Trans Medicine
Insight this week asks members of the trans community about striking the right balance as medical pathways for trans minors in parts of Australia – and around the world - become restricted.
In Australia, people under 18 generally require guardian consent and a diagnosis of gender dysphoria (also referred to as gender incongruence) for medical practitioners to provide gender-affirming treatments.
However, legislative changes in Queensland and the Northern Territory mean doctors in the public system can no longer prescribe gender-affirming medication to new trans patients under 18. Patients already accessing this care can continue their treatment.
Not all trans and gender diverse people experience gender dysphoria, and the term itself is contentious due to the concern it stigmatises trans healthcare as a mental health condition.
In 2019, the World Health Organization approved changes to its ICD-11 manual (effective 2022) to declassify transgender health issues as mental disorders and reclassified "gender incongruence" under sexual health.
"Gender dysphoria" still appears in the American Psychiatric Association's diagnostic manual (DSM-5) as a diagnosis of distress that can help provide access to medical treatment and support.
Gender-affirming medical treatments currently available in Australia to trans youth include puberty blockers, gender-affirming hormone therapy (GAHT), typically from age 16, and in rare cases, gender-affirming chest surgery (more commonly known as 'top surgery').
Puberty blockers, administered in the early stages of puberty, are a medication that temporarily suppresses sex hormone production to delay puberty and its physical changes, such as breast development or voice deepening.
Teens usually around age 16 and adults can be prescribed GAHT, which is the medical administration of estrogen or testosterone to help align a person's secondary sex characteristics (such as body fat distribution, voice pitch and body hair) with their gender identity.
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