<\/p>\n
A sociologist who surveyed more than 100 young transgender people and their parents following a puberty blocker ban in the UK<\/a> has warned similar bans in Australia and New Zealand will lead to youth suicides.<\/p>\n Dr Natacha Kennedy from Goldsmiths, University of London, analysed the impact of the UK ban<\/a> that was first implemented in March 2024, and extended indefinitely<\/a> last December.<\/p>\n The ban followed the Cass review,<\/a> a non-peer reviewed, independent assessment of gender identity services for children and young people, commissioned by England\u2019s National Health Service and led by paediatrician Dr Hilary Cass.<\/p>\n The review<\/a> proposed restrictions to youth accessing gender-affirming care, but has since <\/a>faced extensive peer-reviewed criticism<\/a> for methodological problems<\/a> and insufficient engagement with those with lived experience<\/a> \u2013 including trans people and clinical experts working in gender affirming care.<\/p>\n According to Kennedy, the review also disregarded the level of harm caused by denying youth with gender dysphoria access to puberty blockers and hormone therapy. Her research found \u201cthe harm the UK puberty-blocker ban has caused is truly appalling\u201d.<\/p>\n \u201cThese are young people living in abject misery and severe distress, unable to lead normal lives and socialise with their peers at a crucial time as they are developing into adults,\u201d Kennedy told Guardian Australia.<\/p>\n Sign up: AU Breaking News email<\/sub><\/a><\/p>\n \u201cThe psychological harm they were experiencing was very significant and included extreme levels of stress, anxiety, fear, trauma and increased suicidal ideation.\u201d<\/p>\n Her study, published in the Journal of Gender Studies in June<\/a>, found that these harms were constant, pervasive and all-encompassing.<\/p>\n After bans were introduced in Queensland and New Zealand<\/a>, Kennedy said her \u201cinitial response was of absolute horror\u201d.<\/p>\n \u201cThis ban will harm trans children,\u201d she said.<\/p>\n \u201cNot might, may or could. Will.<\/p>\n \u201cSome \u2026 will take their own lives. They [politicians and policymakers] may choose to ignore this inconvenient fact, but their actions will be directly responsible for harming children.\u201d<\/p>\n Asked about the Cass review in 2024, Queensland\u2019s then health minister, Shannon Fentiman, described the state\u2019s Children\u2019s Gender Service as \u201cone of the best in the country<\/a>\u201d and said \u201call trans young people deserve access to high-quality and timely healthcare\u201d.<\/p>\n But after defeating her Labor party at an election later that year, the Liberal National government issued a directive blocking doctors in the public system from prescribing puberty blockers<\/a> or hormones for gender dysphoria in new young patients.<\/p>\n Then, in November, the New Zealand government announced a similar ban<\/a>, only to delay its introduction<\/a> pending <\/a>a judicial review<\/a>.<\/p>\n Rachel Hinds is the chief executive of the Open Doors Youth Service, which offers mental health support and help accessing healthcare to the LGBTQ+ community. She said was given no notice ahead of Queensland\u2019s puberty blocker ban.<\/p>\n \u201cWe\u2019re now supporting a number of families who have their young people on suicide watch,\u201d Hinds said.<\/p>\n \u201cI was talking to one mum after the pause on puberty blockers, who was just was sobbing down the phone to me and saying: \u2018The goalposts have changed for us now. We just need to keep her alive\u2019.<\/p>\n \u201cIt is taking an incredible toll.\u201d<\/p>\n Puberty blockers pause the onset of puberty and prevent the development of associated physical characteristics. This is fully reversible and gives adolescents time to explore their gender identity before any further steps are taken.<\/p>\n Gender-affirming hormones such as oestrogen or testosterone, which produce physical changes aligned with the young person\u2019s gender identity, may also be prescribed. Some effects of hormone treatment are irreversible without surgical intervention.<\/p>\n Governments implementing bans have cited concerns over the quality of evidence regarding long-term effects of puberty blockers, adopting a precautionary approach.<\/p>\n A spokesperson for Queensland\u2019s health minister, Tim Nicholls, said that \u201cin light of the divergent and inconclusive evidence around the world\u201d, the government had appointed psychiatrist Dr Ruth Vine \u201cto lead an independent team to investigate and report on the evidence and to provide policy advice for consideration\u201d.<\/p>\n Despite Vine finding that with proper and cautious oversight, standards and appropriate reporting, \u201cthere can be benefit for a young person in being able to access puberty blockers,\u201d Nicholls extended the ban until 2031<\/a>.<\/p>\n What the Cass review \u2013 and governments in the UK, Queensland and New Zealand \u2013 appear to have ignored is that most paediatric medicine operates on a low to moderate-quality evidence base, according to the paediatrician and biomedical researcher, associate professor Ken Pang.