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Queensland’s ban on gender-affirming care for minors faces a Supreme Court challenge, based on a lack of consultation and concern for the interests of the children. By Cheyne Anderson.
The fight to overturn Queensland’s trans ban
On January 28 of this year, the same day President Donald Trump signed an executive order threatening to criminalise the provision of gender-affirming care to minors, the Queensland state government made a surprise announcement of its own. It ordered a freeze on new public patients under 18 accessing treatment for gender dysphoria.
Less than a year ago, Queensland’s model of gender-affirming care was recognised as the best in the country. The new bans on puberty blockers and hormone treatments – also known as stage one and stage two hormone therapy, respectively – make it the most restrictive of the states and territories in regard to treatment for trans minors.
For the 491 young people on the waiting list for the Queensland Children’s Gender Service, the impacts were immediate – families faced the painful decision of forgoing treatment or entering the costly private system. Advocates in the state were left wondering why they were not consulted on the decision.
“We really didn’t have any forewarning, and that really left us scrambling,” says Rachel Hinds, chief executive of Open Doors Youth Service, Queensland’s only dedicated LGBTIQ+ SB organisation for young people.
This lack of consultation forms part of a legal challenge lodged on May 6, spearheaded by a Queensland mother and her transgender child – neither of whom can be named for legal reasons.
In addition, new information is emerging that questions the legal and medical basis upon which the Queensland Health director-general, Dr David Rosengren, directed the ban. Advocates are concerned it was influenced by overseas culture wars inappropriate for the Australian medical context, and that it puts the mental health outcomes of trans and gender-diverse minors at risk.
A statement of reasons provided by the director-general, seen by The Saturday Paper, shows Dr Rosengren’s sole consultation regarding the decision occurred at 10am on January 28 over a Teams meeting with health service chief executives. As reported by The Guardian, Health Minister Tim Nicholls’ press conference announcing the ban started at 10.06 that same morning.
“It’s a fake consultation to try and tick the box,” says Paula Gerber, professor of international human rights law at Monash University. “The decision had already been made and I therefore don’t think it satisfies the legal requirements for consultation”.
The Saturday Paper can also reveal that in order to establish that the directive was compatible with human rights law in that it protects children “in their best interest”, Rosengren relied solely on a report in Britain led by paediatrician Dr Hilary Cass. Rosengren wrote that the Cass review “recommended, among other things, that the ‘evidence based [sic] underpinning medical and non-medical interventions in this clinical area must be improved’ ” and that the review has “prompted fresh consideration of medical interventions for trans and gender diverse young people internationally”.
The Cass review, which was published in April 2024, was used as the basis for criminalising gender-affirming care for minors in the United Kingdom.
A number of organisations warned against its adoption in the Australian healthcare system, including the Royal Australian and New Zealand College of Psychiatrists (RANZCP), the Royal Australian College of General Practitioners (RACGP), ACON community health organisation and the Australian Professional Association for Trans Health (AusPATH).
“The Cass review’s recommendations just don’t fit the Australian model,” says Eloise Brook, chief executive of AusPATH.
“The medical profession does not put a lot of weight or credence in its findings because of the make-up of the review panel and the environment in which it was undertaken,” says Monash’s Paula Gerber. “What’s being centred in the discussion is the views of gender-critical feminists.”
The Cass review is one of the few that critics of gender-affirming care can point to in support of their case, says Matthew Mitchell, a lecturer in criminology at Deakin University who studies the legal regulation of hormones. He says the review is being “instrumentalised” amid uncertainty around gender-affirming care for young people, “when in fact it stands alone among a legion of evaluations that have supported [such care]”.
In response to questions from The Saturday Paper, a spokesperson for Queensland Health said that it would be inappropriate to comment while an application relating to the health directive is in the Supreme Court.
