V is for validated

After four hard years, Australian psychiatrist Jillian Spencer has been vindicated in her professional right to criticise the gender affirmation of minors

Photo by Priscilla Du Preez 🇨🇦 on Unsplash

The gist

Child and adolescent psychiatrist Dr Jillian Spencer hopes that the end of disciplinary proceedings against her will encourage other Australian health practitioners to speak up about the harm to children of the gender-affirming treatment model.

Earlier today, her former employer issued a statement acknowledging that Dr Spencer’s concerns about the Brisbane-based Queensland Children’s Gender Service “were grounded in her training and background as an experienced child and adolescent psychiatrist”. (Critics of the gender-affirming model are often assailed as hateful bigots by transgender rights activists and gender clinicians.)

As part of a settlement of her litigation as well as disciplinary action against her, Dr Spencer’s former hospital accepted that her opposition to the medicalised gender-affirming model was part of “legitimate professional and public debate”. The hospital’s statement also recognises “that clinicians play an important role in raising concerns about patient safety and clinical practice”.

Dr Spencer had launched legal actions to fight disciplinary proceedings for “transphobia” and dismissal for criticising the gender-affirming clinic run by the Queensland Children’s Hospital. Her conflict with her employer, as she raised concerns internally at first and then in public forums, dated back to 2022, when she became familiar with the operations of the gender clinic as a senior clinician at the hospital.¹

Today’s statement—which describes Dr Spencer as “a strong advocate for change in Queensland in the model of care for children and adolescents experiencing gender dysphoria”—marks an end to the dispute between her and the hospital.

“All matters between the parties have been resolved by mutual agreement,” the statement says. “All disciplinary proceedings against Dr Spencer have been discontinued. The terms of the resolution are confidential.”

Dr Spencer told GCN: “This whole time [since 2022] there’s been a cloud over my name, and I’ve been constantly accused of wrongdoing through four different ‘show cause’ notices and a termination notice—and [I’m so pleased] to have all of that withdrawn, so now my professional record is clear again.”

“I would love for more health professionals to speak out about the gender-affirming model, but we still have the problem of AHPRA (the Australian Health Practitioner Regulation Agency), which is taking a biased approach because, in my opinion, the gender activists have influenced AHPRA.”

In March this year, another Queensland psychiatrist, Dr Andrew Amos, was in the news after AHPRA ordered him to cease his social media critique of gender affirmation. Since then, Dr Spencer had noticed that “every single child and adolescent psychiatrist that I know—in fact, every psychiatrist I know—has stopped posting on social media. People have become very scared and have stopped contributing publicly to any debate”.

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Speaking out: “I could not hold my head up if I didn’t speak about this”—Dr Spencer was interviewed for Channel Seven’s Spotlight program in 2023.

The detail

Dr Spencer said today’s statement by the Children’s Health Queensland Hospital and Health Service, which is responsible for the gender clinic, set a precedent for other tertiary hospitals across the nation.

The statement says the health service “acknowledges that health practitioners must take a clinical approach to the treatment of gender dysphoria that focuses on the best available research and the child’s best interests rather than directing a child down a pre-determined treatment pathway”.

“Health practitioners must employ a holistic clinical approach that comprehensively assesses all relevant factors—including any co-morbidities or other mental health conditions—and use information gathered from that process to determine the best available mode of treatment and care for the patient.”

In an interview with GCN, Dr Spencer said: “It’s really important that a tertiary hospital within Australia has publicly acknowledged that the affirmation model is not the right model, that the model needs to be changed.”

“We need those other hospitals [outside the state of Queensland] that are harbouring a gender clinic using the affirmation model to be called to account as to why they’re not changing their model,” she said, citing recent Finnish research showing an increase in the need for specialist psychiatric care after young people undergo hormonal or surgical affirmation.

“In [today’s] statement, the hospital is acknowledging that hormonal interventions are ‘serious decisions for children regarding their body and long-term health’.

“We all just know, as human beings, that adolescents can’t understand the long-term implications of infertility and lack of sexual function and physical health problems [from hormonal treatment] and the risk of regret,” she said.

