Naming the harm
Identifying the researchers awarded $5 million in taxpayers' money for a gender clinic study could expose them to harm, according to an Australian funding agency
A government agency in Australia has refused to release the names of 46 individuals entrusted with $5 million in public research funds.
The National Health and Medical Research Council (NHMRC), which administers the grant, said that identification could harm these people by linking them to a study involving controversial treatment of minors who identify as transgender or non-binary.
The NHMRC was responding to GCN’s application under Freedom of Information (FOI) law.
The 2024-2028 grant of $4.99m to the Australian Research Consortium for Transgender Youth and Children is supposed to remedy the lack of long-term data on the health outcomes of “gender-affirming care”, and “help to build this evidence base and directly inform future clinical guidelines, policies and practices”, according to an official project summary.
The NHMRC said that while the lead investigator’s identity was already known—he is Dr Ken Pang of the Murdoch Children’s Research Institute and the gender clinic at the Royal Children’s Hospital (RCH) Melbourne—it was against the public interest to name the other people involved.
The NHMRC said that naming everyone would reveal that they “took part in, or were associated with, a grant and research involving the care of transgender and gender-diverse youth and children.”
The agency’s senior official handling the FOI request said the “NHMRC recognises that the care of transgender and gender-diverse youth and children is a sensitive community issue.”1
“Noting these sensitivities, I have concluded that release of documents containing personal information could reasonably be expected to harm the personal and professional interests of individuals involved if personal information is disclosed.”
The only example of personal information specified by the NHMRC was “an individual’s name.”
However, all 47 names have already been published as part of the announcement of the award of the grant by the federal Department of Health and Aged Care, which together with the NHMRC is responsible for grants under the Medical Research Future Fund.2
The fact that the NHMRC has refused to release the names suggests a heightened sensitivity on the part of the agency at a time when the safety of gender-affirming medicalisation of minors is under intensifying scrutiny in Australia.
The 47 researchers and activists on the “chief investigator team” for the $5m study of paediatric medical transition include—
Paediatrician and gender clinician Michelle Telfer of RCH Melbourne (both the subject of heavy criticism by Family Court Justice Andrew Strum in April’s re Devin ruling on puberty blockers)3
Senior staff from other public children’s hospital gender clinics and paediatric gender services across Australia
GP Dr Michelle Dutton of the relatively new Orygen/headspace Trans and Gender-Diverse Health Service, which prescribes cross-sex hormones for minors, including those who previously would have been referred to the RCH gender clinic
Queer theorist and “family diversity” scholar Professor Damien Riggs, who was a key influence in the “affirmation-only” policy adopted by the Australian Psychological Society; a policy in limbo following a review begun in 2022
Trans health researcher and NHMRC fellow Professor Ada Cheung of Melbourne University, who claimed in 2022 that “no data suggests safety in women’s sport is compromised by including trans women [who are male]”
Trans activist Jeremy Wiggins, who occupied a position of influence as a member of the federal government’s LGBTIQA+ advisory group chaired by former Assistant Health Minister Ged Kearney
Dr Ashleigh Lin, another NHMRC fellow, and president of gender medicine lobby the Australian Professional Association for Trans Health (AusPATH), who has attributed a shift to more cautious treatment of gender-distressed minors in Europe to an “anti-child and [anti]-adolescent-affirming lobby”4
AusPATH board member Dr Darren Russell, the former director of the Cairns Sexual Health Service, which is the subject of a clinical review and health service investigation by the government agency Queensland Health, following concerns about hormonal treatment of gender-distressed minors (Dr Russell is not accused of any wrongdoing)
FOI: One of the heavily redacted documents released by the NHMRC
Video: Sky News Australia covers Devin’s puberty blocker case, Justice Strum’s ruling and the RCH Melbourne gender clinic
Who guards the guards?
The $5m consortium study on “improving health outcomes” for trans-identifying minors brings together all four authors of the RCH gender clinic’s contentious 2018 treatment guideline, a de facto national document which the NHMRC has been asked to submit to “a comprehensive review”.
Health Minister Mark Butler also requested in January that the agency develop new national guidelines for treatment of youth gender dysphoria.
In ruling earlier this month that Dr Telfer and the RCH gender clinic could be identified as the targets of his adverse findings, Justice Strum said that, if anything, the “ongoing controversy” about paediatric medical transition strengthened the public interest in ensuring “that all relevant information is available for scrutiny, accountability and informed discourse.”5
In favour of openness, the judge cited evidence in Devin’s case from a consultant psychiatrist, who said: “Given both the lack of evidence and expert consensus regarding gender-affirming treatment, youth gender dysphoria should be viewed as an area of medicine where there is genuine scope for debate about treatment options.”
The NHMRC has also refused to release FOI material relating to the design of the $5m consortium study on “models of care” and the question whether or not the project includes any treatment models alternative to the controversial gender-affirming approach.