<\/p>\n This is because conducting large studies in children is often impossible, unethical or unfeasible \u2013 in part because there may not be enough children with a certain condition.<\/p>\n \u201cThose of us working in the field readily acknowledge the need for more high-quality evidence to continue to strengthen care further,\u201d said Pang, from the Melbourne Children\u2019s Research Institute.<\/p>\n \u201cBut it\u2019s important to realise that the quality of evidence in this field is similar to that of most other areas of child health.<\/p>\n \u201cThis continual focus on the evidence completely disregards the other two pillars of evidence-based medicine, which are patient values and clinical expertise.<\/p>\n \u201cIf politicians and policymakers are interested in families\u2019 best interests and in promoting best practice health care, then they need to up-lift the voices of the young people, parents and clinicians with knowledge and direct experience in this field.\u201d<\/p>\n Pang is a member of <\/em>the National Health and Medical Research Council\u2019s gender guidelines development committee,<\/a> which is drafting recommendations for the care of trans and gender diverse children with gender dysphoria. He said he was commenting based on his clinical experience, and that his views do not necessarily reflect those of the committee.<\/p>\n \u201cMany of the people who criticise gender-affirming care have never actually worked with transgender young people, but that doesn\u2019t stop them from claiming to be experts in the area,\u201d Pang said.<\/p>\n \u201cI know that if I was diagnosed with cancer, then I\u2019d be seeking advice from an oncologist, not listening to some other random doctor.\u201d<\/p>\n This has led to misinformation<\/a>, including that providing access to puberty blocking and hormone medications to gender-questioning children is a standard form of treatment and \u201ctoo easy\u201d to access, Pang said.<\/p>\n But documents released under freedom of information laws<\/a> from the Australian department of health show that puberty blocker prescriptions are not routine treatments for youth with gender dysphoria or incongruence.<\/p>\n The documents cite an independent review of Queensland\u2019s gender clinic, which found out of the total cohort of children and adolescents who attended an initial session at the clinic between February 2023 and April 2023, most (71%) had not been prescribed gender-affirming hormone treatment and puberty blockers at least 12 months later.<\/p>\n The review also found the service to be safe, evidence-based and consistent with national and international guidelines.<\/p>\n Similarly, only 23% of those attending a large clinic in Victoria over a 10-year period had started puberty blockers.<\/p>\n The documents note that the UK\u2019s Commission on Human Medicines recommended ongoing restrictions on prescribing puberty blockers due to insufficient evidence for this specific use, not because of any new safety concerns.<\/p>\n The medicines themselves remain safely used in for conditions such as precocious puberty, endometriosis and fertility preservation during cancer treatment, the commission found.<\/p>\n \u201cThere are now trans people in their late 40s who were prescribed puberty blockers [as children], so if there were any significant long-term harm caused, we would know about it by now,\u201d Kennedy said.<\/p>\n Research has also found fast access to gender-affirming care is crucial <\/a>for those who need it.<\/p>\n But in recent years, healthcare for gender-questioning youth has become increasingly politicised, and misinformation is rampant, making it more difficult for youth to access care when they need it, said Dr Ronita Nath, the vice-president of research at the Trevor Project.<\/p>\n The organisation is the leading nonprofit for LGBTQ+ youth mental health in the US. In 2024, a first-of-its kind study<\/a> co-authored by Nath found state-level anti-transgender laws in the US had led to a direct increase in recent suicide attempts among a sample of more than 61,000 youths.<\/p>\n \u201cIt\u2019s understandable to have questions,\u201d Nath said.<\/p>\n \u201cHowever, stripping young people of this life-saving care only results in causing them harm.<\/p>\n \u201cIt is deeply disappointing to see lawmakers, in any country or community, take action to prevent transgender and non-binary young people from receiving access to best-practice medical care.\u201d<\/p>\n In Australia, the crisis support service Lifeline<\/a> is 13 11 14. In the UK and Ireland, Samaritans<\/a> can be contacted on freephone 116 123, or email jo@samaritans.org<\/a> or jo@samaritans.ie<\/a>. In the US, you can call or text the 988 Suicide & Crisis Lifeline<\/a> at 988 or chat at 988lifeline.org<\/a>. Other international helplines can be found at befrienders.org<\/a><\/em><\/p>\nThe Queensland situation<\/h2>\n
\u2018Evidence\u2019 limitations<\/h2>\n
Politicisation fears<\/h2>\n