Episode 8

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Welcome back for the final episode of Desexing Society Season 1. I’m your host, Stassja Frei. Episode 8: What next?

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Finland, Sweden, England and Florida USA, have all taken significant steps to wind back the gender affirmative model for minors. Journalist Bernard Lane, who we met in episode 2, has been closely following these developments.

Bernard Lane

Yeah well Finland was the first in 2020 and it was the gender clinicians themselves who realised that the Dutch protocol was not producing the positive outcomes that it was supposed to, so they did a systematic review, I guess it was probably the first of the systematic reviews, looked very carefully at the evidence base and decided that the Dutch protocol couldn’t apply at all to the new group of patients, primarily adolescent females with multiple problems and so the Finnish moved to a more cautious approach where you deal with all the mental health issues first, you deal with the social and schooling issues because it may be that they are the real issues and don’t get fixated on gender. And then Sweden was the next, 2021 I think, the famous Karolinska hospital which had a gender clinic, youth gender clinic – it seems that the managers inside that hospital became alarmed, not the clinicians. And the Karolinska in effect, puberty blockers and cross sex hormones had been routine first line interventions and the Karolinska said, no, not anymore, we’re going to have first line interventions that are more psychological and the hormonal interventions are going to be strictly controlled.

Investigative journalism by Sweden’s public broadcaster definitely helped put the brakes on youth gender medicine. In 2019 they aired a documentary, The Trans Train, which explored the new presentation of rapid onset gender dysphoria, as well as the negative side effects of puberty blockers. It also featured the devastating accounts of detransitioners. Referrals to youth gender clinics dropped by 30% after the program aired. Two years later, Karolinska hospital announced puberty blockers and hormones for minors would be restricted to clinical research studies only. Then in 2022, Sweden’s National Board of Health & Welfare, released the findings of their systematic review. They found the evidence base for hormonal interventions was weak.

In Florida USA, it seems that politics played a part in bringing about changes to youth gender medicine. First, the federal department of health and human services, working under the Democrats, released a fact sheet promoting the gender affirmation model as best practice. Republican led Florida, took issue with it. In April 2022, Florida’s Surgeon General, Joseph Ladapo, hit back. He released a fact check of the federal government document and the Florida Department of Health released their own guidance for treating youth gender dysphoria. The guidance highlighted the lack of conclusive evidence for hormonal treatments and advised against social transition and medical interventions for minors. In a press release, Florida’s Surgeon General said, “The federal government’s medical establishment releasing guidance failing at the most basic level of academic rigor shows that this was never about health care. It was about injecting political ideology into the health of our children.” The Deputy Secretary for Medicaid was asked to investigate whether such treatments are consistent with generally accepted professional medical standards and not experimental. 

Less than 2 months later, in June 2022, the investigation was complete. The evidence for medical interventions was found to be weak to very weak. And, puberty blockers do not improve mental health. A year later, in June 2023, Florida governor Ron DeSantis signed into law a ban on puberty blockers, hormones and surgeries for minors. 

Meanwhile in England, similar to Finland, staff working at London’s Tavistock gender clinic became concerned. 

Bernard Lane

A reasonable number of staff were disturbed at what was happening, worried about whether or not they were unnecessarily medicating kids, I mean you know the line was, are we medicating autistic kids, are we medicating gay kids, will there be any gay kids left? So there was a lot of concern about the fact that as the years went on, a rather different very troubled patient group arose – mostly teenage females with lots of mental health problems, autism and some struggled with possibly first signs of same sex attraction and according to the staff, a number of whom became whistle-blowers, too often these kids were simply being assessed for puberty blocking and the wider issues which may in fact have been the true cause of the distress were not properly examined. 

In 2020, BBC’s Newsnight aired an investigation into the Tavistock clinic, featuring some of those whistleblowers.

Bernard Lane

The other thing about Tavistock I suppose is the media environment was very different. I just think that the traditions of the press and of really robust commentary and investigative reporting – they go much deeper in the UK than they do in Australia – probably in most other anglophone countries. And so reasonably early on there was very good investigative reporting. Hannah Barnes whose book we now have, she did a lot of that for the flagship BBC investigative TV program Newsnight. But there was also very good reporting in the Observer, in the Times, the Sunday Times, The Telegraph, the Economist and I think that that, together with the willingness to run judicial review, made a huge difference. 

In Australia, only one investigative news program has covered the harms of gender medicine. And it wasn’t the ABC or SBS, it was Channel 7’s Spotlight. In September 2023, they aired an episode called Gender Agenda, which featured detransitioners, and concerned doctors and parents. Unfortunately, unlike in England and Sweden, the program did not spark a national conversation. 

The other significant development which put pressure on the Tavistock clinic was a judicial review brought by detransitioner Keira Bell. She’d been prescribed puberty blockers, cross sex hormones, and had a double mastectomy before realising it was all a big mistake. She was simply a lesbian. Her case reviewed whether children have the capacity to give informed consent to puberty blockers. 

