Doctors treating children and teens with gender dysphoria have opened up about feeling pressured to prescribe puberty blockers and cross-sex hormones before non-medical interventions, such as psychotherapy, have been explored.In the first Australian study of its kind, clinicians at The Children’s Hospital at Westmead in Sydney say the emergence of a “conveyor belt” mentality to treating the condition has forced them to compromise their own ethical standards.The treatment of gender dysphoria in children and adolescents remains contentious. A group of Sydney clinicians is concerned that families are pinning hopes on pills rather than broader psychosocial therapies.
The Sydney doctors, including paediatric endocrinologist Professor Geoffrey Ambler and psychiatrist Dr Kasia Kozlowska, said many children equated gender affirmation with medical intervention and believed their distress “would be completely alleviated if they pursued the pathway of medical treatment”.
Both the patients and their families arrived at the clinic with strongly entrenched beliefs, and the doctors’ efforts to discuss psychological, social or family issues “fell on deaf ears”.
Another challenging aspect of their work was the increased pressure to prescribe cross-sex hormones to children aged 16 and over following a 2017 ruling by the Family Court of Australia.
The ruling essentially removed the requirement for court approval to access stage 2 treatment — cross-sex hormones — and put this responsibility into the hands of doctors.
“In the wake of [this] … some families presented to the clinic with the expectation that a child nearing the age of 16 could attend the gender service, see the mental health team for a one-off consultation, collect a diagnosis of gender dysphoria, and move to another service to obtain stage 2 treatment … with no engagement in a therapeutic process.”
Criminalising coercive control – controlling and intimidating behaviour in a relationship – is on the agenda across Australia, including in NSW where a parliamentary committee is looking at the proposal.
But Aboriginal women’s legal service Wirringa Baiya says a new crime could have unintended consequences, and other changes need to happen first.
Indigenous women going to police face “judgmental and stereotypical attitudes”, says Wirringa Baiya’s co-ordinator, Bundjalung woman Christine Robinson.
According to South West Sydney Legal Centre CEO Yvette Vignando: “In situations of coercive control, usually the male has the ability to manipulate people.
“There’s a much higher chance of the police being hoodwinked, for want of a better word, into believing the primary perpetrator is the woman. And when you add onto that the racial bias, there’s an even higher chance of that with Aboriginal and Torres Strait Islander women.”
In some cases, women who seek help are wrongly identified as the primary perpetrator and are then themselves subject to an AVO or even criminal charges.
Research by ANROWS CEO Heather Nancarrow shows this is more likely to happen to Indigenous women.
Frontline workers are worried a coercive control crime could lead to more misidentification, ironically harming those the law is designed to help.
“Sometimes (police will) turn up and by then she’s overwhelmed,” Ms Turner says.
“She might come across as angry but she’s not, she’s frustrated because she’s not being heard. A lot of my defendants are (actually) victims.”
Neither Wirringa Baiya and South West Sydney Legal Centre opposes criminalisation of coercive control but both say other reforms have to happen first.
During the 1970s, second-wave feminists thoroughly critiqued the relegation of women to childrearing. This left some with a lingering sense that becoming a mother was an old-fashioned or politically regressive choice.
But in fact there is a long tradition of maternal radicalism in Australia. Mothers have been out on the streets, fighting for change, as frequently as they have kept the home fires burning.
The effectiveness of these maternal activists was proven in 1894 when South Australia became the first electorate in the world to give women the vote.
Further evidence of the political power of first-wave feminists came in 1912, when the Commonwealth government approved the Maternity Allowance. This was radical in using government funds to provide state support to mothers as citizens, undercutting the authority of their husbands.
In the 1960s and 1970s, while women’s liberation movement activists such as Merle Thornton, Marcia Langton and Zelda D’Aprano were demanding equal rights for women, middle-class mothers around Australia were quietly rebelling against the medicalisation of pregnancy, childbirth and breastfeeding.
Mothers have a long history of political activism not just in Australia, but around the world.
Up till now, the government has failed to deliver meaningful reform for women. If the government is truly “listening to women” as the Prime Minister recently promised, we’ll see some big reforms coming out of our federal budget handed down next week.
Additional and more inclusive paid parental leave
Domestic violence funding
Wage increases to those working in care sectors
A 3-part documentary series that explores one of the most complex and urgent issues of our time – domestic abuse. Presented by investigative journalist Jess Hill, this series examines the fine lines between love, abuse and power. Available from Wednesday 5 May 8:30 PM AEST.
In 2018, the federal government promised to improve the visibility of superannuation assets during family court proceedings by setting up a new “electronic” system. But more than two years later, advocates are concerned the “urgent” changes have not been implemented. A spokesperson for the Superannuation Minister Jane Hume said the government would begin consulting on the legislation soon
Labelling women as offenders has far-reaching effects, especially for First Nations women, research shows
Almost half the women murdered by an intimate partner in Queensland had previously been labelled by police as the perpetrator of domestic violence, research shows.
