Unequal verdicts
Dismissal for a psychiatrist who warned of gender medicine's safety risks, but exoneration for a judicially-rebuked gender clinician
Australian psychiatrist Jillian Spencer, who went public with concerns about paediatric medical transition, has been sent a termination notice by her hospital, while a complaint against the country’s most influential gender clinician, Michelle Telfer, has been dismissed.
Dr Spencer, suspended from clinical duties in 2023 after raising concerns about patient safety, has been given notice of termination, the Courier Mail newspaper reports.
The 14-day notice of dismissal comes two and a half months before the reporting deadline for an independent review of puberty blockers and cross-sex hormones in her home state of Queensland.
“Why haven’t they waited for that [report]?” Dr Spencer asked.
A leading advocate for an inquiry into the gender medicalisation of minors, Dr Spencer was a senior clinician with an unblemished record at the Queensland Children’s Hospital, which is home to a large gender clinic.1 She said her attempts to raise concerns internally had come to nothing.
“The 59-page termination letter lists occasions where she allegedly broke the code of conduct by speaking on Sky News and at public meetings,” the Courier Mail reported on September 12.
New hormonal treatment at the Queensland gender clinic has been paused, pending the findings of the review headed by psychiatrist Professor Ruth Vine, who is due to report by November 30.
The review was commissioned by Queensland Health, the government agency that presides over the gender clinic and employs Dr Spencer.
“Is the hospital trying to silence me, get rid of me in advance of any external scrutiny?” Dr Spencer said. “Don’t we want doctors to speak up when there is harm to children?”
Video: Dr Spencer says the silence of worried health practitioners creates a false impression of widespread support for the gender-affirming treatment model
Up to standard
Meanwhile, a complaint against the clinician who pioneered the contentious gender-affirming treatment approach in Australia has been dismissed.
Dr Michelle Telfer, chief of medicine at the Royal Children’s Hospital (RCH) Melbourne, was found to be ‘‘meeting accepted standards of practice’’ by the Australian Health Practitioner Regulation Agency (AHPRA).
Dr Telfer, the former director of RCH Melbourne’s influential gender clinic, was first author of the 2018 RCH treatment guidelines which spread the gender-affirming approach nationally.
On September 12, AHPRA told the complainant, Burchell Wilson, it would take no further action.
Heavy criticism of Dr Telfer in a Family Court ruling led Mr Wilson, a concerned citizen with no personal stake in the matter, to lodge a complaint against her with AHPRA, alleging ‘‘breaches of professional standards, potential professional misconduct, and failure to provide sufficient informed consent to patients.’’
Mr Wilson told GCN that, in his opinion, the dismissal of the complaint “cements the case for legislative reform” of paediatric gender medicine, although he conceded there was “very little political leadership in this country on this issue, despite the pressing need.”
“I have absolutely no confidence in AHPRA following this decision, and it’s not clear to me how it can continue to enjoy the confidence of the wider community,” he said.
“The contrast between the treatment of Michelle Telfer and Jillian Spencer should trouble anyone with a passing interest in clinical governance and regulatory oversight.
“One practitioner authors the very guidelines now under judicial fire, yet sails on untouched by disciplinary sanction; the other raises uncomfortable questions about evidence, consent, and risk—and finds herself suspended, isolated, professionally caught in a state of perpetual limbo.2
“This asymmetry reeks not of science but of politics, of institutions circling wagons around orthodoxy while punishing informed expert dissent. Public trust in medicine is at stake.”
In his April ruling, Family Court Justice Andrew Strum had faulted Dr Telfer for giving evidence as a “trans rights advocate,” not an objective witness, in a case involving a dispute about whether to prescribe puberty blockers for “Devin,” a 12-year-old gender non-conforming boy.
Justice Strum found that the RCH Melbourne clinic offered no alternative treatment to puberty blockers for gender-distressed minors.
He expressed concern about the “seeming dismissal” by Dr Telfer of “the possible relevance of other factors, such as maternal influence and underlying neurodivergence, playing any part in the child’s presentation [with gender distress].”
He accepted a submission that Dr Telfer had given the court a misleading and selective account of England’s landmark 2024 Cass report, which advises a more cautious approach to gender dysphoria care.
And the judge questioned the advice of the 2018 RCH treatment guideline that even young children with gender distress be “unreservedly affirmed”.
In its September 12 letter advising dismissal of the complaint against Dr Telfer, AHPRA said it was “not our role to critique” Justice Strum’s ruling.
“Our role is to assess concerns raised about a practitioner’s performance, conduct and health and determine whether regulatory action is necessary to protect the public and uphold professional standards,” the agency said.
It said that Dr Telfer’s response to the complaint had outlined her—
“approach to assessing gender incongruence;
“approach to providing informed consent for puberty blockers;
“understanding of her obligations in a court setting;
“and her experience, history of advocacy in the field of trans and gender-diverse children and adolescents.”
After the judicial criticism of Dr Telfer, RCH Melbourne issued a statement in her defence, describing her as “a highly respected paediatrician, expert in adolescent medicine, and fierce advocate for the health and wellbeing of all children and young people.”
GCN does not dispute that gender-affirming clinicians believe their treatment approach helps vulnerable youth
Dr Spencer did not work in the gender clinic itself but came into contact with its patients within the children’s hospital.
Mr Wilson made these comments before news of Dr Spencer’s termination notice.
Wow! If APHRA didn’t have double standards they would have no standards. Dr Spencer raised doubts, Telfer mislead and she gets to keep her job. How can we ever trust the healthcare authorities ever again?
There exists parallels in the application of logic and justice in the recent tragedy in the United States: An individual with wisdom and courage silenced.