The Queensland government has announced an immediate ban on hormone treatments through the public health system for new patients under the age of 18.
Health Minister Tim Nicholls also announced an independent external review into the evidence for stage one and two hormone therapies, puberty blockers and cross sex hormones.
“The review will encourage the participation of clinicians and professionals with relevant expertise, as well as young people with lived experience and their families,” he said.
Mr Nicholls said there had been an “apparently unauthorised provision of paediatric gender services” within the Cairns Sexual Health Service, resulting in 17 children receiving hormone therapy that “may not align with the accepted Australian treatment guidelines”.
Two separate investigations will take place into the Cairns Sexual Health Service, one analysing the governance framework and the other investigating the services delivered.
“Patients who are already on a treatment plan with the Queensland Children’s Gender Service will be exempt,” Nicholls said. “I’m advised that medically that is the appropriate procedure to follow.”
“The pause will remain in effect until such time as the government considers and acts on the outcomes of the broader review.”
Psychiatric and psychological treatments, counselling, and other clinically recommended medication interventions will still be offered to children experiencing gender dysphoria.
“We want people to know that they will be supported,” Mr Nicholls said.
“We owe it to children to ensure that care is grounded on solid evidence and that we act in this contested area and this developing area with caution.”
The ban will remain in place until the outcomes of the report are assessed by the government, which will take place within 10 months of a reviewer being appointed.
Ban could have “catastrophic impacts” for trans and gender diverse young people
The move has been condemned by queer advocacy groups around Australia.
Spokesperson for Just.Equal Australia, Rodney Croome, said the Queensland government were barring young trans and gender diverse people from receiving lifesaving treatments.
“While we support any inquiry the state may conduct into an individual service, this shouldn’t be used as an excuse to bar access to gender affirming care across the state.
“The Queensland Government’s decision runs against a recent Family Court decision in Queensland, re Ash, in which Justice Peter Tree received clinical evidence for and against hormone treatment and decided it be immensely beneficial to some young people.
“Young transgender people, their families and doctors should be able to make important health decisions free from meddling by politicians.”
Australian Professional Association for Trans Health (AusPATH) CEO Eloise Brooks reiterated the necessity of puberty blockers and hormone therapy for children experiencing gender dysphoria.
“When that young person is insistent and persistent about their gender identity, is displaying all of the signs that they are a gender diverse young person and that gender affirming care is the right path for them, then where do they go after that? What’s your next access point?
“Access to healthcare, the provision of healthcare, needs to be based upon the science, on clinical practices. Best practice, not politics.”
A study published by JAMA Paediatrics earlier this year found that fewer than 1 in 1,000 U.S. adolescents with private health insurance received gender-affirming medications between 2018 and 2022.
More than five million patients aged 8 to 17 were assessed, with 926 of these patients receiving puberty blockers, and 1,927 receiving hormones.
No children under the age of 12 were prescribed puberty blockers.
“Queensland is now an outlier state,” said EqualityAustralia in a statement. “This extreme position from the Queensland Government will have catastrophic impacts on the health and wellbeing of trans and gender diverse young people.”
“This decision is at odds with expert consensus from around the world, health services in every other state and territory and the current evidence base.”
Recent independent review found care “safe, evidence-based”
An independent review comprised of a panel of experts last year found that the care being provided at the Queensland Children’s Gender Service was safe, evidence-based, and adhered strictly to national and international guidelines.
There was no evidence of coercion, malpractice, or inadequate mental health screenings prior to the administration of puberty blockers and other gender-affirming treatments.
The review was triggered after allegations of children and families being pressured into gender-affirming care.
While Mr Nicholls acknowledged the review, he said that it failed to examine the “evidence base” for stage one and stage two hormone therapy.
“The evaluation that was undertaken was in the nature of how is the service delivered, not whether that service ought to be delivered,” he said.
Nicholls announced only earlier this month that the Queensland Children’s Gender Service would be expanded, and that a steering committee would oversee the implementation of all 25 recommendations of the review.
He later rescinded the decision, making an appearance with Deputy Premier Jarrod Bleijie, who said the government would halt any further delivery on the recommendations.
“We remain very concerned about the use of those puberty blockers, particularly in light of evidence that’s coming in from around the world.”
The Queensland Liberal and National Party voted at their 2024 conference to ban puberty blockers to minors outside of clinical research trials, based on the recommendations of the Cass Review.
The Cass Review was a significant motivator behind the United Kingdom’s indefinite ban on puberty blockers in the treatment of transgender youth, which was enacted in December last year.
Lydia Jupp
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