Australian clinicians call for halt of gender affirming interventions

Over 100 Australian clinicians have signed the letter calling for the halt of gender affirming interventions.

Read below:

OPEN LETTER TO AUSTRALIAN HEALTH BODIES REGARDING GENDER-AFFIRMING INTERVENTIONS

As clinicians, we call on our professional bodies and regulatory authorities to urgently acknowledge and respond to recent international and local developments in the field of youth gender medicine. These developments indicate that what is known as the “gender affirmative treatment” model (GAT), currently used in Australian public youth gender clinics, risk the health and well-being of vulnerable children and adolescents.

The UK Cass Review[1], widely recognised as the most comprehensive review of paediatric GAT, and a growing number of systematic reviews[2] conclude the evidence for puberty blockers and cross-sex hormones for young people with gender dysphoria is weak and uncertain.

Invasive treatments such as puberty blockers, cross sex hormones and surgery hold known and potential risks of harm. These include sterility, urogenital and sexual dysfunction, effects on bone, brain and cardiovascular health.

Due to the above, countries including Finland, Sweden, Norway, Denmark, Brazil and the UK have all recommended their use be restricted in minors.

Current Australian standards ignore evidence supporting a normally timed puberty leading to resolution of symptoms in approximately 85% of children with gender dysphoria[3]

A guideline review undertaken as part of the Cass Review (2024)[1] rated the ‘Australian Standards’ 19/100 for rigour of development.

The Federal Circuit and Family Court of Australia recently relied on the findings of the Cass Review1 and clinical expert evidence in Re Devin[4].

In his judgment, Justice Strum:

  • Endorsed the Cass review.
  • Regarded the risk of harm from puberty blockers as “unacceptable.”
  • Rejected the idea that gender identity is innate and immutable.
  • Criticised the gender clinic’s policy of unreserved affirmation.
  • Found that a senior gender-affirming clinician had failed in her duty of impartiality as an expert witness.
  • Found the gender clinic lacking in its approach to assessment, diagnosis, and therapeutic options.

The judiciary has set an example of considered, evidence-based, developmentally appropriate analysis, which Australian health bodies have so far failed to adopt, leaving Australian clinicians in legal jeopardy.

A US Health and Human Services  review of treatment for paediatric gender dysphoria[2], released 1st May 2025, found that there has been a “rapid expansion and implementation of a protocol that lacked sufficient scientific and ethical justification” and “when confronted with compelling evidence that this protocol did not deliver the health benefits it promised, and that other countries were changing their policies appropriately, the US medical professionals and associations failed to reconsider the “gender-affirming” approach.” 

Australian health bodies need to respond to this compelling evidence to avoid the same error.  

We call on Australia’s peak medical and professional bodies and institutions to cease the use of puberty blockers, cross-sex hormones, and surgery for children and adolescents due to the lack of evidence of benefit and known risks of serious harm. We request unambiguous advice to the profession that clinical practice should align with the Cass Review[1] and the National Association of Practising Psychiatrists (Australia)[5], which recommends psychosocial support as the first-line intervention for young people with gender-related distress.

References

[1] Cass, H. (2024). Independent review of gender identity services for children and young people. NHS England. https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143633/https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf

[2] Treatment for Paediatric Gender Dysphoria: review of evidence and best practices. Department of Health and Human Services 1 May 2025. https://opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report.pdf

[3] Singh, D., & Zucker, K. J. (2021). A follow-up study of boys with gender identity disorder. Frontiers in Psychiatry, 12, Article 632784. https://doi.org/10.3389/fpsyt.2021.632784

[4] Federal Circuit and Family Court of Australia. (2025). Re Devin (FedCFamC1F 211). https://www.fcfcoa.gov.au/judgment?field_judgment_type_target_id=187&page=0

[5] Morris, P. Managing gender dysphoria/ incongruence in young people: a guide for health practitioners. National Association of Practicing Psychiatrists 8th June 2025. https://napp.org.au/napp-statement-on-gender-dysphoria-in-young-people/ 

