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WHO is really developing guidelines for transgender health?

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One of the subtle tricks used for parliamentary inquiries on contentious issues is to hold public consultations over December and January, while Christians are otherwise occupied and everyone is on holidays.

More often than not, there is a religious freedom bill or report or something similar to digest over the Christmas break.

This year the inquiries in Australia are not directly about religious freedom issues, but certainly affect them.

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First, there is a bill that seeks to change the law in a way to require defendants in anti-discrimination cases to pay the costs of the person complaining against them if the complainant is successful on just one ground.

Under the proposed law, even if the one successful ground was among a number of other frivolous or vexatious claims, the defendant would nonetheless be required to pay all costs, even those related to the spurious claims.

Blind Freddy would be able to see that this will only encourage complainants to make a complaint on as many grounds as possible, in the hope that even one sticks and funds their whole endeavour.

Second, there is a Productivity Commission inquiry into its draft report on philanthropy. I hope to unpack this report in the coming weeks but among my favourite proposals in that report is the suggestion that the Commissioner of the Australian Charities and Not-for-Profits Commission should be able to suspend or remove the leader of a religious charity and appoint someone of their choosing.

But quite possibly the most extraordinary Christmas “consultation” gift came from the World Health Organisation (WHO), as it sought consultation on the 21 people it has entrusted with developing guidelines for transgender health.

The list of proposed appointees was announced on 18 December, with submissions on the appropriateness of the list due on 8 January 2024.

Without wanting to impugn the motives of WHO, one might think that if it was serious about seeking feedback on its nominees, it would not have chosen a three-week period where most of the world is taking a break.

Fortunately, the Society for Evidence-based Gender Medicine (SEGM) was paying attention, and quickly got the word out about WHO’s plans.

SEGM noted that many of the 21 proposed members of the group appeared to have conflicts of interest for the task ahead. Many of them are members of pro-trans organisations, several identify as transgender or non-binary, and others have published many articles promoting a gender-affirmative model of care.

In contrast, none of the proposed members appear to be medical professionals who have called for a more cautious approach to the use of puberty blockers, cross-sex hormones and surgery. For example, a key oversight in WHO’s nominations is Dr Hilary Cass, the former President of the Royal College of Paediatrics and Child Health in the UK who has, for more than three years, been chairing the independent review of gender identity services for children and young people in that country.

It was Dr Cass’ interim report that resulted in the closure of the UK’s Tavistock Clinic, because the report noted—among other things—that staff reported being under pressure to adopt “an unquestioning affirmative approach” to gender transition, and there was a lack of data tracking the outcomes for children treated by the clinic.

It is difficult to see how a balanced group of experts would not involve Dr Cass or someone similar.

According to WHO, this group of 21 will meet from 19-21 February to formulate guidelines for the “provision of gender-affirming care, including hormones; health workers education and training for the provision of gender-inclusive care; provision of health care for trans and gender diverse people who suffered interpersonal violence based in their needs; health policies that support gender-inclusive care, and legal recognition of self-determined gender identity.”

While three days might seem rushed for the development of guidelines in such a contentious and ever-developing space, the topics listed for the guidelines are clearly weighted in favour of pushing medical practitioners towards affirmative treatments and pushing legislators to adopt a definition of gender that has no connection to biology.
Looking at it this way, three days is more than sufficient for the group to arrive at a pre-determined outcome.

What relevance is this WHO group to health care in Australia?

If the guidelines issued by this group are biased towards a gender-affirmative approach, it could have significant influence on the policies of Australian peak medical bodies around the treatment of children experiencing gender dysphoria, as well as what governments across the country do with issues around so-called conversion practices, the risks posed to children by puberty blockers and more.

When it comes time for these debates in Australia, we should be wary of anyone who claims the WHO guidelines as the reason to push a gender-affirmative approach because unfortunately, it isn’t immune from ideological influences.

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