Bernard Lane

The story really took off once Keira Bell as a detransitioner agreed to take part in a judicial review in the English courts and even though in a sort of astrict legal sense the case ultimately failed, it nonetheless drew attention to some really alarming features of what was going on at the clinics.

Initially, the high court found that it was highly unlikely that children aged 13 and under had the capacity to give informed consent. For those aged 14 and 15, it was doubtful they could truly understand the long-term risks and consequences. And for 16 and 17 year olds, the court recommended that clinicians seek court approval for all prescriptions. On appeal, all of this was overturned, handing decision making powers back to the clinicians. 

Even before the high court had made its initial ruling, England’s National Health Service, the NHS, must’ve seen the writing on the wall. They announced a wide-ranging independent review into the Tavistock clinic. Dr Hillary Cass, former President of the Royal College of Paediatrics and Child Health, would lead the review. It included two systematic reviews of the medical literature undertaken by the National Institute for Health and Care Excellence – one for the use of puberty blockers and the other for cross sex hormones. In March 2021 they released the findings of those two reviews, stating that, “The available evidence was not deemed strong enough to form the basis of a policy position.”

Then in February 2022, the Cass Review released an interim report. The key findings were that a single clinic to service the whole country was not a safe or viable long-term option. It couldn’t keep up with demand. There had been no consistent data collection, making it impossible to track patient outcomes. There was a lack of consensus about the nature of gender dysphoria and how to treat it. And quality controls that would usually apply to new or innovative treatments were never introduced.

Five months later, in July 2022, Dr Cass wrote to NHS England with a further update. She recommended the opening of regional centres to treat children closer to home. The centres would take a holistic approach, addressing other mental health concerns like autism and trauma. She emphasised the need for “supportive exploration and counselling”. Importantly, she highlighted the lack of certainty around puberty blockers. Are they a first step in the treatment pathway or are they a pause button, allowing children time to think? If it’s unknown how they affect the brain long term, do they disrupt that decision making process? The rationale for puberty blockers was based on data related to childhood gender dysphoria in boys, not the new patient group of adolescent girls. In light of all this, Dr Cass recommended that research be embedded in the new regional clinics.

Within weeks, NHS England announced the Tavistock gender identity service would close.

Bernard Lane

So Tavistock is really very important internationally because it’s pushed other countries to look more closely at what they’re doing, it’s pushed the Dutch themselves to at least have more of a debate about what’s going on.

Unfortunately, Australia is not one of those countries. Yet. 

So far, Australian gender clinics haven’t really been impacted by the Cass Review. The Australian Professional Association for Transgender Health, AusPATH pointed out that Australia already has multiple, regional gender clinics, unlike England’s single Tavistock service. And they said research and data collection is already embedded in Australian clinics. It’s not clear what they’re referring to here, but it’s true that the Royal Children’s Hospital, in conjunction with the Murdoch Children’s Research Institute, is running a long-term study called Trans20. 

Bernard Lane

This is the sort of flagship long term study for Royal Children’s Hospital and I suppose it’s the flagship Australian long-term study. They started recruiting patients in 2017, they didn’t publish a protocol describing how they’re going about the research until 2019 and that protocol referred to an urgent need for more empirical data and now we’re in 2023 and there’s still no outcome data published. They published some data quite recently but it’s not outcome data it’s about the conditions these kids present with. So I suppose another issue about that study is that they’re not comparing the gender affirming interventions to any alternative interventions, so we won’t know at the end of it whether or not some kind of psychotherapeutic approach might’ve produced better results.

I can’t help but see parallels here with what happened at the Tavistock clinic. You might remember from episode 2, that for years, the Tavistock didn’t publish the results of their study. When they finally did, it showed that puberty blockers did not significantly improve gender dysphoria. Why haven’t the Royal Children’s Hospital published any preliminary finding?

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I’m recording this update on 12 April 2024, about two weeks before this podcast goes live. Two days ago, the Cass Review’s final report was published. It validates much of what you’ve heard in this series. 

A month prior to the Cass Review’s final report, NHS England announced that puberty blockers will no longer be available as routine treatment for children and adolescents. They’ll only be available in exceptional circumstances and as part of research trials.

Cross sex hormones will still be available for 16 and 17 year olds, but the Review advised extreme caution when prescribing them. All recommendations for hormones will be evaluated by a national, multidisciplinary team, who are not directly involved in the care of the patient. The NHS announced that it will, “define the role of gender affirming hormones through the development of a new evidence based national clinical policy which will cover all people over the age of 16.”

The Cass Review also noted that all the problems associated with the gender affirming model also apply to vulnerable young adults aged 18-25. The Review recommended the new regional clinics see patients up to the age of 25.

As part of the Review, the University of York undertook a systematic review of international guidelines for the treatment of youth gender dysphoria. They identified 23 such guidelines. Only the Swedish and Finnish guidelines were found to be credible and even they couldn’t be directly applied to the NHS setting. The supposed gold star Australian Standards of Care, developed by Melbourne’s Royal Children’s Hospital, didn’t make the cut. Neither did WPATH’s.

