of “gender-affirming care” were in fact conversion practices.

“Girls like [former Tavistock patient and detransitioner] Keira Bell who were rushed on to puberty blockers by the NHS, and had a double mastectomy, now regret the irreversible damage done to them. I believe this is a new form of conversion therapy,” Ms Badenoch told MPs.

Not all minds inquire

In the Australian state of Tasmania, which goes to the polls on Saturday, 16 candidates so far have agreed to support a call for urgent parliamentary inquiries into the island’s gender-affirming clinic for minors, and into laws enabling self-declared change of sex markers in official documents and male intrusion into female spaces, according to the group Women Speak Tasmania (WST).

“Children are unable to consent to life-changing [gender] treatment, and yet this treatment is being practised in Tasmania with no evaluation,” WST said.

But Equality Tasmania, a former gay and lesbian lobby now campaigning for queer and trans rights, has mobilised against the very idea of an inquiry.

Under the banner of “LGBTIQA+ equality and inclusion”, the lobby has interrogated political parties and candidates about their policy positions, and put the question, “Will you oppose an inquiry into health care for young trans and gender diverse people?”

Equality Tasmania claims that there are “strict medical guidelines for such [gender medical] care in Australia, which are constantly under review”; that peer-reviewed research shows the benefit of gender-affirming care; and that an inquiry may “become a platform for hatred and misinformation.”

The two major parties in Saturday’s state election—the centre-right Liberals and centre-left Labor—as well as the Greens have pledged to oppose the inquiry sought by WST.

However, the Shooters, Fishers & Farmers (SSF) Party of Tasmania, has backed the inquiry.

“What’s happened to kids being kids? We’ve become a society that’s kind of pushing ideologies onto children and not giving them the chance to actually have a childhood,” SSF candidate Phillip Bigg told GCN.

“And then of course, there’s the whole thing with the puberty blockers.”

He contrasted the early access to blockers for children with the Tasmanian government’s promise to raise the age of criminal responsibility from 10 to 14.

“Yet, it seems OK that a child can determine that they want to be a boy or a girl, or whatever, at the age of nine—it’s absolute lunacy.”

Mr Bigg dismissed as “insane” the suggestion by Equality Tasmania that a gender clinic inquiry could become a vehicle for “hatred.”

He said WST had made it clear that they proposed an “inclusive” inquiry in which everyone was to have a voice.

“It’s about bringing everyone together and having a clear, concise conversation about the implications of what’s going on,” he said.

No public access

Yesterday in Australia’s most populous state of New South Wales (NSW), a proposal to hold a public inquiry into a draft law to ban “conversion therapy” was defeated.

Parliament’s Selection of Bills committee had recommended that the Conversion Practices Ban Bill 2024 be referred for an inquiry, but this was voted down 21-20 by members of the ruling Labor Party, the Greens and the Legalise Cannabis Party.

“The Bill was made behind closed doors with selective input,” said the Libertarian Party’s John Ruddick, who argued for a proper inquiry. He had expected the Bill to be sent to the Law and Justice Committee for a two-month public inquiry.

He said most citizens of NSW would have concerns about the Bill—if they were made aware of its existence.

“An inquiry would have invited submissions and witnesses and be live-streamed,” Mr Ruddick told GCN. “It would have generated public interest, but that is the last thing the [Labor] government wants. It’s all a disgrace.”

He said such “anti-conversion” laws, which assume medicalised gender change to be safe and effective, were “contrary to the international trend” exposing the lack of evidence for youth gender clinic treatments, and would probably have to be repealed within a decade.

In parliament on March 13, Attorney-General Michael Daley sought to justify the lack of open public consultation by arguing that the “targeted, confidential” soundings taken by the government enabled “frank discussion and contributions from stakeholders.”

A notorious 2019 report on trans activist lobbying, sponsored by the law firm Dentons, outlines a strategy to de-medicalise campaigns; get ahead of the government agenda and the media story; use human rights as a campaign point; tie policy demands to more popular reform (such as gay rights); avoid excessive media coverage and exposure; and be wary of compromise

Like other “anti-conversion” legislation, the NSW Bill stipulates that it is not an illegal conversion practice if a health practitioner is helping someone who is “considering or undergoing a gender transition.”

However, the Bill also provides an exemption if the practitioner is advising someone “about the potential impacts of gender-affirming medical treatment.” Early puberty blocker drugs followed by synthetic cross-sex hormones carry the risk of sterilisation, sexual dysfunction and other side-effects.

Dr Philip Morris, a psychiatrist who has followed the progress of anti-conversion bills, told GCN that in his opinion, the NSW Bill was less extreme than counterpart laws in Victoria and the Australian Capital Territory, and more in line with Queensland’s statute, which was amended to give more leeway to the professional judgement of clinicians.