Dr Spencer said affirmative gender clinics did not live up to their public claim that they practise multidisciplinary care following a comprehensive assessment and consideration of a range of potential underlying causes of what is presented by minors as gender distress.

“When you work alongside these clinics, you see exactly how much kids are put on a pre-determined pathway,” she said.

“You see the model of care failing to acknowledge the co-morbidities and mental health problems and family issues and trauma of these children, and instead celebrating these children as being trans and encouraging them along a pathway of changing their body as a strategy to manage their distress.

“The gender clinics do claim that distress in children is related to the stigma and difficulties of being a trans person in a ‘cis-heteronormative’ world. They say that in order to justify delivering this cookie-cutter approach of affirmation, but it’s simply not true.

“Anyone who works with these children can see that these children are very troubled and confused and traumatised. It’s intuitively obvious, and when you’ve had training in child and adolescent psychiatry … it’s barn-door obvious.”

Today’s statement includes a reference to the Queensland government’s moratorium on any new treatment of gender-distressed minors with puberty blockers and cross-sex hormones in the public health sector following an independent review. Queensland is the only Australian state with such a policy. Private prescription of these hormonal drugs is unaffected.

The hospital’s affirmation of traditional mainstream psychiatry contrasts with the sparse and brief public comments on the gender clinic controversy from Queensland’s Liberal National Party Health Minister, Tim Nicholls, who does not appear to have criticised the gender-affirming model. In an understated way, he has pointed to the “paucity of evidence about other long-term risks or benefits of these [hormonal] treatments”.

The minister sent a stronger message in March this year, as he responded to a petition that declared an “urgent need to protect access to gender-affirming healthcare for children and adolescents”.

Mr Nicholls invoked his then UK counterpart, Health Secretary Wes Streeting, who in 2024 placed an indefinite ban on puberty blockers outside a clinical trial.

Mr Nicholls wrote: “I refer the petitioners to a statement to the UK Parliament on 12 December 2024 by Labour’s Secretary of State for Health and Social Care, Wes Streeting MP, who states—

‘[England’s] Cass Review made it clear that there is not enough evidence about the long-term effects of using puberty blockers to treat gender incongruence to know whether they are safe or beneficial.

‘That evidence should have been established before they were ever prescribed for that purpose. It is a scandal that medicine was given to vulnerable young children, without proof that it was safe or effective, or that it had gone through the rigorous safeguards of a clinical trial’.”

On today’s settlement, Mr Nicholls said it was “exclusively concerned with employment disputes between Children’s Health Queensland and Dr Spencer.”

Back in Queensland, the gender clinic continues to treat existing under-18 patients with poorly evidenced hormonal interventions.

The clinic states that its healthcare is “informed by” two low-quality affirmative guidelines, one from the Royal Children’s Hospital Melbourne, the other from the scandal-plagued World Professional Association for Transgender Health.

A 2021 work instruction for the Queensland Children’s Hospital mandated the affirmative policy and cited two court rulings that 15-year-old girls had the capacity to consent to trans mastectomies.

On its website, the Queensland gender clinic says it “is currently reviewing and updating its fact sheets and other resources. While this important work is under way, please email us if you need any information or questions”.

The website still hosts a 2019 podcast titled “My Amazing Body”, in which a female psychiatry registrar explains a child’s distress at the onset of a normal puberty by imagining that she herself was transformed into a male.

“If I was about to be going into puberty and my body started developing into a man, I’d be really distressed because inside I know that I am female, and I know that when I grow up, I’m going to be a woman, and if all of a sudden, I was faced with the prospect of facial hair and other things, I’d be pretty upset.

“So, it’s not unusual for us to get a referral of a young person early in adolescence,” the registrar says.

The podcast comes with a caveat that “Information contained within it should be taken as accurate at the time of recording”.

The website of Children’s Health Queensland includes an article on “Helping trans, non-binary and gender-diverse kids thrive” by child and adolescent psychiatrist Dr Stephen Stathis, who founded the gender clinic.

“Research tells us that with the right support these kids can grow up to be trans adults with similar health, social and educational outcomes as same-aged peers. Gender-affirming specialist care is associated with decreases in psychological distress and improvement in quality of life for trans youth,” Dr Stathis wrote.