As the Queensland police again reckon with the brutal consequences of family violence – the deaths of Gold Coast women Doreen Langham and Kelly Wilkinson, who both repeatedly sought help – they have acknowledged and pledged to address systemic failings in their response.
But there are already concerns among experts and women’s advocates that police are resisting the need to look too deeply within, in the face of research last year into the misidentification of victims that found “racism, poor relationships with local communities, misogyny, and the patriarchal culture of the police service” were ongoing concerns.
Lynch said – and the Anrows research also found – that police often tended to look at calls or complaints about domestic violence in isolation, rather than consider the context of ongoing abuse.
“Often they’re trying to work out: is there a technical breach of an order when a woman makes a complaint, when what she’s really saying to them is ‘please make me safe’.”
Free child care must be a cornerstone of the Budget spending spree if the Morrison government is serious about getting unemployment down, unions say.
Child-care funding has emerged as a focal point amid reports the Morrison government is considering a new multi-billion-dollar funding plan that could see subsidy rates increased from 85 to 95 per cent.
The ACTU, meanwhile, is calling for a free universal early childhood and education scheme. In other words, unions want the government to make child care effectively free for Australian families, or extremely low cost.
The current prospective study examined the clinical characteristics of children (including adolescents) presenting to a newly established, multidisciplinary Gender Service in New South Wales, Australia, along with the challenges that clinicians faced in providing clinical services to these patients and their families. We found that the clinical characteristics of the children presenting to our service were comparable to those described by other paediatric clinics: a slight preponderance of biological females to males and high levels of distress and comorbid mental health disorders. While previous studies of children have highlighted high rates of abuse, bullying, discrimination, victimization, and family rejection or lack of family support in a general way—often under an umbrella heading of “abuse and victimization experiences” (p326) (Chew et al., 2020)—the results from our study, including the developmental stories told by the children and their families, highlight that many of these experiences have occurred within the family setting itself. That is, our results highlight that many of the ACEs reported by the children and families—family conflict, bullying, parental mental illness, financial stress, maltreatment, and a breakdown of the family system—occur within the family system itself and that the ACEs reflect a long-standing history of relational stress and a chronic disruption of what are normally comfortable and nurturing attachments.
Our study found that the children and families who came to the clinic had clear, preformed expectations: most often, children and families wanted a diagnosis of gender dysphoria to be provided or confirmed, together with referral to endocrinology services to pursue medical treatment of gender dysphoria. . . . It was our impression that these expectations had been shaped by the dominant sociopolitical discourse—the gender affirmative model. It will be interesting to track the expectations of children and families in the years to come as sociopolitical discourses become more varied and diverse and as the voices are heard of both those who have done well and those who not done well via the medical pathway.
Source: Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service – Kasia Kozlowska, Georgia McClure, Catherine Chudleigh, Ann M Maguire, Danielle Gessler, Stephen Scher, Geoffrey R Ambler, 2021
Probably few Tasmanian voters going to the polls on May 1 will be aware that their recently dissolved Parliament was responsible for some of the most radical (and incoherent) legislation in the world concerning gender issues. Remarkably, it was passed from opposition by Labor and Greens MPs in 2019. It was supported in the Legislative Assembly by Speaker Sue Hickey, a member of the Liberal Party at that time, who voted against the position of the Government. The changes were also supported in the Legislative Council by a sufficient number of independents.
The legislation was the Justice and Related Legislation (Marriage and Gender Amendments) Act 2019 . It allows a person 16 years or older to register ‘a gender’ which has the effect of amending the birth register, and for parents to do so for a child under 16. The application must be accompanied by a “gender declaration”. This is a statutory declaration in which the person declares that he or she identifies as being of the gender specified and lives, or seeks to live, as a person of that gender.
The problem with the Tasmanian legislation is that it begins from the premise that sex and gender are different, and then concludes that gender is the same as sex once someone fills in a form which is accepted by the Registrar of Births, Deaths and Marriages. Through an application to an administrator without more, a person can, in essence, change their sex for legal purposes in Tasmanian law.
The intentions of the Parliament to make it possible for transgender people to identify as another gender without sex reassignment surgery could have been fulfilled in a range of ways without embracing unscientific and highly controversial beliefs. People who self-identify as the opposite sex could have been given a gender recognition certificate for the purposes of indicating gender on driving licences or other such official documents. This does not impact upon the rights of anyone else.
Is it so unreasonable for Tasmanians to want their birth certificates to be what they are meant to be – a record of their birth? If 99.98% of the Tasmanian population have no difficulty with their sex or gender, and have not sought to change official records, should policy be dictated by tiny minorities who would like to see sex at birth erased from public records?
The Tasmanian Parliament, recently dissolved, lost its way in a fog of ideological confusion and unscientific beliefs. The new Parliament needs to do better, and to take account of the beliefs of the large majority of people who do not have degrees in gender studies.