The Supreme Court of Victoria recently ruled in favour of allowing a 12-year-old child to begin puberty-blocking treatment.

The question to be decided in the case was whether the mother’s consent to puberty blockers (referred to as stage 1 treatment) was “proper consent” in circumstances where the other parent, the child’s biological father, was absent and had had no involvement in the child’s upbringing.

The judge determined that “stage 1 treatment is not a special medical procedure” requiring court approval.

According to the court:

As a result, the legal requirements for consent to stage 1 treatment for gender dysphoria are no different from those that apply to any other medical treatment to which a parent may consent – such as childhood vaccinations, surgery to mend a broken bone, or chemotherapy to treat cancer.

The judge ruled that the mother could provide the consent on behalf of the child, and that the father’s consent was not required.

In the course of her judgment, the judge also provided an assessment of the effect of puberty blockers, based on the evidence provided to the court:

This treatment halts the progression of the physical changes that come with puberty, but is reversible and may be stopped at any time. The clinicians say undertaking stage 1 treatment will provide [the child] with both immediate psychological relief and additional time to explore her gender identity before making decisions about the use of other ‘stage 2’ hormonal treatments, such as oestrogen.

However, as commentator Monica Doumit has noted:

With respect to the judge, the statement that the effects of puberty blockers are reversible is not correct. A study from Westmead Children’s hospital’s gender clinic reported that they cause a decrease in bone density, while the most comprehensive study in the world – the recent Cass Review from the UK – found that there was inconsistent evidence about the effects of puberty suppression on things like cognitive development, cardio-metabolic risk or fertility.

No one presented this evidence to the court and so the judge made her decision based on the evidence before her. This is a real problem in these cases. Many things have changed since 2013… the number of children seeking puberty blockers has risen exponentially, and the evidence against their use is also increasing.

The study conducted by the Westmead Children’s Hospital’s gender clinic highlighted “sparse evidence justifying the use of puberty blockers, instances of serious side effects from the drugs, ongoing mental distress following transition and the significant potential for later regret among patients”:

In an era of evidence-based medicine, the evidence base pertaining to the gender-affirming medical pathway is sparse and, for the young people who may regret their choice of pathway at a future point in time, the risks for potential harm are significant.

It is concerning that this medical treatment is still being provided to minors in Australia, despite recent developments in research about puberty blockers and concerns being raised internationally.

Getting this evidence before courts and tribunals is an important part of the cases HRLA is involved in, such as the case of child and adolescent psychiatrist Dr Jillian Spencer. With HRLA’s assistance, Dr Spencer is challenging the actions of her employer arguing that its policies violate her conscience and compel medical practitioners to take a politicised approach which is harming vulnerable children.

Courageous physicians like Dr Spencer are being silenced or punished for raising their concerns, which in turn is stifling robust debate on this contested issue. It is children and young people who are being put in harm's way as a result.

Dr Spencer is also one of a number of physicians calling for health ministers around Australia to establish an independent body to investigate Australia’s paediatric gender services and implement recommendations from the Cass Review.