The article does not comment on the quality of that research and does not use footnotes, making it difficult to know which studies are cited to support which claims.

The reference list includes 17 studies, but there is no mention of the “gold standard” systematic reviews undertaken since 2020 in jurisdictions such as Finland, Sweden and England. Those reviews have confirmed that the evidence base for hormonal treatment of gender-distressed minors is weak and uncertain.

(GCN is not suggesting any wrongdoing by Dr Stathis; gender clinicians may be confronted with complex cases and very distressed young people.)

In a 2023 talk to a conference, Dr Stathis acknowledged the low-quality nature of the evidence for hormonal treatments, a weakness which he said was the norm for paediatric psychiatry.²

He conceded there were “questions about the reversibility” of puberty blockers, which suppress natural sex hormones. He noted that suppression of sex hormones in sheep affected their cognitive function and he also mentioned data showing cognitive decline in men under hormone suppression for advanced prostate cancer.

He told the psychiatry conference that he was unaware of any evidence—“at this point in time… it might change”—that puberty blockers could harm cognitive development or executive function in children being treated for the distress of gender dysphoria. (There is a lack of robust data on the effects of puberty blockers on today’s gender clinic caseload.)

Although the Stathis article on the website of Children’s Health Queensland is dated 7 May 2026, internet archives suggest it was first published in 2022 or earlier.

An earlier version of the article made a claim that does not seem to be supported by high-quality evidence: “Trans youth have a 20 times increased risk of suicide compared with same-aged peers in Australia and 7 times higher rate of self-harm.”³

The current version of the article says: “Trans youth have substantially elevated risks of suicide attempts and self-harm compared with same-aged peers in Australia.” This claim appears to rely on a low-quality anonymous online survey promoted through social media and other avenues, including “queer departments at universities, trans and LGBTIQ support groups”. Such surveys are considered unlikely to be representative and may overstate suicide risk.

And the current version has also lost a paragraph—

“While gender-diverse children and young people are thankfully seeking help, the referrals are exponentially greater than a decade ago. European gender clinics that have been providing care for 40 years tell us today’s gender clinic youth have no greater rates of mental health distress nor are they less likely to be transgender than the smaller numbers that sought help a decade ago. The good news is that more of these kids are reaching out for support and that specialist gender services are now established.”

Since the mid-to-late 2010s gender clinics around the world have reported the rise of atypical teenage female patients often with complex mental health problems. This has been documented in research, particularly studies using Finland’s comprehensive health registry data.⁴

GCN has sought comment from Children’s Health Queensland, the gender clinic and Dr Stathis. GCN does not dispute that gender-affirming clinicians believe their interventions help vulnerable minors.

1. Dr Spencer did not work within the gender clinic itself, but had dealings with it as a senior psychiatrist at the Queensland Children’s Hospital.

2. Dr Hilary Cass, the distinguished paediatrician who ran England’s 2020-24 inquiry into youth gender dysphoria, has said that the quality of the evidence in this field is “remarkably weak”—even in comparison to paediatric medicine where clinical trials are less likely to occur. In a 2024 interview with The New York Times, she said: “The most important concern for me is just how poor the evidence base is in this area. Some people have questioned, ‘Did we set a higher bar for this group of young people?’ We absolutely didn’t. The real problem is that the evidence is very weak compared to many other areas of pediatric practice.”

3. In 2024, Dr Cass’s final report said it was “well established that children and young people with gender dysphoria are at increased risk of suicide, but suicide risk appears to be comparable to other young people with a similar range of mental health and psychosocial challenges. Some clinicians feel under pressure to support a medical pathway based on widespread reporting that gender-affirming treatment reduces suicide risk. This conclusion was not supported by [a systematic review commissioned during her inquiry]…

“In summary, the evidence does not adequately support the claim that gender-affirming treatment reduces suicide risk.”

4. The Cass report noted an Australian study (Elkadi 2023) reporting that 88.6 per cent of patients at a paediatric gender clinic “received co-morbid mental health diagnoses or displayed other indicators of psychological distress” at initial assessment. The original Dutch protocol for paediatric gender transition sought to exclude patients with severe psychiatric conditions.