In response to the Cass Review, NHS England announced a systemic review of adult gender clinics will now take place. This appears to be a response to adult gender clinics refusing to cooperate with the Cass Review. Dr Cass attempted to obtain data from the adult clinics to help evaluate long term outcomes of patients who had begun treatment at the Tavistock clinic and then transferred to the adult clinics. Only one of the seven adult clinics agreed to provide the data.

In a world first move, the Cass Review recommended,  “NHS England should ensure there is provision for people considering detransition, recognising that they may not wish to reengage with the services whose care they were previously under.”

In their preliminary analysis of the Cass Review, the Society for Evidence Based Gender Medicine said, “the implications of the Cass Report will likely reverberate worldwide. It now appears inevitable that the arc of history has bent in the direction of reversal of gender-affirming care worldwide, although in some countries it will take considerably longer to change medical practice.”

Australia may well be one of those countries where change takes considerably longer. The ABC reported that Federal health Minister, Mark Butler described the Cass Review as “significant” but clinical pathways in Australia are different to those offered in the UK. He seemed to pass the buck to state and territory health ministers, saying, “Everyone, including the states and territories who are responsible for these services in Australia, will take the time to consider this review.”

Meanwhile, Dr Jillian Spencer, who we first met in Episode 3, spoke with Peta Credlin on Sky News about the implications for Australia.

Peta Credlin: The National Association of Practicing Psychiatrists this morning said that they’re – the Cass Review proves that we must have an inquiry of this scale in Australia, you’re reported as saying, look we don’t need another inquiry, let’s just adopt the findings of the Cass review now, why risk more harm to children. Is that accurate, have I got that right?

Jillian Spencer: Yes, I think we’ve got a fantastic opportunity to not waste time and money on repeating the Cass Review. As part of the Cass Review they commissioned a number of independent systematic reviews of the global research literature, so there’s no reason for us to do that again. If we do want to have an inquiry maybe we maybe could have one into why it was that such poorly evidenced and harmful interventions were just rolled out to children across Australia, whether anyone needs to be held accountable for that and how we can prevent it from occurring in the future and maybe whether we need to set up a compensation scheme for all the children that have been harmed, we may need such an inquiry to come to terms with what’s happened.

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Dr John Whitehall is a paediatrician with over 50 years’ of experience. He was one of the first Australian doctors to raise the alarm about the gender affirmation model. 

John Whitehall

I was in fact the director a neonatal intensive care ward in Townsville, and in that process we were really determined to reduce the stress on the baby’s brain, we were worried about whether it’s getting affected by all sorts of things, hormones that are given to the mother before birth, lack of oxygen obviously, enough food and everything, so I was interested in the science of the brain, you might say I suppose, and I went to a physicians’ conference in Cairns and that was in 2016, in about May and I heard a presentation, I believe it was from the Royal Children’s Hospital in Melbourne, and I had nothing better to do, I just went in and sat down and I thought what is this about anyway and then I heard all this and heard the assurance that the blockers would be safe and entirely reversible and knowing what I had known about the brain, I just couldn’t believe it.

John has written a number of articles for Quadrant magazine, highlighting the dangers of gender affirmation. And he was vocal in opposing the 2016 national roll out of Safe Schools. He went on a speaking tour to warn against the curriculum. He also appeared in a 60 Minutes episode that covered the story of a teenager who started on puberty blockers and estrogen but then changed his mind. The concerns John raised in that episode have since been proven true by systematic reviews of the medical literature.

60 Minutes

Ross Coulthart: Professor Whitehall has grave concerns about giving estrogen to a transgender teen.

John Whitehall: There is no proof that this is going to work. You think that their emotional problems are going to get better by giving them estrogen? Fine. That’s called optimism. It’s not called scientific method. So I think the whole thing is experimental in that sense. 

John’s concerns were easily dismissed by the progressive LGBT+ crowd due to his religious beliefs. He’s a Baptist Christian and was once the deputy president of the Christian Democratic Party. Unfortunately, we’d stopped recording when I asked him about this. He chuckled at being called a fundamentalist Christian, because his particular branch of Christianity isn’t fundamentalist. He said it was his medical training, not his Christian beliefs that first led him to be concerned. His Christian beliefs did, however, lead him to take action.

In 2019, John wrote a 16 page submission to then federal health minister, Greg Hunt. He requested a parliamentary inquiry into youth gender medicine. Shortly after, six other doctors set up a website inviting medical practitioners to add their signature to a letter in support of John’s submission. In just three and a half days, they collected 260 signatures. Then, The Australian newspaper ran an article drawing attention to their efforts. The website came under attack and was inundated with false names. They closed the petition.

John Whitehall

I can’t believe that 120 of us wrote a letter…

Just to clarify, 260 medical practitioners signed the letter, not 120.