The agency claimed the disclosure of such material “could jeopardise the project by giving other researchers a competitive advantage by revealing the current research plan and works-in-progress”. The NHMRC also cited the confidential nature of the grant application process.6
A separate FOI release shows that in December last year Minister Butler’s senior departmental officials briefed him on the $5m study, stating its aim was “to collate the data from over 2,800 young people from gender clinics in Australia. This data can assist to monitor the impact of puberty suppression.”
“[Some] 60 researchers, clinicians and consumers from [the gender clinic consortium] will come together to conduct interdisciplinary research that develops, implements and evaluates the effectiveness and acceptability of different models of physical and mental health care for transgender children and young people,” the officials said.
Nothing on the public record suggests that the $5m consortium study seeks to measure outcomes from gender-affirming puberty blockers and cross-sex hormones against alternative interventions for gender distress, such as exploratory psychotherapy, meaning the research project is unlikely to deliver high-quality data or firm conclusions about what actually helps these children.
It was funded within the Medical Research Future Fund (MRFF) as a “targeted competitive grant” and one not openly competitive, meaning applications were limited “to a small number of potential grantees based on the specialised requirements of the grant activity under consideration”.
Two failed attempts in the UK and the US to replicate the positive results for puberty blockers reported by the Dutch innovators of paediatric transition cited practical and ethical reasons not to use control or comparison groups, and this weakness of design would have cast a shadow of doubt over any conclusions they made.
In both studies, the gender-affirming researchers delayed publication of their discouraging results while routine use of puberty blockers continued in gender clinics.
As “gold-standard” systematic reviews accumulate showing there is no firm basis to claim mental health benefits for puberty blockers or cross-sex hormones, gender clinicians internationally are shifting the emphasis to personal autonomy and bespoke “embodiment goals” as rationales for these medical interventions with minors.7
The NHMRC also declined to release FOI material on the design of the RCH Melbourne gender clinic’s own flagship Trans20 longitudinal study, giving reasons similar to those that the agency invoked in the case of the $5m consortium project.
The $1.56m government grant for Trans20 was awarded under a scheme to “support high-quality clinical trials and cohort studies that address important gaps in knowledge, leading to relevant and implementable findings for the benefit of human health”.
Again, the NHMRC refused to name the researchers involved, apart from lead investigator Dr Pang. Again, all six researchers are already named in a public document, this time on the NHMRC’s own website. Again, Dr Telfer is on the research team.
In a 2019 protocol paper setting out plans for Trans20, Dr Telfer and co-authors acknowledged the “limited empirical data” for the treatment being used as routine by the RCH clinic and said “there is an urgent need for more evidence to ensure optimal medical and psychosocial interventions.”
The proposal was to recruit patients receiving routine gender-affirming treatment at the clinic from 2017 to 2020 for follow-up.
The Trans20 researchers said it was ethically not possible to build in “an untreated control group”—there is no mention of the option of including a group given alternative treatment such as psychotherapy—and they conceded their design “will limit the potential to draw conclusions about the effectiveness of interventions [at the RCH clinic]”.
In an April 2022 progress report to the NHMRC, released under FOI law, the researchers said the aim of the study was “to determine the long-term physical and mental health outcomes” of patients at the clinic.
“Having enrolled over 600 trans and gender-diverse children and adolescents into the study, we have now completed the first wave of data collection,” they said.
“These baseline data are currently being used not only to improve our understanding of the profile of children and adolescents who seek specialist gender-related care (e.g., degree of parental support, degree of social transition, presence of mental health issues, overall quality of life) but also to assess how various factors (different gender identities, presence of autism traits) influence the clinical presentation of these young people.
“Several manuscripts describing this work are either in preparation or currently under review.”
In November 2024, a group of 32 clinicians including one of Australia’s most eminent medical scientists TJ Martin, who is an emeritus professor of Melbourne University, issued an open letter urging RCH and the Murdoch Children’s Research Institute “to publish interim outcome data from their Trans20 research study and make the data available to other researchers”.
“With 4-7 years of data now collected, we believe it’s time for the Royal Children’s Hospital to publish their preliminary outcome findings,” the letter said.
The open letter referenced news in The New York Times that data from a high-profile US study showing no improvement after puberty blockers had been withheld from publication because lead researcher Johanna Olson-Kennedy said she feared the results would be “weaponised” by opponents of gender-affirming care.
In Devin’s Family Court case earlier this year, expert witnesses and Justice Strum also focused on the lack of long-term outcome data for minors given puberty suppression and cross-sex hormones.
The judge noted Dr Telfer’s claim that the RCH gender clinic had “a clinical evaluation program in place, as well as a longitudinal cohort study established by it in 2017, which aims to follow up and assess clinical outcomes for 600 patients and families over a period of 20 years”.8
“However, in cross-examination, [Dr Telfer] conceded that the [Trans20] study is not a clinical trial and that there are significant issues with follow-up into adulthood.”
