Opinion: National Guidelines needed before law reforms

It is timely, given the election media frenzy over statements made by Warringah candidate Kath Deves on gender medicine for minors, that the Tasmanian Law Reform Institue has released its long awaited final report on proposed legislative reforms on Sexual Orientation and Gender Identity conversion practices.

It is reasssuring to note that the Tasmanian Law Reform Institute, while not a medical authority, recognises that the affirmative approach to treatment of gender related disorders has no consensus.

Unfortunately, the TLRI report failed to make any reference to the release last year by Dr Phillip Morris, President of the National Association of Practising Psychiatrists (NAPP) – of their Guideline for Managing Gender Dysphoria in Young People. The NAPP Guideline is the first to promote a compassionate, cautious and caring approach to the treatment of gender dysphoria in young people by any health organisation in Australia. 

The NAPP Guideline states

‘Psychotherapy for gender dysphoria in children and adolescents is a respectful, supportive and exploratory process that does not seek any particular outcome in relation to gender identity or sexual orientation. It seeks to understand the nature and meaning of the young person’s gender distress and the context in which it has arisen.  Psychotherapy addresses the multiple factors that contribute to the young person’s difficulties, helping to address issues that resolve distress and support ongoing development and maturation. Conversion therapies, on the other hand, aim to achieve a pre-determined outcome, such as gender normativity or heterosexual orientation. Psychotherapy for gender dysphoria must NOT be conflated with conversion therapies.’

The Tasmanian Law Reform Institute’s suggestion that the Chief Civil Psychiatrist should be responsible for regulating clinical guidelines in consultation with appropriate professional bodies is a process that would better conducted at a national level.

In October 2019, NAPP wrote to then federal Health Minister Greg Hunt ,requesting that he set up a Parliamentary Inquiry and joint committee to inquire into the ongoing controversy of the treatment of children and adolescents under 18 and to establish a set of national practice guidelines. 

Also, in 2019 a petition signed by over 260 health professionals was sent to Greg Hunt calling on the Minister to establish a wide ranging Parliamentary Inquiry. An issue also omitted from the TLRI Final Report and their recommendations.

A cautious approach for general clinical guidance for the treatment of gender dysphoria in minors has been adopted recently by Sweden, Finland, France and the United Kingdom, and most recently in Florida USA. Meanwhile in Australia, the affirmative model continues to be criticised by an ever increasing number of health professionals, parent, LGB and women’s groups. 

In NAPPs Guidelines it states ‘In Finland, the recommendation is that among young people with gender dysphoria and significant psychiatric comorbidity no conclusions can be drawn on the stability of the gender identity of the child’. 

The contentious issue of what defines conversion practices more generally does not receive much attention in the TLRI report. Additionally, many of those who made submissions pointed out that sexual orientation and gender identity are completly different and that the conflation in law of sex and gender needs to be reviewed.

Most notably, claims that the roll out of gender identity programs in the Tasmanian education system is causing many children becoming confused about their gender identity, and along with social contagion through social media, many otherwise LGB children are ‘converting’ to trans. World Professional Association of Trans Health (WPATH) Board Members and whistleblowers Dr Marci Bowers and Dr Erica Anderson, recently spoke out about the impact of social contagion on the alarming increase in numbers of especially girls presenting with Rapid Onset Gender Dysphoria.

The summary, the TLRI final report appears to lack academic rigour, balance and significantly lacks any examination of the adverse impacts on gender dysphoric adolescents from the affirmative only approach. Detransitioners, increasing in numbers, are not mentioned in the report or the alarming rise in the number of children who are being harmed by medical and surgical procedues such as puberty blockers and cross sex hormones. Harms that Dr Marci Bowers and Dr Erica Anderson from WPATH brought to international media attention early this year, and which I formally wrote to the TLRI to inform them of at the time.