John Whitehall

…requesting an investigation from, or by the minister for health and he bounced that sideways to the minsters of health- state ministers who bounced it around and it ultimately went back to the College of Physicians who took a very sort of neutral, they were even more supportive for the affirmation, they were not really neutral and similarly with the AMA. Why would they do that? Have they read the articles? I doubt it. 

Health Minister Greg Hunt wrote to the Royal Australian College of Physicians seeking their advice. They cautioned against a national inquiry, claiming it would, “further harm vulnerable patients and their families through increased media and public attention.”

Although they confirmed the evidence was weak, they parroted the authors of the Australian Standards of Care, claiming there was clinical consensus among experts that affirmation is best. Rather than a need for caution, the College of Physicians recommended an expansion of gender services across Australia. 

There have been other attempts at inquiries. In 2023, One Nation senator Pauline Hanson put forth a motion for a senate inquiry.

Pauline Hanson

If you oppose this, you are telling these Australian families you don’t care about their trauma. You will be telling these families you don’t care about their children. You’ll be telling these families you care more about political agenda than the wellbeing of the most vulnerable people in our Australian society.

The motion failed.

Another attempt was made in late 2023 in the South Australian upper house. Frank Pangallo of the SA-BEST minor party spoke for 34 minutes outlining the many concerns around gender affirmation. 

Frank Pangallo

We must avoid this becoming one of the biggest medical scandals of our time.

Had Premier Peter Malinauskas granted Labor members a conscience vote, the motion would’ve passed. But he didn’t. So Pangallo shelved the motion and the vote didn’t go ahead.

In October 2023, Victorian upper house member, Moira Deeming, who we met in episode 4, also put forth a motion calling for an inquiry.

Moira Deeming

Because it’s not political point scoring that is at stake, it’s the health and wellbeing of children and young people. And I say that everyone should put aside their politics on this issue and do what is clearly and obviously the right thing to do which is to support my motion.

This motion also failed.

In December 2023, Bernard Lane reported that the first independent review of an Australian gender clinic had been announced at Queensland Children’s Hospital. However, the review isn’t investigating whether gender affirming care is safe and effective. Instead, it’ll be looking at whether the Brisbane clinic is adhering to the Australian Standards of Care – the very document that dissenting clinicians view as the problem.

To date, there just hasn’t been the political will in Australia to launch an inquiry. Whether this will change as a result of the Cass Review remains to be seen.

John Whitehall

I think a fundamental issue here is that nobody could believe that major children’s hospitals could embark upon such a program which does not have scientific backing to it. I think that’s unthinkable and when all the dust settles, that may be one of the kind of tragedies out of this, that people now think well hang on, this was a major children’s hospitals and they didn’t read the reprints, they didn’t read the articles and the articles have been round for decades and yet they didn’t read them and they didn’t tell the people about it, they didn’t warn people, they just went ahead. I think there will be, likely to be medico legal consequences of this.

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Anna Kerr is the principal solicitor of Feminist Legal Clinic. A large part of her work is supporting women in domestic violence and discrimination cases. In 2017, her organisation was awarded an accommodation grant by the City of Sydney, giving them free office space to operate from. But that came to an end in 2021 when Sydney councillors voted to evict them. Their crime? Sharing news articles about the conflict between women’s rights and men who claim to be women.

Anna has also provided legal support to women facing discrimination due to their gender critical beliefs. And detransitioners seeking legal advice, have also started reaching out.

Anna Kerr

I get people contacting me and they really want to speak out and then when you actually say yes, look I’ve got a journalist or I want to put you in touch with – they become frightened and that’s particularly the case with detransitioners. It’s a long journey for them to even be contacting me because they’ve often been subjected to so much brainwashing that TERFs are these evil monsters who are filled with hate and so, contacting me is already a huge step, to make that a further step of taking it public, when they’ll be completely ostracised, so if they’ve still got any links with the LGBT community at all and often they do, often they’re still being supported in that community at some level, they’ve still got friends, even if they’ve detransitioned often they’ve still got friends and supporters and if they go public, that they will be completely ostracised and then they’ll lose their only supports and in one case I can think of for instance, they’re still receiving support from a health professional, a psychiatrist who is implicated in what happened to them, so do you know what I mean, they require that emotional support and they’d lose it if they go public or bring litigation. And they’re very very fragile people, this is the thing, you know we hear a lot about how these young people are suicidal before they transition. What we’re not hearing is how suicidal they are afterwards when the initial euphoria wears off, cos there seems to be a bit of initial euphoria, but when that wears off, well, they’re more suicidal, it’s worse than ever and we’re not hearing from those people because they are too fragile and it’s actually quite scary work supporting them because I’m worried all the time that some of the people I’m supporting are, are not going to be there.

Public detransitioners are subject to some of the worst online abuse from transgender activists. They’re bullied and ridiculed. Some receive rape and death threats. Others have been doxxed, meaning their address or phone number is leaked online. Any detransitioner sharing their story for the first time is quickly inundated with hundreds of abusive comments. It’s similar to how Scientology and other cults treat former members.

