The Chief Justice of The Family Court has indicated that the court will soon be able to provide a more streamlined process for adolescents requesting hormone treatment.
The decision was announced on last night’s Four Corners program, ‘Being Me‘. The program featured RCH patient Isabelle, Centre for Adolescent Health Clinical Lead Dr Michelle Telfer, and RCH Infant and Child Psychiatrist Associate Professor Campbell Paul.
What is Gender Dysphoria (GD)?
A person is ‘transgender’ when their sex and gender do not match; when this mismatch causes severe distress, it is referred to as Gender Dysphoria (GD). The RCH Gender Dysphoria Service is the only multi-disciplinary clinic for young people with gender dysphoria in Australia. The clinic is currently treating more than 150 patients a year, with new referrals increasing 60-fold in the past decade.
“The best care of children and adolescents with gender dysphoria is provided by a multidisciplinary team like the one we have at RCH,” Dr Michelle Telfer, Centre for Adolescent Health Clinical Lead said. “The mental health issues and the medical issues that arise are often complex and interlinked. Working as a team we can provide care in this context, making decisions together with the child or adolescent and their family.”
Why is it so important to provide multi-disciplinary treatment for children with gender dysphoria?
The health risks associated with insufficient support for transgender adolescents are well known.
“Research shows that 30 percent of transgendered young people will attempt suicide if they do not have access to adequate care and support, 50 percent will self-harm,” Dr Telfer explained.
An Australian-first survey of 189 gender diverse or transgender young Australians by La Trobe University found that half had been diagnosed with depression and nearly half had been diagnosed with anxiety – rates much higher than those experienced by young Australians more broadly.
What does the decision announced by the Chief Justice of the Family Court mean for adolescents with gender dysphoria?
On last night’s Four Corners program, the Chief Justice of The Family Court indicated that the court will soon be able to provide a more streamlined process for adolescents requesting hormone treatment. Currently, it is a legal requirement for all Australian transgender adolescents wanting hormone treatment, wither testosterone or oestrogen, to gain approval from The Family Court of Australia. This decision comes after doctors from the RCH Centre for Adolescent Health met with with Chief Justice Bryant.
“Until now, in Victoria this has involved a formal court hearing with the family being legally represented,” Dr Telfer said. “This is a very expensive process, costing up to $30,000, and has prevented many young people from accessing treatment. A streamlined process will bring the cost down significantly, minimise delays and allow many more young people to access care. Improving access to treatment has been shown to reduce depression, anxiety, self-harm and even suicide in this age group.”
What does treatment at the RCH Gender Dysphoria Service involve?
Patients in the RCH Gender Dysphoria clinic undergo a series of medical interventions that are initially fully reversible, including the use of medication to suspend puberty. The patient can then progress to partially reversible interventions, such as cross hormone treatment, and finally undergo irreversible surgical interventions once they are in adulthood.
“The process for the assessment is very rigorous,” RCH Infant and Child Psychiatrist Associate Professor Campbell Paul told the ABC.
“Before a child is given treatment, they are assessed by at least five doctors. There is a team of us that are involved and in the first instance it’s a psychiatrist and an adolescent physician or an endocrinologist and we get a detailed assessment from the family.”
“We are committed to zero harm and the service is set up in quite a conservative way,” Dr Telfer added. “We have a very thorough assessment process involving multiple medical and mental health specialists which takes place over an appropriate length of time to ensure that the correct treatment is offered to each individual within the context of their family situation.”
“Throughout the assessment and treatment process we aim to provide extensive education about the risks and benefits of each intervention so that all patients and families can be assisted with making the decisions that are right for them.”
The Gender Team at RCH follow the highly regarded international treatment guidelines published by the World Professional Association of Transgender Health (WPATH) and the International Endocrine Society.