Leading surgeons are calling for the national medical regulator to step in to set “clear and specific guidelines” on gender-affirming surgery, including consideration of whether the age at which transgender adolescents are legally allowed to go under the knife should be raised to 18.
Australia is one of the most liberal countries in the world in sanctioning children under 18 to get double mastectomies, a practice that is rare but appears to be increasing despite only a handful of surgeons around the country being willing to perform such procedures.
The case of a 15-year old child in Queensland having “top surgery” has prompted Mark Ashton, a plastic surgery specialty elected counsellor to the Royal Australasian College of Surgeons and Melbourne University professor of surgery, to question the lack of regulations.
The federal government’s national virtual public health information service Healthdirect says top surgery can be performed, with parental consent, on minors over the age of 16, but “some surgeons will provide surgery to younger people in very specific situations”.
Professor Ashton is one of three breast reconstruction surgeons to whom The Australian has spoken to confirm that as the medical transition of young people has grown more common in recent years, surgeons are now being approached by people who want to reverse surgical procedures. This appears to be a manifestation of the concerns of cautious doctors such as those at The Children’s Hospital at Westmead’s gender clinic that a proportion of teenagers who present wanting to transition gender will later desist or detransition.
There is no public data on how many people are getting gender reassignment surgery, with double mastectomies being performed under the same Medicare item number as cancer surgery.