For detransitioners already struggling to get through each day, opening themselves to this level of abuse must be frightening.

Anna Kerr

It’s quite difficult to find the right client who’s got the ability to stick it out and is not going to be, have their lives devastated in some way by the litigation process and you also have to find the right barristers, as much as I might be willing to do it – I mean especially if you wanted to take it further to the higher courts, you need to have the right team. It’s hard already to find barristers who understand what this is all about.

And there’s the administrative burden. Think about the frustration of gathering all the paperwork for your tax return. Now multiply that by a thousand.

Anna Kerr

Some of them I’ve referred on to a medical negligence firm and when they see all that paperwork that they’ve got to sign up, they just disappear, so they kind of, are very keen and then they kind of disappear again.

In England, a class action lawsuit against the Tavistock clinic appears to be on the way. Law firm Pogust Goodhead is anticipating at least a thousand families will join the litigation. But in Australia, it’s not so easy.

Anna Kerr

People keep saying oh why don’t we have a class action, for a start to get a class action you need like 7 plaintiffs against the same defendant so and this, the way it’s done in Australia, we haven’t got the one Tavistock clinic, we’ve got lots of different places that are doing this stuff so you know it’s complicated and unfortunately if they all go to different lawyers, well it’s going to take a long time before we get the 7 in one place, and, not that class actions are everything, they’re not the be all to end all, litigation is everything because every time a case is brought, it costs the insurance company money. If enough cases are brought, whether it’s a class action or just lots of individual actions. They will then make the premiums higher for those people doing that work and that will then result in change. 

While lawyers at Australian children’s hospitals might not be paying attention, at least one medical indemnity provider is. In May 2023, MDA National announced changes to their coverage. Private practitioners who initiate the prescription of cross sex hormones for patients under the age of 18 are no longer covered. But in the fine detail, prescribing puberty blockers is still covered. In making their decision, MDA National cited “growing criticism globally of the research that underpins medical and surgical transition of children.”

It’s a small step forward for Australia. 

While we might not have a class action yet, there is one legal case underway. Jay Langadinos was 19 when she first met with psychiatrist Dr Patrick Toohey. In their first session he referred her to an endocrinologist for testosterone. A few years later, in their second session, he referred her for a double mastectomy. And in their third consultation, Toohey signed off on a hysterectomy, including the removal of her ovaries. Like Keira Bell in the UK, Jay came to realise that she’s a lesbian, not a trans man. She’s suing Dr Patrick Toohey for professional negligence. 

Five days before Jay’s story was published in the Sydney Morning Herald, The Australian newspaper had covered another detransition story. Ollie Davies was diagnosed with gender dysphoria after just three 45 minute sessions with a psychiatrist. His depression, anxiety and other mental health struggles were ignored. After five years on estrogen, he realised it was a mistake. By then he’d met the love of his life, who he wanted to have children with. Tragically, he discovered the hormones had made him infertile.

In response to these two stories, the AusPATH board of directors released a statement. In it, they said that “gender affirming healthcare is associated with very low rates of regret and de-transition” and “caution must be used when exposing individual stories and extrapolating from them.” AusPATH could’ve used the moment to address the catastrophic consequences of misdiagnosis. They didn’t. Instead, they were essentially saying that detransition is so rare, it doesn’t matter. Don’t listen to detransitioners’ stories. 

Why are gender affirming clinicians so incurious about the cases where they get it wrong? Dr Michelle Telfer, who brought the affirmation model to Australia, gives us some insight into the beliefs of gender affirming clinicians. In an event hosted by the Western Australian Equal Opportunity Commission, she was asked how to best support detransitioners. Apologies, but the audio quality here isn’t great.

Michelle Telfer

Um, well, there’s two points that I’d like to make about this. Uh, the first is that when we look at the research, um, when it comes to people, when – I really dislike the word detransition, cos it’s a really horrible word – but when we look at the numbers, uh, the best study to date comes from Amsterdam, uh, where they’ve been, um, they’ve held the, the largest trans health service for a very long time. And they did a study that looked at all of the, the people that had, uh, utilized their service from, uh, 1972 to 2015, very long period of time. And they looked at the number of people who had regret. Following medical and surgical intervention. Cause there’s more than 6,000 people. And the number that had, um, regret was, um, approximately 0.5%. So half a percent.

Firstly, why does she really dislike the word detransition? Why is it a really horrible word? And what message does this peculiar disdain for the word send to detransitioned people?

Secondly, the Amsterdam study she refers to, where the regret rate is only 0.5%, doesn’t apply to the children and teens being treated today.

The most glaring problem is how the researchers defined regret. Only those who regretted having a gonadectomy, meaning the removal of their ovaries or testicles, were counted as regretters. Obviously, this incredibly narrow definition excludes a vast number of potential regretters, in particular children and teens for whom this surgery isn’t available. But it also excludes anyone who started on puberty blockers or cross sex hormones and then stopped. And girls and women who regretted having double mastectomies, also weren’t counted.