Signatories

Dr Louise Kirby MBBS(Hons1) FRACGP, Dip RANZCOG

Dr Catherine Llewellyn MB BChir (Cantab), AMC, FRANZCP, Cert, Child Adol, Psych.(RANZCP)

Dr Stewart Oxley Doctorate Clinical &Health Psychology, BPsych( Hons), MAPS

Dr Alison Clayton MBBS MPM FRANZCP

A/Prof Peter Parry MBBS PhD FRANZCP Cert Child & Adolescent Psychiatry

Dr Jillian Spencer MBBS FRANZCP Cert Child & Adolescent Psychiatry

Dr Andrew Amos MBBS(UQ), FRANZCP Senior Lecturer, James Cook University

Dr Roberto D’Angelo PsyD, MBBS, M.Med (Psychotherapy) FRANZCP

Dr Eamonn Mathieson MBBS FANZCA

Dr Aniello Iannuzzi MBBS FRACGP ACCRM

Prof Dianna Kenny PhD MAPsS, University of Sydney Association of Professors

Dr Patrick Clark MBBS FRANZCP

Dr John Whitehall MBBS BA DCH MRCP (UK) FRACP MPH and TM.

Dr Christopher Davis MBChB MBA MMed FRACP FAMA

Dr Shannon Morton MBBS(Hons1) FRANZCP Adv Cert Child and Adolescent Psychiatry

Dr  Yekaterina Polyakova-Nelson MBBS FRANZCP

Dr Nicholas Rosoman BPsych (Hons), MBBS(Hons), MRACGP MADF

Dr Randy Juanta BMBS/GP/Emergency Medical Officer

Jane Clarke RN private practice

Dr Leena Chaugule MBBS, FRANZCP

Dr Neilson Wright MBBCh FRACS

Dr Karen Smit MBBCh FRACGP

Dr Ben Symon MBBS, FRACP PEM

Dr Frances Wilson MBBS FRANZCP

Dr Don Bornstein MBBS, DPM, FRANZCP

Dr Melinda Boyd MBBS, FRANZCP, Cert Child and Adol. Psychiatry, MPH

Dr Philip Morris AM MBBS, BSs med, PhD, FRANZCP, FAChAM (RACP)

Dr Jacqueline Condon BMedSc, MD, FRANZCP, MHL, Specialist Cert. in Forensic Psychiatry

Dr John Warlow MBChB, FRANZCP, Adult, Child and Family Psychiatrist

Dr Shannon Abeywardena MD FRACGP

Siobhan Cokell  Former RMN/ Mental Health Practitioner (retired)

Dr Rachel Bradley MBBS FRACGP 

Dr Rachel Hannam Phd Psychology, University of Queensland

David Pirie M Soc Work, Grad Cert Health Studies, B Soc Work UQ

Stacy Barnes, MS Provisional Psychologist

Patricia Weerakoon MBBS (Sri Lanka); MS(Hawaii); MHPEd (UNSW)

Martin Feckie former RN (retired), MSc Health Services Management

Dr Simon Barritt MBCHB, FRANZCP

Dr Al Griskaitis MBBS (Sydney), FRANZCP

Shannon Clarke MPsych (Clin) Registered Clinical Psychologist

Dr Wakinyjan Tabart   MBBS FRACGP, MTH, DCH. 

Barbara Bantos BSocSc, MSW

Inger Richardson Bachelor of Applied Science (Diagnostic Radiography), Grad Dip Sonography.

Dr Marcus Tabart MBBS FRANZCP

Dr Peter Seha General Practitioner (VR)

Timothy Fischer M.Psych (clin) clinical psychologist. 

