Hormones

AMA backs doctors opposed to hormone therapy for transgender youth


The AMA’s Queensland branch has added its support to conservative doctor groups who oppose the use of hormone therapy for young people with gender dysphoria.

In a submission on state government proposals to ban gay conversion therapy, the AMA says an unintended consequence of the legislation may be to criminalise medical practitioners who recommend other approaches such as psychotherapy as part of a ‘wait and see’ approach for young people with gender dysphoria.

AMA Queensland said it strongly supported the view of Dr Philip Morris, President of the National Association of Practicing Psychiatrists (NAPP), whose submission warned that gender dysphoria  may be a transient phase in young people “due to the influences of social contagion, multiple psychosocial factors (including a history of sexual abuse), and the presence of psychiatric illness.”

The AMA cited Dr Morris’s statement that: “Questions arise about the capacity of the child to make decisions related to medical interventions (hormonal and surgical) necessary to transition to the preferred gender. These interventions have long-term consequences and are often permanent. Some will have adverse effects on the health of the individual. At what age and at what level of cognitive sophistication does a child have the competence to make these decisions?”

It called for national guidelines on gender dysphoria treatment in young people to be developed by a working group that would include medical colleges representing specialists such as endocrinologists, paediatricians, and psychiatrists, with input from the NAPP.

“AMA Queensland believes these guidelines, which would set the necessary practice guidelines for the assessment and treatment of children and adolescents under the age of 18 years presenting with gender dysphoria for all health practitioners, would eliminate any non-therapeutic practices which are occurring in this field overnight.”

The NAPP’s position was backed by submissions from the Christian Medical and Dental Fellowship of Australia and  numerous individual medical practitioners, all of whom highlighted the side effects and uncertain efficacy of puberty blocking hormone therapy.

“With such widespread uncertainty of positive effect but the certainty of deleterious side effects, I write to request the Parliament not to oblige therapists to pursue the hormonal intervention and to permit the alternative psychotherapeutic support, which has been shown to be effective in the past,” wrote Dr James Yun a physician specialist in allergy and immunology.

A submission from the RANZCP said it supported the legislation to ban gay conversion therapy but the broad definition of conversion therapoy needed a more specific wording to “exclude  treatments and practices that provide evidence-based acceptance, support, and understanding for the facilitation of an individual’s coping, social support, and identity exploration and development” in gender dysphoria.

“It is important that individuals questioning their gender or considering treatment can be appropriately counselled and supported using an evidence-based approach with reference to accepted professional standards,” it said.

In 2018, clinicians at the Royal Childrens Hospital in Melbourne published “Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents” in the MJA.

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