Doctor’s advocacy trumped duty to objectivity in court
The public should know why gender-affirming care became the dominant practice in Australia without good quality evidence to support it.
Medicalised gender change for distressed minors, driven by puberty blockers and cross-sex hormones, is experimental treatment. Since 2019, jurisdictions as different as Finland, Florida, Sweden and England have independently put these hormonal treatments to the gold-standard test; in each case, systematic reviews of the evidence have shown it to be very weak and uncertain.
So, there is no good-quality evidence to claim that paediatric medical transition benefits mental health, let alone prevents suicide. The known risks include brittle bones, cardiovascular problems, loss of fertility, sexual dysfunction and potential harm to the brain. And yet children’s hospitals and clinics across Australia continue to promote “gender-affirming care” as lifesaving. How was this allowed to happen? The public deserve an answer.
We know this treatment was introduced as routine, bypassing the safeguard of clinical trials. The innovator was the gender clinic of the Royal Children’s Hospital Melbourne, which launched radical treatment guidelines in 2018. Misleadingly badged as “Australian standards”, these low-quality guidelines have nonetheless become the de facto national blueprint for gender clinicians. There are serious questions whether normal governance processes were followed at RCH — or at myriad other institutions that proudly stated their adherence to the guidelines.
Medicalised gender change for distressed minors, driven by puberty blockers and cross-sex hormones, is experimental treatment. Since 2019, jurisdictions as different as Finland, Florida, Sweden and England have independently put these hormonal treatments to the gold-standard test; in each case, systematic reviews of the evidence have shown it to be very weak and uncertain.
So, there is no good-quality evidence to claim that paediatric medical transition benefits mental health, let alone prevents suicide. The known risks include brittle bones, cardiovascular problems, loss of fertility, sexual dysfunction and potential harm to the brain. And yet children’s hospitals and clinics across Australia continue to promote “gender-affirming care” as lifesaving. How was this allowed to happen? The public deserve an answer.
We know this treatment was introduced as routine, bypassing the safeguard of clinical trials. The innovator was the gender clinic of the Royal Children’s Hospital Melbourne, which launched radical treatment guidelines in 2018. Misleadingly badged as “Australian standards”, these low-quality guidelines have nonetheless become the de facto national blueprint for gender clinicians. There are serious questions whether normal governance processes were followed at RCH — or at myriad other institutions that proudly stated their adherence to the guidelines.
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