Even so, Dr Morris saw scope to clarify the NSW exemption for health practitioners, and make it explicit that their therapeutic work would be protected whether or not it was offered in the context of gender-affirming social or medical transition.

“We want the [UK] Government to hold a statutory public inquiry into the extent to which gender identity ideology and queer theory have become prevalent in public services, and the impacts. We believe education, the NHS, and the broader public realm have been cognitively captured, resulting in harm.”—petition, Keith Jordan, deadline 22 May 2024

Missing evidence

On March 12, England’s NHS announced an end to routine use of experimental puberty blockers, opting for non-invasive psychological and social support as the first-line response following an evidence review.

“We have concluded that there is not enough evidence to support the safety or clinical effectiveness of [puberty blockers for gender dysphoria] to make the treatment routinely available at this time,” the NHS said.

In leaked documents published on March 5, members of the hybrid professional-activist group WPATH—cited as experts by Australia’s children’s hospital gender clinics—acknowledged that minors seeking treatment might be too young to understand the implications for future fertility or sexuality.

‘It’s always a good theory that you talk about fertility preservation with a 14-year-old, but I know I’m talking to a blank wall,’ one Canadian endocrinologist and WPATH member had said.

Meanwhile, in response to the NHS decision, the NSW Government said it would “continue to monitor developments in evidence to ensure the care we provide remains consistent with national and international best practice,” according to a news report in The Newcastle Herald.

The regional city of Newcastle is home to the rapidly expanding Maple Leaf House gender-affirming clinic, which had 95 minors on puberty blockers in September 2022. NSW Health, the government department responsible for the public clinic, has claimed it cannot provide data broken down by birth sex in response to requests under Freedom of Information law.

NSW Health also claims that puberty blockers are “reversible” and has adopted an activist treatment policy in partnership with the lobby group ACON to increase provision of gender-affirming treatment. The former Coalition government commissioned but ignored a 2020 report concluding that the overall rating of the available evidence for medicalised gender change with minors was “low quality.”

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Screenshot: Like Australia’s other clinics for minors, the Queensland gender service invokes the World Professional Association for Transgender Health (WPATH) as a guarantee of the quality of its care

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What kind of review?

Health authorities in the state of Queensland have also felt the need to respond in some way to news of the NHS ban on puberty blockers, which are still available as routine treatment in Australia’s children’s hospitals.

A spokeswoman for Queensland Health, which is responsible for the public gender clinic at a children’s hospital in Brisbane, pleaded an ongoing review of that clinic as preventing any comment on the NHS decision or on the possibility of any local restriction on puberty blockers, according to a news report in The Sunday Mail on March 17.

The newspaper reported that 172 minors at the clinic had been prescribed puberty blockers in 2023.

The government spokeswoman said—

“We look forward to receiving [by April 2024] the final report and recommendations of the current [review] which is examining the latest international evidence base to ensure we continue to deliver the best health and wellbeing outcomes for the children and young people we serve.”

That account of the review is at odds with official documents, sighted by GCN, which state that—

“The external evaluation will examine the [gender clinic’s] current model of service delivery against the Australian Standards of Care and Treatment Guidelines for trans and gender-diverse children and adolescents (Version 1.4). The evaluation will also consider international practice relevant to Queensland services [Emphasis added].”

The gender-affirming treatment guidelines apparently being used as the benchmark for the Queensland clinic were issued in 2018 by the Royal Children’s Hospital (RCH) Melbourne.

Whistleblower psychiatrist Dr Jillian Spencer told GCN last December that the RCH guideline was part of the problem.

“When clinics are guided by the ‘Australian standards’, parents don’t have a chance of getting what they want—comprehensive care for their child which won’t set their child up for lifelong problems like infertility, lack of sexual function, the dangers of surgery, complex physical health problems and a lifetime of medication reliance,” Dr Spencer said.

The current, updated Version 1.4 of the RCH guideline takes no account of systematic reviews of the evidence base undertaken independently since 2019 in Finland, Sweden and England; each review found the available evidence to be weak and uncertain.

The RCH guideline claims that “puberty suppression medication is reversible” and afford teenagers “time to develop emotionally and cognitively prior to making decisions on gender-affirming hormone use which [has] some irreversible effects.”

In fact, the claim of reversibility is undermined by the unknown effects of puberty blockers on the still developing adolescent brain—an unknown acknowledged by the RCH gender clinic in a 2022 newsletter sent to patients and their families.

The RCH guideline says that psychosis or depression in a teenager “should not necessarily prevent medical transition”.

No studies after 2018 are cited in the guideline’s list of 70 references. The document falls short of the standards required for a “trustworthy” guideline, according to a pioneer of the evidence-based movement in medicine, Professor Gordon Guyatt.

GCN sought comment from the NSW Attorney General, the Queensland Health Minister and Queensland Health. RCH has ignored many questions about its treatment guideline