The statement attempts to stake out a middle ground between “polarised views” and protecting members from liabilities that could arise in rapidly developing and diverging legal contexts. However, professional views on the appropriate treatment for children and young people with gender dysphoria (GD) are now so polarised that the RANZCP’s ‘middle ground’ position inevitably conflicts with recommendations made elsewhere.
Since publication, an Australian court has ruled that a court order is mandatory when a parent objects.⁷ AusPATH’s advice is now out of date, since the objecting parent will no longer have to initiate legal proceedings.
With the benefit of an extra year of court judgements and law changes relating to conversion therapy, RANZCP advises psychiatrists to avoid cases that could end up in court and take actions to mitigate that possibility:
Conflicting professional opinions speak to the urgent need for regulation. In one Australian state, clinicians must seek court approval before prescribing hormone treatments.⁸ At the same time, a state Supreme court has heard a case brought by parents who lost custody after they refused consent for the child’s hormone treatments.⁹ An unsuspecting parent might receive advice to initiate puberty suppression and hormone treatments or might receive advice to initiate psychotherapy depending on the personal beliefs of the clinician consulted and their professional memberships.
The RANZCP (established 1946, 7000 members in 2020) is an older, larger, and more mature organisation than either AusPATH (predecessor ANZPATH established 2009, 200 members in 2018) or PATHA (established 2019 with 15 members). It is not surprising that they take a more cautious approach.