The next big problem is the patient sample. Of the 6,793 patients included in the Amsterdam study 65% were male. This doesn’t reflect today’s cohort where teenage girls account for an estimated 75% of youth referrals. On top of this, 80% of the sample were adult males when they began treatment. Adult transitioners have a greater capacity for informed consent. They’re more likely – particularly back in the 1970s – to have spent time considering their decision, weighing up the costs and benefits. This could’ve contributed to the low regret rate for gonadectomy.

Also, a lot changed between 1972 and 2015 – the period the researchers were looking at. The psychological assessment of patients in 1972 was far more rigorous than the gender affirmation model in use by 2015. That rigorous screening of earlier patients meant only the most serious cases of gender dysphoria would proceed to gonadectomy, thus reducing the likelihood of regret. 

The truth is, we don’t know what the regret rate is. Detransition studies are difficult. Patients who feel they’ve been harmed are unlikely to return to the clinic that harmed them. This can skew the results in favour of those who don’t regret transition. For example, the Amsterdam clinic lost track of 36% of their patients, meaning they weren’t included in that study. We’ll never know how many of that 36% were regretters.

Despite all the uncertainty around the long-term outcomes of childhood transition, gender clinicians are convinced that they’re doing the right thing. Here, Michelle Telfer explains her ethical stance at the WA Equal Opportunity Commission event. 

Michelle Telfer

We know there are risks, but we know there are benefits. And when you weigh it up with the individual in front of you, to deny care is in my view, knowingly doing harm and not, not only is that, um, unethical as a doctor to knowingly do harm, um, it’s actually sometimes exceptionally cruel.

Many argue the opposite, detransitioners especially. Sterility, sexual dysfunction and a permanently altered appearance are a high price to pay for the benefit of those who are happy with the results.

Detransition is hard. Telling friends and family that you’ve made a huge mistake is embarrassing, especially if you’ve argued with them about pronouns and transgender rights. You’ll likely be excommunicated by your queer friends. And it often means your entire worldview is turned upside down because you see that the trans rights movement isn’t what you thought it was. On top of all this, detransitioners have a lot of self-blame to overcome to even reach a point of taking legal action. Anna Kerr explains:

Anna Kerr

But at the moment, we haven’t got enough cases because we’re having trouble shepherding these individuals because it’s a bit like the sexual abuse stuff, it takes so many years for the individual to realise that it was a mistake, to realise they’re not at fault as well. Ya know like cos they’re kind of been complicit in it, you know and that’s how a lot of kids feel who have been sexually abused, it takes years to work through all of this stuff and get to a place where they can get past all the shame and all of that.

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While things are moving slowly in the push to protect children from medical harm, unfortunately, the same can’t be said for protecting kids from the gender identity belief system. In that regard, Australia seems to be at a complete standstill. Gender ideology is firmly embedded in school curriculum, in the education departments, in the teachers union, and in the minds of young teachers.

Psychologist Dr Dianna Kenny, who we met in episode 1, is deeply concerned about what kids are learning in schools.

Dianna Kenny

It’s absolutely nightmarish what’s going on in the education department because they’re educating children into the gender ideology framework and it’s starting at 5 and 6 years of age. I mean that’s how we make extremists, we educate them in the schools, and in the end they’ve only got one ideology, they’re not getting any balanced view, so the education department is probably one of the key factors that needs to change in order to stop this psychic epidemic from being perpetuated and continuing into the next decades. It is to re-educate our children that there are males and females and you cannot change the fact of your sexuality by any means, medical or surgical, so yes, I’m horrifically concerned about what’s going on in schools and so are parents. 

Challenging education departments is easier said than done. Parents at Clifton Springs primary school, near Geelong in Victoria, tried and failed. In late 2023, the school opened two gender neutral toilet blocks. Two years prior, parents were advised in a newsletter that gender neutral toilets were on the way, but that separate boys’ and girls’ facilities would still be available. That’s not how it played out. The single sex toilets were closed due to construction work and only the mixed sex toilets were open.

A lot of parents were upset, citing privacy and safety concerns. Mum Chelsea, whose son went to the school, was one of those parents. First, she spoke to the vice principal. Then she arranged a meeting with the principal. That meeting was rescheduled. Then it was postponed indefinitely. So she called the Victorian department of education. She emailed them, and made an official complaint. She also complained to the Victorian Ombudsman. And then, she received a letter from the Department of Education threatening her with criminal stalking charges because she shared a flier advertising a rally in protest of what was happening at the school. It was then that she went to the media. Peta Credlin invited her on Sky News to tell her story.

Peta Credlin: You’ve been threatened by the education department with criminal action for speaking out on this issue. What concerns you about gender neutral toilets for little kids?

