A 15-year-old with gender dysphoria who had a double mastectomy has encouraged other teens who do not identify with the sex they were assigned at birth to undergo the operation.
Senior child and adolescent psychiatrist Dr Jillian Spencer said there were Australian psychiatrists and surgeons who were recommending and performing such operations.
These child psychiatrists are providing approval letters to allow adolescents to undergo chest masculinising mastectomies after as little as only one appointment.
Dr Spencer said psychiatrists who wanted to undertake ongoing assessment of adolescents with gender dysphoria risked being publicly labelled transphobic.
Adolescents often have unrealistic fantasies about the cosmetic outcome of surgery,’ Dr Spencer said of children presenting with gender dysphoria.
‘They struggle to understand the serious risks of surgery such as haemorrhage, infection and anaphylaxis to anaesthetic. They think these things could never happen to them.
‘They also struggle to understand how debilitating persistent chest numbness, scarring and phantom nipple pain could be.’
‘Fifteen is too young to be making a decision that can have such profound long-term consequences,’ she said.
Professor Gribble said she had spoken to women who did not understand the complexity of breast structure when they had chest masculinisation mastectomies.
‘I have seen discussions amongst young people online suggesting that they believe these surgeries can be reversed and even in some cases that breast tissue will regrow if the come off testosterone,’ Professor Gribble said.
Anna Kerr, a lawyer from Feminist Legal Clinic . . . said protections for vulnerable young people from such medical treatments were inadequate and varied from state to state.
In a 2020 case known as Re: Imogen, the Family Court clarified medical practitioners cannot proceed with gender affirming treatment for a minor without the consent the consent of both parents.
‘Unfortunately, obtaining consent from vulnerable young people and their concerned parents is only too easy for those ostensibly wielding medical authority,’ Ms Kerr said.
‘Indeed, the recent introduction of gay conversion therapy bans, which have been inappropriately extended to cover ‘gender identity’, effectively mandate gender affirming treatments.
‘However, any health practitioner acting in good conscience should be guided by their duty of care to patients and the foreseeable harm of life altering surgeries hastily undertaken in youth.’
Professor Gribble said the Australian Professional Association for Trans Health did not require adolescents to be given information about the prevention of future breastfeeding after top surgery.
‘I have written to AusPATH asking them to include this in their guidelines,’ she said.
Both Professor Gribble and Dr Spencer said there was no evidence of any long or even medium-term benefit of chest masculinisation surgery on minors.
She said previous versions of the World Professional Association for Transgender Health guidelines recommended such surgery not occur until the age of 16
WPATH’s latest standards of care document published in September 2022 removed all lower age limits for gender affirming interventions.