'Stop the scandal'

An Australian politician adds his voice to calls for an inquiry into youth gender dysphoria

Photo by ilya mondryk on Unsplash

On November 15 in South Australia’s parliament, Frank Pangallo of the SA-BEST party—a former journalist with experience in investigations—put the case for a select committee inquiry into the care of young people with gender dysphoria.

Video: ‘We must avoid this becoming one of the biggest medical scandals of our time’—speech of Frank Pangallo, MLC

During his speech, Mr Pangallo tabled the following letter from a troubled parent…

I’d like to share with you my experience with the [Women’s and Children’s Hospital] gender clinic here in Adelaide. Between 2019 and 2021, my once very happy and girly daughter had started to become withdrawn and very conscious of her changing body, wearing baggy clothes. Nothing her older sister hadn’t done; seemingly normal pre-pubescent behaviour.

Around March 2021, then 10 years old, she came out as trans—identifying as a boy, wanting to use a boy’s name and pronouns. When I asked why she felt this way, she said it was because she didn’t like the way women are treated. My concern was this wasn’t about gender identity, it was a response to learning what it can mean to be a woman.

I wanted her to see a counsellor. Her mother (my ex) preferred to affirm her gender and get a referral to the gender clinic because her reading told her that that’s how you prevent suicide in an adolescent with gender dysphoria.

We saw a social worker on initial intake at the clinic. I asked for a follow-up appointment for my daughter and a phone call so I could air my perspective without my daughter in the room. The appointment and that call never came.

In the first 45 minute psychiatric interview, six weeks later, I raised the question of motive, of root cause for my daughter’s distress. By now well aware that talking about fear of being a woman wouldn’t get her what she wanted, my daughter played it down, emphasising her dysphoria. Eventually she did say she didn’t like the way women are treated, especially that men rape women.

“Has anything like that ever happened to you?” the psychiatrist asked. “Not really,” my daughter said. Did this mandatory reporter [of suspected child abuse] treat that as a red flag? No, she just suggested my daughter talk to her mum about it and never mentioned it again.

At the second 45 minute appointment, a diagnosis of gender dysphoria was announced and in front of my kid, puberty blockers were recommended. When asked for my consent, I said I had concerns, but was cajoled into the next appointment, trying to avoid increasing my daughter’s distress.

In the gender clinic’s mind we were in a race against the clock—now approaching 12 years of age, puberty was around the corner. That my daughter had flipped from identifying as a boy to being gender fluid to non-binary and was on the third name change was of no concern.

There was no effort to explore family dynamics, developmental history and pre-existing mental health conditions and all that other good stuff in the national guidelines; the clock was ticking.

At the next appointment with a paediatrician, the puberty blocker fact sheet was summarised for us. The only risks to be worried about, apparently, were bone density loss, unknown outcomes for height and a sore arm—and can you please sign here to proceed with the treatment?

When I asked about the other risks on the fact sheet—the hot flushes, tiredness and mood changes, the unknown short and long-term effects on social and cognitive development, I was told there was not enough data.

Why is there not enough data? Because there has never been a controlled study into the use of puberty blockers for the treatment of gender dysphoria; the drug company does not list gender dysphoria as one of the conditions the drug is intended to treat. Its use for this purpose is off-label and therefore experimental.

“I’m reasonably confident to say that no matter where you stand on gender-affirming health care for children and adolescents, that you agree that we need more evidence— our evidence isn’t robust, it isn’t good enough.”—psychiatrist Dr Georgie Swift, a prime mover in setting up the gender clinic at the Women’s and Children’s Hospital in Adelaide, psychiatry conference talk, 14 October 2023

Had enough information been divulged for informed consent? Hell, no. Especially making sure the 11-year old knew what she was agreeing to.

When I asked for a treatment plan, I learned that the [Women’s and Children’s Hospital’s] idea of ongoing mental health support and mine were poles apart.

Once a month psychiatric appointments? No.

Once every two months? No.

Try an “assessment” once every six months; and we recommend patients obtain private counselling.

In short, the gender clinic is delivering treatment for which it isn’t resourced to provide the necessary ongoing support, even though they said they provide ongoing mental health support in a recent statement to a member of the South Australian Legislative Council [Sarah Game of the One Nation party].

“As of 13 September 2022, the Women’s and Children’s Hospital Gender Diversity Service currently prescribes puberty blockers to 68 youth ranging between the ages of 10 and 17. All youth accessing the gender diversity service need to have a formal assessment by a psychiatrist prior to treatment commencement and are reviewed every three to six months while receiving ongoing mental health support.”—advice to South Australia’s Minister for Health and Wellbeing, Chris Picton, relayed by Attorney-General Kyam Maher, 7 March 2023

I was excluded from the next appointment [at the gender clinic]—whether by my daughter’s mother or by the clinic, or both, I will never really know.

By now I had submitted in writing that I did not consent to the treatment. From my understanding of the [Australian Standards of Care and Treatment Guidelines] and any information I could track down on the internet, I thought this would mean court authorisation would be needed for them to proceed. But, no, the issue was escalated to the Women’s and Children’s Hospital Ethics Committee who authorised treatment to proceed without my consent. That’s right—to stop my daughter receiving experimental treatment, I would have to take it to a federal court.

I sought legal advice, and that advice was that I would be wasting my time and tens of thousands of dollars. The Family Court could be expected to request a second opinion and that second opinion would come from the [Royal Children’s Hospital] in Melbourne, our foremost proponents in gender-affirming care.

In the end, it was me who had to sit down with [my] 11-year-old daughter and ensure she understood the risks. I read her the fact sheet line-by-line, took her through the drug company literature, explained what osteoporosis means, explained what it means to not be able to experience an orgasm—to an 11-year old.

I told her again that there is a broad spectrum of femininity, that female puberty is daunting but transformative and that I would fully support her in that journey of self-discovery, but please don’t let them use drugs to interfere with that process.

In the end, the day before the first injection [of puberty blockers], my daughter decided not to proceed. Within days, her sleep and anxiety levels improved, the cutting and talk of suicide stopped.

Today, my daughter identifies as non-binary, goes by a gender-fluid name, her fourth name in two years, uses they/them pronouns. They continue to develop in their own unique way and I will always love them for whoever they are.

But we dodged a bullet; no doubt about it.

In October 2019, the National Association of Practising Psychiatrists wrote to the then federal health minister Mr Greg Hunt requesting a parliamentary inquiry into the treatment of gender dysphoria in Australia. In their words, not mine, the current approach to the treatment of gender dysphoria in children and adolescents under the age of 18 has become a controversial subject within the medical community.

Today, I call on our current federal health minister, the Hon Mark Butler MP, to follow through on that request. Our gender clinics have allowed ideology to overtake their duty of care and the guiding principle to “first, do no harm”, and our children deserve better.

Mr Pangallo also quoted from the new book by the group Parents with Inconvenient Truths about Trans.