A public gender clinic claims it has no data on how many children it is putting on hormone therapy or what their sexes were at birth, despite taking in the vast bulk of NSW teenagers who want to change gender. Maple Leaf House in Newcastle received 443 new referrals in 2023 and saw 983 patients. That compares with only 63 new referrals at Sydney’s major children’s hospital gender clinic at Westmead, where 149 were seen. The service is prescribing puberty blockers, found to have “unproven” effects by the UK Cass review and banned by the NHS, Finland and Sweden from use outside of clinical trials, at the highest rate in the country as a proportion of patient caseload. Maple Leaf House has been unable to reveal in response to FOI requests either the natal sex at birth of its patients, which is not kept on a central record system, or how many of its patients have been placed on cross-sex hormone therapy, which frequently follows the prescription of puberty blockers.
An upcoming journal paper by academic psychiatrist Andrew Amos has revealed previously unknown data on the number of Australian children being treated at children’s hospital gender clinics and calls for greater transparency amid major data omissions. The figures were obtained under Freedom of Information laws by NSW Labor MP Greg Donnelly. The paper reveals 420 children were prescribed puberty blocker medications in 2023 in children’s gender clinics in NSW, Queensland, WA and Victoria, with the highest rates of prescription at the Queensland Children’s Hospital gender clinic and Maple Leaf House, where almost one in four patients was given the drugs. The NSW Crown Solicitor told Mr Donnelly during an FOI legal challenge that Maple Leaf House could not reveal the number of adolescents prescribed cross-sex hormone drugs, given to older teenagers because “there is no extractable data field in the Patient Information System” used by the service in relation to the prescription of such drugs and “nor is a manual register maintained with respect to this information”.
Mr Donnelly said ahead of Dr Amos’s new paper: “The failure to have and maintain a detailed record-keeping system for patients at Maple Leaf House is nothing short of a scandal. Maple Leaf House operational procedures make the UK’s failed Tavistock Gender Identity Clinic’s look good.” Maple Leaf House forms part of NSW’s expanding statewide program of gender clinics, which is taking place despite some of the state’s most senior specialised clinicians in the field based at The Children’s Hospital at Westmead backing away from gender-affirmative medicine. NSW Health is in the process of establishing a hub to treat teenagers within the South Eastern Sydney Health District, despite not yet receiving the results of an evidence-check review it has ordered of its own policies. NSW Health did not comment directly on the record-keeping deficiencies at Maple Leaf House but said under its new statewide network of gender clinics “appropriate data collection to inform clinical care, service monitoring and management, and evaluation is a key aspect”.
“NSW Health continues to monitor developments in the evidence to ensure the care we provide remains consistent with national and international best practice,” the department said. Gender clinics nationwide do not publish any information about their case load or prescription patterns, and clinicians, health executives and ministers are refusing to acknowledge the relevance of the findings of the UK Cass report to Australia. That refusal is despite the British review demolishing the evidence for the prescription of puberty blockers, which have been given to many hundreds of children under the auspices of Australia’s public hospital adolescent gender clinics during the past five to 10 years and are still being prescribed. The prescription is continuing in the wake of the Cass report concluding that “the rationale for early puberty suppression remains unclear, with weak evidence regarding the impact on gender dysphoria, mental or psychosocial health”.
The report states, “there seems to be a very narrow indication for the use of puberty blockers in birth-registered males as the start of a medical transition pathway in order to stop irreversible pubertal changes” and that “other indications remain unproven at this time”. Australian gender clinics argue they already are pioneering the kind of multidisciplinary, decentralised approach that the Cass report has recommended in Britain. Dr Amos, a James Cook University academic who chairs Australia’s psychiatry college’s rural psychiatry section, has called in his upcoming article for the identification of “clear treatment goals and annual reporting” to ensure safe, effective care. “The central principle of the gender affirming model of care is that all health clinicians have an ethical responsibility not to question or evaluate patient reported gender identity, even when that identity is unstable, changes rapidly, and is comorbid with severe mental illness,” he says. “Data suggests its rollout in Australia has not been cautious or transparent.”
Source: Compiled by APN from media reports
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