Carmen Pace, Clinical Psychologist and Research Fellow, Murdoch Childrens Research Institute
Ken Pang, Clinician Scientist Fellow and Paediatrician, Murdoch Childrens Research Institute
Michelle Tollit, Research Officer, Murdoch Childrens Research Institute
Today the first guidelines specific to the health-care needs of transgender and gender diverse children and adolescents have been released in the Medical Journal of Australia.
Gender identity is a person’s innermost sense of who they are – male, female, a blend of both or neither. Most children grow up thinking of themselves as a girl or a boy and don’t question their gender. But some children and teenagers identify as a gender that’s different to the sex they were assigned at birth. This is often referred to as being gender diverse, or transgender.
Being transgender or gender diverse is now largely viewed as part of the natural spectrum of human diversity. For some people, this is just part of who they are, and it’s not a cause of concern. Others experience gender dysphoria – the distress related to the mismatch between one’s sex and gender. It’s the reason many seek help from health-care professionals.
Our clinic is the largest paediatric gender service in Australia. In the last five years referrals to our service have increased tenfold. Rising referral rates have also been reported in many other countries across the Western world.
Although more research is needed, we know supportive, gender affirming care during childhood and adolescence contributes to improved mental health and well-being.
As gender diversity is an unfamiliar area for many people, the guidelines include a list of commonly used terms. Language is rapidly evolving and people may use words in different ways. An important part of providing affirming and respectful care is to understand and use inclusive language. For example, when we see young people, we often ask what name and pronouns they would like used to build rapport and affirm their gender identity. Read more via the Conversation
Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents
Abstract
Introduction: The Australian standards of care and treatment guidelines aim to maximise quality care provision to transgender and gender diverse (TGD) children and adolescents across Australia, while recognising the unique circumstances of providing such care to this population. Recommendations are made based on available empirical evidence and clinician consensus, and have been developed in consultation with Australian professionals from multiple disciplines working with the TGD population, TGD support organisations, as well as TGD children and adolescents and their families.
Main recommendations: Recommendations include general principles for supporting TGD children and adolescents using an affirmative approach, separate guidelines for the care of pre-pubertal children and TGD adolescents, as well as discipline-based recommendations for mental health care, medical and surgical interventions, fertility preservation, and speech therapy.
Changes in management as a result of this statement: Although published international treatment guidelines currently exist, challenges in accessing and providing TGD health care specific to Australia have not been addressed to date. In response to this, these are the first guidelines to be developed for TGD children and adolescents in Australia. These guidelines also move away from treatment recommendations based on chronological age, with recommended timing of medical transition and surgical interventions dependent on the adolescent’s capacity and competence to make informed decisions, duration of time on puberty suppression, coexisting mental health and medical issues, and existing family support.