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Puberty blocker pause leaves patients ‘languishing’


Jo Roberts


29/01/2025 5:32:45 PM

GPs caring for young trans people in Queensland will face ‘a very hard time’ following a pause on hormone therapy for under 18s.

Transgender health.
Gender affirmation therapy will be unavailable to potential new patients aged under 18 in Queensland while a State Government review is conducted.

A GP expert has slammed the Queensland Government’s pause on gender-affirming hormone therapy for trans people aged under 18, fearing it may spread to other states and territories.
 
On Tuesday, Queensland Health Minister Tim Nicholls announced an immediate pause on new trans patients under the age of 18 from accessing hormone therapies in the state’s public health system.
 
It follows the announcement of an investigation of paediatric gender services at the Cairns Sexual Health Service, which has in turn triggered the broader statewide review.
 
Minister Nicholls said he has ‘serious concerns’ about the current provision of Stage 1 (puberty suppression with puberty blockers) and Stage 2 (gender-affirming hormones) hormone therapy to patients under the age of 18 in the state’s public health system.
 
Children’s Health Queensland currently operates the Queensland Children’s Gender Service (QCGS), which, as of June 2024, has 547 children and adolescents actively receiving care.
 
Patients already on a treatment plan with QCGS will be exempt from the pause.
 
RACGP Specific Interests Transgender and Gender-Diverse Healthcare immediate past Chair Dr Michelle Dutton said the move would leave young trans people ‘languishing in uncertainty and fear for their future’, and place Queensland GPs at the coalface of distress among young trans people, their families and communities.
 
‘This decision is being framed as being about protecting young people, but this kind of blatantly political decision, and the media coverage that results, significantly increases hostility towards trans people in the community,’ she told newsGP.
 
‘This will be a very hard time for GPs who look after trans young people in Queensland. Young people and their families will be experiencing all kinds of emotions – fear, despair, anger, helplessness.
 
‘GPs will be on the frontline of helping to manage this distress and will inevitably have times where they feel all of these feelings themselves.’
 
Dr Dutton said the time between seeking medical affirmation and being provided with it is a time of particularly high stress and distress for patients, and fears this pause would further lengthen that period.
 
‘Trans young people can also struggle with school avoidance, depression and anxiety and disordered eating relating to gender dysphoria,’ she said.
 
‘Being able to medically affirm their gender can be transformative in managing these issues.’
 
Dr Dutton said the review of one Queensland healthcare service provider did not justify a statewide halting of treatment.
 
On 4 January, the Queensland Government announced it would not support expansion of the QCGS and had paused further delivery of the evaluation recommendations, pending further consideration by Government.
 
‘There is contested evidence surrounding the benefits of Stage 1 and Stage 2 hormone therapy for children and adolescents with gender dysphoria emerging from studies throughout the world,’ Minister Nicholls said.
 
‘The purpose of the broader review is to undertake an independent and robust investigation of best practice in this field.’
 
However, Dr Dutton argued that the Queensland service had already proven successful.
 
‘There had already been an independent report into the Queensland Children’s Hospital gender service in 2024, which found not only was its care excellent, but that more funding should be provided to allow them to expand the service and make it more accessible statewide,’ she said. 
 
Dr Dutton said there was ‘absolutely’ a concern that the treatment pause could make its way into other states and territories.
 
This is an area of healthcare that has and continues to be shamelessly politicised – and nowhere in Australia is completely safe from that,’ she said.
 
She encouraged GPs to connect with each other to ensure they were aware of what support they could still offer young patients who could not access puberty blockers or gender-affirming hormones.
 
‘Things like menstrual suppression for trans masculine people, or referrals to speech therapy for gender-affirming voice training can make an enormous difference,’ Dr Dutton said.
 
Dr Dutton encouraged GPs to look after themselves during what she feared could be a challenging time.
 
‘Our challenge as GPs is to not let that concern morph into despair or hopelessness, because then we are no good to our patients or ourselves,’ she said.
 
‘We need to come together, support each other and keep providing the best care that we can for our patients.
 
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Dr Ian Truscott   30/01/2025 11:07:03 AM

First do no harm.
This is one of the ways well-meaning doctors can be sucked into a patient's delusion, rather than addressing the main problem.
Don’t make permanent changes likely to be regretted later .


Dr Lise Susan Legault   30/01/2025 3:26:30 PM

What wonderful news. Most GPs will support the principal of first do no harm and will be in favour of children having supportive care including watchful waiting and psychological support. Blocking puberty and cross sex hormones at a young age before children have a true understanding of themselves is of course concerning and experimental.
I hope the election of Trump and his endorsement of their only being 2 sexes will help give confidence to the clinicians advocating for evidence medicine and the safe guarding of children and adolescents. After the age of 18, patients can make an informed decision about what is right for them.

I definitely hope this common sense will spread to other states and Territories.


Dr Bilal Khan   30/01/2025 11:06:47 PM

It is a reasonable decision from Queensland health and should be adopted by other states as well. Some common sense prevailed. Children should not be given these hormone therapies except in very special circumstances. Children should not be harmed.


Dr Kate Frances Douglas   1/02/2025 1:53:21 PM

Some of the above comments above are abhorrent - referring to Trans people as having 'delusions' or agreeing with Donald Trump that there are 'only 2 sexes' despite living breathing evidence of otherwise. Terrifying to me that doctors who make these comments are seeing patients who may be experiencing gender dysphoria and are looking for help.


Dr Annette Hackett   2/02/2025 12:41:33 PM

I'm so sorry to any trans folk reading the above comments. Just reassuring you that not all RACGP members feel this way. Puberty blockers are safe and effective, and most of us support you in your quest for health and identity.

18 is not some magical age that we suddenly discover our identity. And puberty blockers allow young people the time and space to make important decisions and discoveries about themselves.

There are allies out there - please find them and let them support you.


Dr K   9/02/2025 2:13:38 PM

As a GP with a neurodiverse child, and having had gender dysphoria/body image disorder as a child, I think examining our approach to puberty blocking and hormonal interventions in children who seek these treatments, almost all of who are neurodiverse, is worthwhile.
Psychology, radical self-acceptance and body affirmation got me through to a fulfilling self-image without medications or surgery and it has been the path of others who have recovered, including desisters and detransitioners.
I am concerned that neurodiversity and the implications of that on identity formation is not adequately understood yet. We need time to formulate a more considered approach to these children given their increasing numbers and the long-term implications on their wellbeing, and the medicolegal implications if we are getting any part of this wrong.


Dr K   10/02/2025 9:31:54 AM

As a GP with a neurodiverse child, and having had gender dysphoria/body image disorder as a child, I think examining our approach to puberty blocking and hormonal interventions in children who seek these treatments, almost all of who are neurodiverse, is worthwhile.
Psychology, radical self-acceptance and body affirmation got me through to a fulfilling self-image without medications or surgery and it has been the path of others who have recovered, including desisters and detransitioners.
I am concerned that neurodiversity and the implications of that on identity formation is not adequately understood yet. We need time to formulate a more considered approach to these children given their increasing numbers and the long-term implications on their wellbeing, and the medicolegal implications if we are getting any part of this wrong.