Rosengren’s statement of reasons does not mention the independent investigation released in July 2024 by the then Labor state government into the use of puberty blockers at the Queensland Children’s Gender Service (QCGS), following reports of breaches of care. The investigation found only a third of the 547 patients were being prescribed stage one or two hormone therapy, and that the unit provided “effective care” with no evidence of coercion.
Former Queensland health minister Shannon Fentiman said the findings of the review showed the QCGS is “one of the best in the country”.
In his statement of reasons, Rosengren noted concerns over the Cairns Sexual Health Service (CSHS). Nicholls claimed in his media statement the service had provided care that “may not have aligned with Australian treatment guidelines”. The nature of the allegations and the findings of a preliminary review cited in the ban are vague.
Documents obtained under freedom of information and seen by The Brisbane Times show two complaints regarding “parental engagement in the consent process” from the families of patients receiving hormone therapy. The risk assessment acknowledges that the model of care set by the Queensland Children’s Gender Service deals with consent of estranged parents on a case-by-case basis.
The CSHS has been closed to new patients since November 2024.
The state Liberal National Party vowed to ban puberty blockers at the national party conference in late 2024. Guardian Australia has reported a Queensland LNP official on the eve of the conference claimed in an email that the state had been “captured by transgender ideology”.
In the Queensland Supreme Court, the transgender child’s mother is represented by Matilda Alexander of LGBTI Legal Service. She contends that “disrupting access to vital health care for hundreds of Queensland children” is an improper use of state power.
Meanwhile, the political firestorm ignited by the ban has had an enormous impact on the lives of trans and gender-diverse youth in the state. Rachel Hinds, who says almost all of Open Doors Youth Service’s client base identify as trans or gender diverse, notes their service has seen a 78 per cent increase in referrals this year alone. Their counsellors can take no new clients.
The ban “has had a significant impact”, says Hinds. “I just want to make it really clear that to access any kind of medication in this state is a two-to-three-year process. It’s not taken lightly.
“What puberty blockers do is they prevent puberty from happening, which lessens gender dysphoria, meaning that young trans people aren’t growing into a body that they don’t feel correctly represents who they are. It gives them time to think without having to worry about that. It improves mental health while they’re going through an incredibly difficult time in life.”
The ban “was one hell of a shock,” says one Queensland mother, whose child was due to begin puberty blockers within weeks of the announcement. She says the ban triggered a scramble to access appropriate doctors in the private system, where they face upfront costs of up to $739 for a single dose of puberty blockers.
“I had to ask my pensioner mother to pay for it,” she says. “We’re in a cost-of-living crisis, my rent is huge, that’s my biggest expense. I just didn’t have enough spare income.”
She says there was no alternative. Her child, who had been socially transitioned for a few years prior, faced entering the wrong puberty. A recent review of research by youth mental health foundation headspace found puberty blockers are associated with reduced depressive symptoms and suicidal ideation. Trans people are known to experience poorer mental health compared with the broader queer community, with the Australian Institute of Health and Welfare reporting more than half of trans men have attempted suicide in their lifetimes.
Another parent of a transgender child, who had been due to start puberty blockers in the first week of March, described having their access denied after years on the waitlist as emotionally and financially devastating.
“I thought at one stage that if I wasn’t alive, my husband could use my super to pay for it.”
Deakin University’s Matthew Mitchell describes restrictions in gender-affirming care for minors as “the new frontier for conservative and religious fundamentalist groups”.
He points out that hormone therapies are not controversial in any other context, such as in treating hormone-sensitive cancers or precocious puberty.
“It’s always peculiar that [puberty blockers] get uniquely politicised in this one specific domain.”
Rachel Hinds agrees. “It’s less about the medication and more about the questioning of whether young people know who they authentically are … I sit at tables with trans kids every single day and what I can tell you is that they are the most courageous, the most authentic young people you will ever meet.
“They turn up as themselves every single day, even though there is a war against their identity and who they are. And that just blows me away.”
This article was first published in the print edition of The Saturday Paper on May 17, 2025 as "Gender politics".
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