News outlets reported last week that the Victorian Supreme Court had allowed a 12-year-old boy to be administered puberty blockers, without the consent of his father. The decision comes as the Federal Family Court is dealing with another case where one parent is in favour of the administration of puberty blocking drugs to a child and the other one opposes.
Whatever the news reporting, it seems to me that the decision of Justice Melinda Richards in the Victorian Supreme Court will have very little bearing on matters such as these.
In the Victorian case, no one was objecting to the child being given puberty blockers.
The Royal Children’s Hospital—Australia’s epicentre of placing children on a “gender-affirming” pathway—was unsurprisingly in favour of the puberty blockers. The boy’s mother, known in the court documents as AB, was also in favour. The boy, known as CD, also wanted them administered.
The question before the court was whether CD’s father, long absent from the child’s life, needed to consent to the prescription of puberty blockers. The dad had not had any involvement in the child’s life for more than a decade, and he had not been involved in any of the parental decision-making up until that point.
The effect of the decision was that the Royal Children’s Hospital did not have to actively seek out the absent father before prescribing the puberty blockers. Justice Richards had nothing to say about what would have happened had the father been around, or if he had objected.
In reading the decision, two key problems were apparent to me. The first is that the administration of puberty blockers is treated by the courts as being the same as any other medical treatment.
This is not new, of course. It is the result of Re Jamie, a 2013 decision of the full court of the Family Court. However, the way Justice Richards expressed it was jarring: “[The] legal requirements for consent to stage 1 treatment for gender dysphoria [puberty blockers] are no different from those that apply to any other medical treatment to which a parent may consent—such as childhood vaccinations, surgery to mend a broken bone, or chemotherapy to treat cancer,” she wrote.
This wasn’t necessarily the opinion of Justice Richards; she was just stating the law as it has been for the last ten years. The comparison of puberty blockers to life-saving chemotherapy or the mending of a broken bone is nevertheless unsettling because these other examples are not the subject of significant scientific disagreement.
I don’t know of any serious body of scientific research that questions the appropriateness of surgery to mend broken bones or chemotherapy to reduce the effects of cancer. However, the same cannot be said of the use of puberty blockers to treat gender dysphoria.
As I have written many times, there is increasing opposition to the use of puberty blockers on minors. The United Kingdom, Sweden and Norway have all banned their use.
This brings me to the second problem with the case: there was no one present to present evidence to the court about the questions around the use of puberty blockers, nor to question whether their use was appropriate. The absence of a contradictor in this matter led to some problematic commentary in the decision.
In speaking of puberty blockers, Justice Richards wrote: “This treatment halts the progression of the physical changes that come with puberty, but is reversible and may be stopped at any time … If she later becomes unsure about her gender identity, she can stop the treatment.”
With respect to the judge, the statement that the effects of puberty blockers are reversible is not correct. A study from Westmead Children’s Hospital’s gender clinic reported that they cause a decrease in bone density, while the most comprehensive study in the world—the recent Cass Review from the UK—found that there was inconsistent evidence about the effects of puberty suppression on things like cognitive development, cardio-metabolic risk or fertility.”
Even the World Health Organisation, which cannot be accused of being ideologically opposed to gender transition, recently said that the evidence base for gender-affirming treatments for children and adolescents is “limited and variable.”
No one presented this evidence to the court and so the judge made her decision based on the evidence before her. This is a real problem in these cases. Many things have changed since 2013 and Re Jamie: the number of children seeking puberty blockers has risen exponentially, and the evidence against their use is also increasing.
To solve a matter like this, legislative intervention is required. The question becomes whether there is a government courageous enough to take the short-term popularity hit for the long-term safety of children.