Endocrinology Update, Australia
18 July 2013
A paediatric endocrinologist has been given court approval to start
urgent puberty-suppression LHRH treatment for a 13-year old orphan
diagnosed with gender dysphoria.
In proceedings outlined in the Family Court of Australia
<http://www.austlii. edu.au/cgi- bin/sinodisp/ au/cases/ cth/FamCA/ 2013/518. html>
, the endocrinologist had been asked to provide treatment to the child
who had been born as a female but strongly idenitified as a male.
The child, whose privacy has been protected, was described as being on
the cusp of puberty and had already started menstruation. The judge
was told that if puberty proceeded, female body maturation changes
would soon become significant and changing them in the future to
permit the child to become an adult male would require very extensive
The child had consulted with a psychiatrist and a clinical
psychologist and been described as having insight appropriate for
their age and “insight with respect to gender far advanced for their
The endocrinologist had recommended “urgent” commencement of LHRH
Analogue Therapy, which involved the administration of Lucrin for
suppression of oestrogen and progesterone as three-monthly injexctions
to halt further progress of puberty.
However, as the child was an orphan and living with foster parents
there was a question as to who could provide consent for the child to
undergo the gender dysphoria treatment, the court heard.
The judge accepted that the treatment was reversible, in that if the
Lucrin treatment was stopped, the child’s normal pubertal development
would continue. He ruled that the treatment was in the child’s best
interest given the high long term risk of psychological and social
adverse effects of untreated gender dysphoria.
“It seems to me, the child’s erstwhile views have, for some time,
manifested themselves in him aligning himself as a male, dressing as a
male and evidencing a desire socially and at school to be treated as a
male,” the judge said.
He ruled that in the absence of both natural patents, consent for
treatment could be authorised by the head of the relevant government
department on behalf of the child until the individual was old enough
to consent for themselves.