Chelsea: I think the biggest thing for me as a parent is that we’ve always taught our children to protect themselves, to speak up when they feel uncomfortable, and our children have come to us with very legitimate concerns and just a real feeling of unease since these toilets have been introduced into the school, and as parents it’s our job to speak up for a children and we have done so, and I’ve gone through every correct channel possible and I have been blatantly ignored, dismissed, sometimes even belittled, and just, nobody seems to care that our kids are uncomfortable with these new toilets. And we are so aware of the need for safe spaces for gender diverse students, we’re not against unisex toilets, we just want a safe space for boys, girls and unisex facilities, and we want them separate because we believe that every child deserves the right to privacy and dignity and boys and girls are just so different, like their, you know their needs are so different and I just feel like that’s being ignored.

I had a phone call with Chelsea who gave me a lot of details that didn’t make it into the news. Each unisex toilet block contains 8 cubicles. Three for girls, three for boys and two gender neutral. Only the gender neutral toilets have doors that reach all the way to the floor. Some boys had taken to urinating in bottles and sliding them under the door, into the girls’ cubicles. Boys would often use whichever toilet was available, so when girls came to use the girls’ toilets, the seats were covered in urine. One girl had her period which bled through onto her school dress. She tried rinsing the blood out in the communal hand washing area, terrified a boy would walk in. Little grade prep girls were intimidated by the bigger, older boys, so they would avoid going to the toilet, even when they really needed to. Some parents reported that their child would get in the car at school pick up, complaining how urgently they needed a toilet.

Federal Senator Sarah Henderson, the shadow minister for education, stepped in to advocate for the one hundred concerned parents. She demanded the Victorian education minister, Ben Carrol withdraw the threat of stalking charges and apologise. He doubled down, implying in a letter that parents had compromised staff safety and that he fully supports mixed sex toilets. 

The school eventually reopened the single sex toilets which had been closed due to construction. By then, Chelsea and three other families had removed their kids from the school – six children in total. Because all of this happened in term 4, a handful of other families waited out the year, then changed schools in the new year. Another casualty was a teacher, who resigned in protest. 

This complete shutdown of parents’ safeguarding concerns stands in stark contrast to developments in England. There, the Department of Education has released draft schools guidance for gender questioning children. Under the proposed changes, schools will no longer be able to socially transition children without the parents’ knowledge. Schools must provide single sex toilets, changerooms and overnight accommodation. Teachers and students won’t be compelled to use opposite sex pronouns for students. And, it restores girls’ right to single sex sports. It’s a huge step forward. However, if passed, the guidance won’t be legally binding, and teachers unions have pointed out as much. Activist teachers are already saying that if passed, they’ll defy the recommendations. At the time of this recording, England’s schools guidance is yet to be finalised.

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The good news is that most Australians don’t support what’s happening in gender clinics and schools. Polling commissioned by the Australian Christian Lobby found that 74% of Australians oppose any medical interventions for minors. 78% are opposed teaching primary school children that they can change sex. And 74% don’t agree with allowing boys to use the girls’ change rooms or play in girls’ sports. 

Of course, trans activists don’t believe these results. If they were commissioned by the Australian Christian Lobby then they must be biased. Even if that were the case, which I don’t believe it is, those polling results should be a green light for the Liberal National Coalition to take action on these issues. And this is one of the critical differences between Australia and England. UK conservatives have taken a stance. Australian conservatives haven’t. 

It’s hard to know what’s going on with the Liberals. Do they believe humans can change sex? Do they believe boys in the girls’ showers on school swim day is a good thing? Or, have they been cowed into silence by a hostile, pro transgender media? Maybe they’re simply unaware of what’s going on. 

The fact is, this shouldn’t be a left versus right issue. Protecting children from medical harm goes beyond political lines. But any dissenting Labor MPs are severely restricted in what they can do. They risk expulsion from the party if they vote against Labor policy. This makes it unlikely that any change will come from the left. So like it or not, it’s up to the Liberal party to force these issues into the spotlight. Behind the scenes, a small group of parents have been doing their best to make that happen.

Judith Hunter

We really want to get a parliamentary inquiry into these practices that have been rolled out around the world and practices that are now being rolled back in other countries. I don’t know why Australia’s so slow off the mark to not, get on board with what Sweden and Finland and some American states and the UK, the evidence is coming out that there’s never been an evidence base to this protocol that they’re using and I think, I’m hoping it’s inevitable we’ll get an inquiry because I don’t want to see any more young people harmed.

That’s Judith Hunter who we met in episode one. She and other mums have met with federal politicians explaining how gender affirmation has harmed their families. 

Judith Hunter

I think we met about 16 different members of parliament. Pauline was a stand out, she baked us a cake and she was very kind. Peter Dutton, I think he was really shocked to hear our stories, the four mums who we each told a bit of the story of what we’d been through.

