Irish psychotherapist Stella O’Malley has worked with parents of gender-distressed children across dozens of countries. She says Australian parents stand apart.

“There was something about the extraordinary loneliness and isolation of the Australian parents that felt more poignant than the others,” O’Malley told The Australian this week. 

O’Malley is the executive director of Genspect, an international organisation providing evidence-based support to detransitioners and families navigating gender distress, and has been running online therapy sessions since 2020. Australian parents were there from the beginning. They were also, she noticed, among the most afraid.

“It’s a different level of fear and silencing that’s happening in Australia,” she said. “They seem to be genuinely fearful of legal consequences in the way that other countries aren’t.”

The legal architecture producing that fear is not accidental. O’Malley pointed directly to so-called conversion therapy laws, which she and other clinicians argue have placed a statutory chill on any therapeutic approach that does not affirm a child’s stated ‘gender identity’.

In the United Kingdom, the Cass Review – an independent four-year review commissioned by the National Health Service – found the evidence base for so-called ‘gender-affirming care’ to be weak, prompting the UK Labour government to ban puberty blockers for gender dysphoria. 

Australia has moved in the opposite direction: legislating affirmation as the only acceptable treatment model while creating regulatory risk for clinicians who ask anything deeper.

That risk is not theoretical. Queensland child psychiatrist Dr Jillian Spencer spent three years under investigation after raising concerns about gender interventions in children at the Queensland Children’s Hospital. 

Last week, the hospital cleared her of wrongdoing, and the Australian Health Practitioner Regulation Agency also dropped its investigation. No misconduct was found but, as is often the practice with such high-profile cases, the process itself is the punishment. In Dr Spencer’s case, this meant three years of professional suspension and enforced silence.

That is what conversion therapy laws in their current form produce.

O’Malley’s authority to make that observation is both professional and personal. She experienced what she describes as severe gender dysphoria from the age of three, did not receive puberty blockers, and went on to complete a PhD on parents’ perspectives of children’s gender dysphoria. 

Her organisation Genspect grounds its work in conventional psychotherapy – Freud, Jung, Carl Rogers, Aaron Beck, Albert Ellis – rather than affirmation frameworks she describes as “anti-psychological”. 

The job of psychology, she argued, is not to accept the surface story as the only story. Affirmation, by definition, does exactly that. “Australia is losing more than it realises,” she said, “by not allowing people to speak freely.”