The much anticipated final report of the Cass Review of gender services for children and young people has been published, and, as expected, it recommends a significant change to the care and services for children and young people experiencing gender confusion in the United Kingdom.

Dr Hilary Cass was tasked with chairing an independent review and making recommendations on how to improve services for children and young people experiencing issues with their gender identity or gender incongruence, as well as ensuring that the best model/s for safe and effective services are commissioned.

For Queensland psychiatrist and HRLA client Dr Jillian Spencer, this report is a welcome development. The report’s final recommendations validate her own cautious and holistic approach to the treatment of gender dysphoria cases, rather than an automatic ‘affirmation’ only approach.

Dr Spencer’s approach is consistent with growing international medical discourse on gender treatment for minors following investigations in Finland, Sweden, and the Netherlands, as well as the approach endorsed by the Cass Review.

Despite these major developments overseas, this cautious approach is not permitted by the Queensland Children’s Hospital, where Dr Spencer is employed.

Dr Spencer has lodged a complaint with Queensland’s Human Rights Commission, on the basis that she should have a right as a doctor to object to the unscientific “affirmation” model of care for children.

With assistance from the Human Rights Law Alliance, Dr Spencer’s matter will be heard in the Queensland Industrial Relations Commission (QIRC). Dr Spencer will be contesting the requirement to use preferred pronouns and names and keep all clinical records according to a patient’s preferred gender identity. She will argue that the imposition of the requirement to adopt a gender affirmation approach is incompatible with human rights, limiting her freedom of thought, conscience and belief, her right to hold an opinion without interference, and to impart ideas.

While the Cass Review focused on clinical practice in England, the ramifications for Australia are significant, and it is hoped that similar scrutiny of Australia’s gender clinics will ensue.

As Dr Andrew Amos, Queensland chair of Rural Psychiatry at the RANZ College of Psychiatrists has noted:

“Cass makes it impossible for Australian authorities to continue to ignore warnings that Aussie kids and their families face the same systemic problems and clinical risks the English, Swedes and Finns are now scrambling to correct”.

Indeed, as Professor Patrick Parkinson has forecast: 

The only way forward is likely to be a judicial inquiry or one led by a medical expert without taint--someone of the calibre of Prof. Cass.

Such an inquiry needs to look closely at the medical records of cases in the gender clinics around the country, to explore just how thorough or otherwise the diagnostic process is, and how much information the children, young people and their parents are given to help them make wise decisions about the long-term future.

Dr Spencer is to be commended for her courageous stance and firm resolve to provide safe and ethical medical care for her patients in line with the best available scientific evidence.