Claire Chandler (Tasmania, Liberal Party) Share this | Link to this | Hansard source

'It is right to call the treatment of gender-dysphoric children with puberty blockers experimental or innovative in the sense that there are currently limited studies and evidence of the efficiency or the long-term effects of the treatment.' That's from a recent judgement by the English High Court. 'There is no other field of medicine where such radical interventions are offered to children with such a poor evidence base.' That was US psychiatrist Professor Stephen Levine, in evidence to the English High Court. 'Children have been very seriously damaged.' That's according to Dr David Bell, a recently retired senior psychiatrist at England's Tavistock youth gender clinic. This is the expert evidence which is only now being allowed to come to light through the British media and court system.

It was in 2018 that Dr Bell wrote an internal report, warning that Tavistock's Gender Identity Development Service was not fit for purpose and that children's needs are being met in a woeful, inadequate manner and that some will live on with the damaging consequences. Instead of being listened to, Dr Bell was subject to disciplinary action for raising these concerns. One of the governors of the clinic resigned, stating, 'In my 40 years of experience in psychiatry, I've learned that dismissing serious concerns about a service or approach is often driven by a defensive wish to prevent painful examination.' He went further: 'The need to adopt an attitude which examines things from different points of view is essential. This is difficult in the current environment, as the debate and the discussion required are continually being closed down.'

It was not until two years later, when one of those young people who had been let down by this system went to the High Court, that the media and the public at large started to listen. That's two years in which large numbers of children were put through a service which has been described by its own senior clinicians as not fit for purpose and as having damaged children very seriously. Only last month, England's Care Quality Commission rated the Gender Identity Development Service as inadequate, highlighting the exact same concerns which whistleblowers had been raising for years. It said that records provided insufficient evidence of staff considering the specific needs of young people, such as autistic spectrum disorders. The service did not record how many patients had a diagnosis, or a suspected diagnosis, of an autistic spectrum disorder. Records did not demonstrate consideration of the relationship between ASD and gender dysphoria. Further, the Care Quality Commission explicitly stated that staff did not always feel able to raise concerns without fear of retribution.

How do Australian gender clinics rate on these measures? We simply do not know. Although the concerns brought to the fore in the English High Court last December quite clearly have major relevance in Australia, there was muted or non-existent coverage in most of our major media outlets. To suggest, as some have done, that these are British issues with no relevance to Australia defies logic. Do Australian gender clinics have access to research about the links between gender dysphoria and autism spectrum disorders that are unknown to clinics in the UK? Do they have a scientifically based explanation for the explosion in numbers of teenage girls presenting with gender dysphoria? Do they have records demonstrating proper consideration of other psychological factors before proceeding to irreversible medical interventions? Do they have records tracking the ongoing physical and mental wellbeing of patients five, 10 or 15 years after being given puberty blockers and cross-sex hormones? How do they explain the increasing number of detransitioners? How do they align the experience of detransitioners with the oft stated narrative that a distressed teenager asking for permanent physical alterations won't change their mind down the track?

If Australian gender clinics and the state governments running them do have this data, it's obvious that they should release it so that concerned medical practitioners, parents and the general public can see it. State governments are supposed to have this data, having conducted an audit and review of youth gender dysphoria treatment in the last year. Why haven't the results been released? Why is the Victorian government, this week, seeking to criminalise just speaking about the concerns that are being openly discussed in the UK, concerns that are shared by Australia's National Association of Practising Psychiatrists?

Australia has a choice: are we going to spend the years ahead pretending there are no legitimate concerns about teaching children that they can literally be born in the wrong body and then changing their bodies to fit that idea, or will we listen to these concerns and demand this area of medicine be scrutinised transparently and independently?