Justice Strum described as “concerning” the evidence from one medical witness that—
“No children’s gender clinic, including those studying the original Dutch cohort, has produced any long-term data on outcomes of puberty blockade and cross-sex hormone treatments. [The RCH Melbourne] gender clinic has not produced any long-term data on the patients it has treated.”
The judge returned to these concerns earlier this month when upholding an application by The Australian newspaper to identify Dr Telfer and the RCH gender clinic as the targets of his adverse findings in re Devin.
Justice Strum agreed with the newspaper that the public should be told that RCH “does not have a clinical ‘puberty blocker trial’ in place and has significant issues with follow-up into adulthood with participants in its 2017 longitudinal cohort [Trans20] study.”
GCN sought comment from RCH, Professor Cheung and Dr Russell. GCN does not dispute that gender-affirming clinicians believe their interventions help vulnerable youth.
This is a loaded description of the community debate, because it presupposes that the category of “transgender and gender-diverse youth and children” is stable and unproblematic, rather than potentially misleading and requiring open-minded therapeutic exploration for any underlying “non-gender” issues such as mental health problems, autism, awkward same-sex attraction, or family trauma.
The focus of my FOI application was the design and ethics approval of publicly funded research, not the names of those involved, since I was already aware of those names being on the public record.
The application was decided at a high level within the NHMRC by its executive director, research foundations, Dr Julie Glover.
The NHMRC’s refusal to release the researchers’ names suggests sensitivity on the part of the agency, whose 2023-24 annual report shows the influence of gender identity ideology.
The annual report states: “During 2023–24, the Inclusion Network developed and released an LGBTQIA+ Action Plan, which aims to support staff to be their full and authentic selves at work within a strengthened workplace culture that seeks to improve awareness, understanding and acceptance”.
In the report, the agency’s chief executive Professor Steve Wesselingh hails as “fantastic” a decision to count “non-binary researchers” with women in a positive discrimination program for funding Investigator grants.
These ideological markers raise a question about the NHMRC’s neutrality in the gender medicine debate and its openness to the argument that automatic “affirmation” of a child’s declared trans or non-binary identity is unethical because it closes off open-ended exploration of all the possible causes of gender distress, and may lead to unnecessary and harmful medicalisation.
The NHMRC decision not to name names was dated June 3, two days before Justice Strum agreed with an application from The Australian newspaper that it was in the public interest to identify Dr Telfer and RCH Melbourne as the subjects of his criticism. Both had been anonymised in his April ruling, which protected Devin, a 12-year-old gender non-conforming boy, from proposed puberty blocker treatment at RCH.
Professor Lin appears to mean a bias against the gender-affirming treatment approach. She did not respond when asked at the time for evidence of this bias.
A week after the naming of Dr Telfer by Justice Strum, RCH issued a statement in her defence. (She is chief of medicine at the hospital.) The statement said: “Associate Professor Michelle Telfer is a highly respected paediatrician, expert in adolescent medicine, and fierce advocate for the health and wellbeing of all children and young people. Throughout her career, [her] leadership has been instrumental in improving the research and clinical care of all children, in particular trans or gender-diverse children and adolescents and those experiencing gender dysphoria”.
As well, the NHMRC’s FOI response said: “Without the context of additional information and the details contained in wider research, there is a risk that the release of this information about the individuals contained in these documents may lead to misrepresentations and negatively impact the professional standing of the individuals and future research collaborations”.
In its June 18 ruling on the right of American states to ban gender medicalisation of minors, the US Supreme Court noted a recent systematic review, commissioned by the Society for Evidence-based Gender Medicine, which concluded: “There remains considerable uncertainty regarding the effects of puberty blockers in individuals experiencing [gender dysphoria]. Methodologically rigorous prospective studies are needed to understand the effects of this intervention.”
A clinical trial would make explicit to under-age participants and their families that the medical interventions are experimental.
The ethics of using a control group to measure effectiveness is well established, so that statement by the groups reeks of motivated reasoning and obfuscation. Of course pouring attention, love bombing children and offering them a simple answer to complex mental anguish is already a powerful placebo in the short term. We desperately need new treatments funded equivalently.
We're very close to gender researchers just confirming their biases through a myriad of ways (they clearly already have formed a view and will be desperate to confirm it) and then claiming they have reached a higher evidence standard and have settled the matter.
The issue is upstream from medicine and requires strong leadership across institutions and a strong fourth estate. Both have been sorely lacking.
Oh Bernard, this is so very concerning. When FOI officers are so indoctrinated and politicised they’re failing to do their job on previously partially released information - we are in a whole world of pain.
“chief executive Professor Steve Wesselingh hails”… non-binary nonsense in last years annual report this is just awful. Head, wall, bang.
Thankyou for doing this painstaking work Bernard. I hope you can stand appealing to the OAIC or Ombudsman- whomevers next.