Tony Bradley Nurse Practitioner

Dr Peter Nesbitt MBBS, FRACGP, FACRRM, Dip (Adv) RANZCOG   

Dr Linda Thomas BSc (Hons), MSc (Hons), PhD

Jasmine Sussex Breastfeeding Advocate BA (Public Relations) MA (Politics) 

Dr Michael Paul Burt MBBS, FRANZCA, FCICM

Roshanak Vahdani BA(Psych), MA(Psych) MAPS

Kelly Wright RN/registered psychiatric nurse grade 3

Elizabeth Gillanders Bachelor Social Work

Jane Flanagan Occupational therapist, Master’s in public health

Dr Carl B Scott MBBS, FANZCA, FCICM

Assoc Prof Mike Sladden MBChB, MAE, MRCP(UK), FACD, FRACGP, MRCGP, DRCOG

Dr Belinda Doherty MBBS FRACGP AFRACMA MHA

Vivienne Chapman Registered Nurse, Clinical Nurse Consultant Emergency

Dr Guy van Hazel Clinical Professor of Medicine, School of Medicine and Pharmacology, UWA

Dr Vincent Keane MBBS, DipRACOG, MPH&TM, FAFPHM (RACP) Retired

Dr Kerrie MacDonald MBBS FRACP

Helen Shanahan Registered Psychologist

Dr Gabrielle Elliot Mental Health Nurse Practitioner

Dr Dylan Wilson MB BCh MRCPCH FRACP

Dr Diana Whitehead MBBS FRANZCP

Dr Jennifer Wells MBBS FACD

Dr Robert Brennan BSc (Hons1) MBBS

Dr Serene Lim MBBS

Professor Gerald B Fogarty BSc MBBS FRANZCR PhD

Dr Terrence Neal Kent MBBS (Qld) FRACGP NFPMC

Dr Deirdre Little MBBS FRACGP

Dr Mary Walsh MBBS FRACGP

Dr Julian Fidge BPharm, MBBS, FRACGP, MMed (Pain Management)

Dr Umberto Paolo Villa, MBBS

Dr Michael Knight BSc, MBBS, FRACS Orthopaedic Surgeon

Dr Eugene D’Souza. MBBS (Hons), FRACP.B.Physio, MHlthServMt, AFCHSM

Ms Margaret Morton RN RM BN BEd Grad Cert Emergency Nursing, CNC

Annmarie Hosie PhD RN Assoc Profess, School of Nursing & Midwifery, UNDA

Dr Peter Duffy MBBS (Hon), DDR (Syd), DDU, DRACR, FAMA, FAICD, MRCR, FRANZCR

Dr Johnny Khoury, GP BSc (Med) MBBS FRACGP DCH DRANZCOG

Dr Benjamin McOwan BBiomed MD

Dr Pamela Jean Ho MBBS, BSc (Med), FRACP, PhD

Dr Richard McMahon, MBBS, FANZCA

Dr T John Martin AO MD FRACP FRCPA FAA FRS Emeritus Professor of Medicine UO Melbourne

Dr David Chee MBBS, DipRACOG, FRACGP

Dr Peter Hanley MBBS BSc. FRACGP

Roger Bowen Advanced Diploma in Health Science, Paramedic (retired)

Dr Joanne Wright MBBS MGerMed FRANZCP Cert

Dr John Obeid MBBS FRACP

Dr Mark Patterson MBBS(Hons) SpecCertClinLead FACEM

Dr Caitlin Byrne MBBS, MScMed(RH&HG), BSc

Dr David Kardachi BMed, BSc(Hons) RACGP member

A/Professor M. McDonough FAChAM-RACP (Life Fellow).

Dr Paul E Adams MBBCH, FRACP, FCPaed, DCH, MMEd, FSCAI

Dr Mark Hanley BSc(USyd), MBBS(UQ), FRACGP, Master Health, Prof.Ed(UNDA)

Dr Jonathan Chia GP MBBS, FRACGP 

Dr Rhonda Buskell MBBS FRANZCP

Dr Frank New MBBS FRANZCP FFPMANZCA.

Dr Larry Hermann MBBS MPM FRANZCP Cert Child Psychiatry

Dr Mary Stavropoulou MBBS FRACGP

Dr Julie Sladden, MBBS BMedSci PGCertMedEd, Retired Medical Doctor

A/Prof Luke Torre MBBS (hons) FANZCA FCICM

Dr Stephen Myers MB BS BSc (Med) JCCA FRACGP Dip Child Health

Margie Stuchbery MA(Psych) FCCLP MAPS