Transgender teenagers under the age of 16 should be able to access hormone therapy in some circumstances, according to new guidelines published in the Medical Journal of Australia.
The new Australian guidelines published on Monday say doctors should recommend hormone therapy not based on an “inflexible” chronological age but on the child’s individual circumstances, in a bid to reduce their risk of depression and anxiety.
The individualised care would depend “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,” the report reads.
Associate Professor Michelle Telfer, director of the Royal Children’s Hospital Gender Service in Melbourne and acting President of the Australian and New Zealand Professional Association for Transgender Health (ANZPATH), is the lead author of the new advice.
She told SBS News the international guidelines for transgender children written by the World Professional Association for Transgender Health were last published in 2011, and the new guidelines better reflect the progress made in trans medicine.
“The [new Australian] guidelines are the most progressive and clinically relevant guidelines that exist internationally at this point in time,” she said.
“What we know now is that transgender children and adolescents experience high rates of stigma and discrimination, bullying, social exclusion and abuse and as a consequence of all of those negative experiences the mental health outcomes for this population are very poor.
“But with supportive care, affirming care and access to medical interventions at the right times those harms can be reduced and in some cases ameliorated.”
Prior guidelines stated that medical intervention should not start until the age of 16 to avoid possible regret over the treatment, SBS News reported.
Professor Telfer said a Dutch study which looked at patients from 1972 to 2015 found the number who regretted hormone treatment was low, and research had shown starting intervention as young as 13 or 14 is more beneficial than waiting until 16.
“The rate of regret is very low, as low as 0.4 to 0.6 per cent,” she said.
“It’s not at all controversial within those with expertise because we all know that we have been doing this for years.
“The consequences of not treating are known to be severe in terms of depression, self harm, suicide.
“Clinicians need to weigh up the benefits with the risks rather than just sticking to an inflexible age.”
The new guidelines were developed in consultation with clinicians, trans community members and families, and support organisations, the authors said.
In March, the Family Court of Australia ruled that children no longer have to seek court approval to undergo hormone therapy if they have the support of their parents and doctors.
About 1.2 per cent of Australian adolescents identify as transgender.
According to a 2017 study by the Telethon Kids Institute, 80 per cent of transgender people under the age of 24 have self harmed, while almost half have attempted suicide.
If you need someone to talk to, help is available from QLife on 1800 184 527 or online at QLife.org.au, Kids Helpline on 1800 55 1800, Lifeline on 13 11 14, or beyondblue on 1300 22 4636.
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