It was in early April that Richard*, a dad from NSW’s Hunter Valley, first heard about a 58,000-word judgment handed down by Justice Andrew Strum in the Family Court.
In his bombshell ruling, the judge blew a hole in Australia’s gender-affirming treatment guidelines for children, which accept the wish of young people to assume their preferred gender identity and offer therapies that reinforce their plans to transition gender. He also referenced a 2024 UK report known as the Cass Review, which dramatically altered care for gender dysphoric youth in that country, moving away from gender affirmation and banning the use of puberty blockers in favour of a more holistic, therapy-based model of treatment and care.
Justice Strum criticised the approach of Australian hospitals to “affirm unreservedly” children who questioned their gender, and was critical of an anonymised medical expert who he said had given “concerning” evidence in support of Devin’s mother. The expert was later revealed to be Michelle Telfer, chief author of the Australian Standards of Care and Treatment Guidelines (ASCTG) for trans and gender diverse children and adolescents, and the chief of medicine at the Royal Children’s Hospital in Melbourne, where Devin had been treated.
Justice Strum’s words hit Richard hard. Only four months earlier, he too had been in the Family Court, battling his ex-wife and medical experts from a NSW Health clinic offering gender-affirming medical services. Richard spent $150,000 arguing to retain his parental rights over his biologically female teenage daughter, known as Ash, and prevent her from taking testosterone to transition from female to male.
For Richard, the final outcome had been very different. Family Court Judge Peter Tree ruled in favour of Ash’s mother, who obtained sole parental responsibility over the 16-year-old in order to approve the administration of hormones. “I have earnestly tried to ascertain what is best for Ash,” ruled Justice Tree, who also wrote that he had given “great weight” to the ASCTG – “because they are models of care arrived at by consensus of the relevant professional bodies”.
In the past decade, Richard points out, it’s been common for parents of trans kids to be silenced or minimised after voicing concerns about their child’s medicalisation and mental health. At every turn, the voices of trans support groups and lobbyists, the medical fraternity, health departments, education departments and ministers instead put their children on a path to gender transition – no questions asked.
But with Justice Strum’s judgment, is the pendulum about to swing back the other way? Richard certainly hopes so. And so does Perth mum Tess Hackett.
Tess was cooking dinner one evening in 2016 when her daughter announced she had something important to say. “What’s up?” Tess asked, as she dollied between the chopping board and the hotplates. At first she thought she had misheard when her daughter, then aged 16, said: “Mum. I’m a man trapped inside a woman’s body.”
In the early and mid-2010s, states across Australia opened specialist gender services for young people with a flurry. A significant rise in children seeking gender-related care put pressure on existing services, and state governments identified the need for specialist medical intervention as a priority. It was deemed a public health priority, one that mirrored the demand in other Western nations.
Melbourne’s Royal Children’s Hospital gender service was established in 2012. In NSW, Sydney’s Westmead Children’s Hospital and Newcastle’s John Hunter Children’s Hospital added similar services in 2013. By 2015, Perth Children’s Hospital Gender Diversity Service was operational. It had been decided by figures in the medical fraternity – and consolidated by support from administrators – that these clinics were the best model to treat Australian kids experiencing gender dysphoria.
So when Tess took Veronica to their GP in 2016, he wasted no time referring her to Perth Children’s Hospital. While waiting for their appointment, scheduled for March 2017, Tess says Veronica slipped further into trans-affiliated online communities and chat rooms. And one day that summer, there came a knock at the door. A well-dressed man announced he was there to take Tess’s son, who he believed was in danger. Tess says she was bewildered – obviously, there had been a mistake. She assumed firstly that the man was from the WA Department of Family Services, and secondly that he was referring to Veronica’s younger brother. When she asked him for identification, he revealed that he was actually a representative of TransFolk of WA, a support service for the transgender community, and that he was a transgender man. He was here for Veronica. Tess says he pushed past the threshold, entered Veronica’s bedroom and collected armloads of her clothes. Tess called the police, but was told because Veronica was 16 there was nothing officers could do to prevent her from leaving.
The situation devolved. Tess tells me she pushed the man out her front door. He tripped and fell to the ground. He called the police. They arrived shortly after.
Police officers spoke with Veronica, who told them she was suicidal, and they took her to hospital for psychiatric evaluation. It was here, Tess said, that she first heard a phrase similar to the one Richard had heard in Newcastle. A psychiatrist informed Tess and her husband that from this point forward, they should affirm their daughter as a boy. “It’s better to have a live son,” the psychiatrist told them, “than a dead daughter.” Veronica was sent home, and Tess was given a list of instructions, including to allow her daughter full access to digital devices and to remove from display any photos that showed Veronica as a girl.
