Who am I? A boy, a girl or somewhere in between? A presentation by the RCH Gender Dysphoria Service

SYNOPSIS:Sex refers to a person’s physical appearance determined by their chromosomes and hormones. In contrast, gender refers to a person’s inner sense of whether they are male or female – or somewhere in between. A person may identify as transgender when their bodily sex and gender do not match in terms of being male or female. When this mismatch causes severe distress, it is referred to as Gender Dysphoria (GD). Although there are significant controversies in this area, there have been major steps forward in our understanding about how children experience gender, and about ways in which professionals and families themselves may be able to help.

Referrals to the RCH for children and adolescents with gender identity concerns have increased over the past 10 years from one new patient per year to 40 new patients in 2013. Providing health care to children and adolescents with Gender Dysphoria is challenging medically, psychiatrically, ethically and medico legally. The RCH Gender Dysphoria Service has been recently developed and expanded to include clinicians from Mental Health, Adolescent Medicine, Endocrinology, Gynaecology, Bioethics and Legal Services.

This presentation will include a case study and a description of the RCH Gender Dysphoria Service. We will also examine the treatment options in the context of international data and published international treatment guidelines.


Dr Michelle Telfer is a Paediatrician and Clinical Lead, Adolescent Medicine at The Centre for Adolescent Health, RCH. Michelle has been instrumental in the development of the RCH Gender Dysphoria Service over the past 18 months. She is a determined advocate for transgender patients and their families especially with regards to improving access to great clinical care.

Associate Professor Campbell Paul is a Consultant Infant, Child and Family Psychiatrist in the RCH consultation liaison psychiatry service. For many years Campbell has had an interest in young children and adolescents who experience gender dysphoria and he has been involved in their care since the inception of a multidisciplinary service at RCH where he worked in collaboration with Endocrinologist Professor Garry Warne.

Dr Debi Feldman is a Paediatrician at The Centre for Adolescent Health, RCH. She joined the RCH Gender Dysphoria Service six months ago following the rapid increase in referrals to the service in 2013. Debi has degrees in Law and Arts and an interest in Bioethics, and enjoys the challenge of working with this remarkable group of children and young people.

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