In due course, Veronica attended the long-awaited appointment at the Perth Children’s Hospital gender clinic with Tess in tow. Tess welcomed the chance to speak with professionals. At an absolute minimum, she says, she expected her daughter’s state of mind to be assessed. Veronica had been through a terrible trauma only a year before, which Tess believed she had never recovered from. She had been sexually assaulted by a boy from her school. It was an experience Tess says shattered her daughter’s worldview; she went from being a happy and vibrant girl to somebody who needed real help.
Furious about not being allowed to get testosterone, Veronica ran away a few months later, leaving a note saying she wanted her mother to acknowledge she’d given birth to two boys. Veronica spent a couple of weeks living with a TransFolk representative before moving into a homeless shelter. At 18, she began testosterone injections. Transfolk of WA did not respond to questions submitted by this magazine.
The group, Parents of Rapid Onset Gender Dysphoria Kids, now has several hundred members, Tess says. She’s one of only a few people willing to put her face and name to the cause. Others remain fearful of the power of transgender activists, while many more are trying to maintain a relationship with their children.
“It’s called the trans train. You get on at thestation and there are no stops until the end when the body is destroyed,” says Dianna Kenny, a Professor of Psychology at the University of Sydney. For seven years Kenny has been working with “gender declaring” children and their families, and studying the rapid rise of minors identifying as transgender. She says kids are first “imbued with the trans philosophy” through their peers, institutions or online, and “once they are hooked into the cult, they get a lot of reinforcement from going through to the next stage and the next stage… it becomes a self-reinforcing loop”.
Kenny firmly believes the rise of transgenderism in youth is a social contagion. Last year she published a book titled Gender Ideology, Social Contagion and the Making of a Transgender Generation, in which she makes the case for dismantling the “mythology and misinformation around transgenderism” and reports on the findings of her work with young patients.
Dr Jillian Spencer became a lightning rod in the gender wars when she first spoke out against affirmative care models in 2022. Spencer worked as a psychiatrist at the Queensland Children’s Hospital until April 2023, when she was suspended from clinical duties after she raised concerns about the safety of the model and a patient made a complaint of transphobia.
Like Kenny, Spencer says she’s swamped with parents reaching out to her looking for a more critical approach to care.
Public gender clinics don’t release official numbers of patients seen or treated; the only information available has come via Freedom of Information (FOI) requests, which show a significant increase in children seeking treatment. Responses to FOI requests, published by psychiatrist Dr Andrew Amos, a lecturer at James Cook University, reveal that in 2014 there were just 56 children under the age of 18 treated for gender dysphoria at public gender clinics. By 2022, this number had jumped to 3231.
Professor John Whitehall, foundation chair of Paediatrics and Child Health at Western Sydney University, says he was at a medical conference in Cairns in 2016 when he attended a presentation by Telfer on treating minors with gender dysphoria.
Whitehall’s criticism of gender-affirming care is well documented and he has written widely on the subject. Chief among his concerns is “the clinics’ mantra that puberty blockers are safe and reversible”, he says. “There is a huge amount of research proof that ought to slow people up when giving [puberty blockers] to the developing brain of a human. It’s unregulated experimentation on children.”
There is one group who are over-represented in gender clinics: autistic youth. Autism Spectrum Australia cites a 2018 study that found 22.5 per cent of transgender adolescents had a diagnosis of autism, compared to 2.5 per cent of all Australians. Researchers worldwide acknowledge this correlation and have called for more investigation.
Gender-affirming care originated in the Netherlands in 1998 and although the model has not been without its critics, it was not until last year that it was brought under extreme scrutiny.
Referrals to youth gender identity services in the UK had increased 100-fold over a decade; since 2011, thousands of British children have received puberty blockers on the National Health Service. But in April 2024, a review conducted by paediatrician Hilary Cass found there was no good evidence to support the practice of prescribing hormones to under-18s to halt puberty or transition to the opposite sex. Her final report, now referred to as the Cass Review, moved treatment away from puberty blockers.
Around the world – in Norway, Sweden, Finland and France – the use of gender-affirming care and puberty blockers has also been wound back. In the US, 18 states have placed bans on puberty blockers, and last month, the US Supreme Court knocked down a legal challenge that argued a ban on prescribing puberty blockers to minors introduced in Tennessee had been discriminatory and should be overturned.
n January, the Albanese Government ordered a review of the Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents, and federal health minister Mark Butler instructed the National Health and Medical Research Council (NHMRC) to develop new guidelines for the care of young people with gender dysphoria.