Short of a federal inquiry, it’s hard to see how Australia’s public health system will find its way out of this mess. To make matters worse, Queensland, the ACT, Victoria and now NSW have all passed legislation banning not just gay conversion therapy, but gender identity conversion therapy. The Victorian legislation, called the Change or Suppression (Conversion) Practices Prohibition Act, is the most draconian version. It criminalises practices that seek to change someone’s gender identity with penalties of up to 10 years in prison and $10,000 fines. It’s had a significant chilling effect on therapists who disagree with the gender affirmation model. Therapists who might’ve once offered explorative psychotherapy for gender dysphoric minors, are now simply declining such clients. The Victorian government’s fact sheet explaining the Act offers little clarity. It says the law does not ban psychological counselling for children with gender dysphoria. But in the very next paragraph, it says the opposite, that counselling and psychotherapy might be considered conversion therapy. It’s left therapists unwilling to risk having their lives turned upside down with potential legal action. And it’s left parents with nowhere to turn.

Without some sort of government intervention to put the brakes on gender clinics, it may well fall to those most harmed by gender medicine – the detransitioners. Anna Kerr from Feminist Legal Clinic is happy to help.

Anna Kerr

They should come to me and I’ll refer them to a large medical negligence firm and the more we get, I mean at the moment we’ve got so many, I don’t want to go into de- but thing is, the more that we get, then it becomes easier and easier. So they may be able to recover compensation.

Out of all those I interviewed for this series, Dr Dianna Kenny is probably the least optimistic about the future.

Dianna Kenny

We’ve got to put the breaks on this, this is madness, this is absolute madness and there’s going to be tens if not hundreds of thousands of young people from this generation mutilated and damaged for life before this nonsense will stop. And look, I can’t foresee in 10 or 20 years’ time because Australia is still seeking to pass legislation supporting gender affirmation so when it’s going to stop here I don’t know. 

In light of the Cass Review, all predictions are now up in the air. Maybe the Labor Party will swoop in, launch an inquiry and take credit for ending this medical scandal that they’ve been cheering on. Or maybe they won’t and we’ll have to wait for the Liberal Party to be voted back in. Perhaps management or legal departments at Australian children’s hospitals will finally intervene. Or, maybe nothing will happen. Maybe we’ll see no change in Australia for another 5 years. At the moment, it’s impossible to predict.

I have sometimes wondered whether change will come from the kids themselves. If we accept that the current epidemic of gender dysphoria is part of a youth subculture, then it’s destined to lose popularity. Soon enough, it’ll be uncool to be trans or non binary and the next youth trend will take its place. 

In the meantime, a good starting point would be dialogue and civil debate. No one should lose their livelihood for raising concerns about child safeguarding. Framing all criticism of the gender affirming model as transphobic bigotry just doesn’t stand up to scrutiny. Everyone you’ve heard from in this series is deeply concerned about what’s happening to kids. We fear a tidal wave of detransitioners is on the way.

Judith Hunter

I think in 10, 20 years time it will be viewed with absolute horror. I think as a society people will look back and think how did we ever ever allow this to happen to young people. I do believe that. How are we going to reach that point? I’m seriously hoping we can get a parliamentary inquiry underway here in Australia.

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Post script. Aside from the Cass Review, there have been some major international developments in the lead up to recording this episode.

Firstly, as reported by Bernard Lane for Gender Clinic News, Dutch politicians seem to have realised they might have a medical scandal on their hands. In January 2024, the House of Representatives passed a motion seeking advice from their independent medical advisory body, about the possible legal implications of medical transition of minors. Then in February they passed a second motion commissioning research that will compare the outcomes of the Dutch Protocol with the outcomes of more cautious approaches, such as explorative psychotherapy.

Then came a huge announcement out of Canada on January 31^st 2024. Conservative Premier for the province of Alberta, Danielle Smith announced sweeping changes to gender identity policies. No more puberty blockers or cross sex hormones for under 16s. No more double mastectomies for under 18s. Schools will need parental permission to socially transition kids aged 15 and under. And for 16 and 17 year olds, parents will still need to be notified if their child is using a new name and pronouns. Schools will also need parental permission for any lessons on gender identity. And, males will no longer be allowed to compete in girls’ or women’s sports. If Canada has made this leap, surely it’s just a matter of time before Australia catches up.

Then on March 5^th, independent journalist Michael Shellenberger, in conjunction with researcher Mia Hughes, released the WPATH Files. Here’s Shellenberger’s announcement: 

Michael Shellenberger

Whistelblowers have given me the internal files from the main gender medicine organisation which is known as WPATH and stands for the World Professional Association for Transgender Health. The WPATH Files show surgeons therapists and activists discussing internally how to treat people with gender distress. What they show is that what’s happening is neither good science nor good medicine. There’s a discussion, for example, about the blocking of puberty of a 10 year old girl. There’s a discussion of doing genital surgery on people with schizophrenia, and dissociative identity disorder, which used to be called multiple personality disorder. At the core of medical ethics is getting this informed consent from the people receiving the medicine, or from their care givers. The WPATH Files show overwhelming evidence that the professionals within WPATH know they’re not getting consent from children, adolescents and vulnerable adults, or from their care givers. They know that so called gender affirming care can result in lifelong complications and sterility, that their patients do not understand the implications.

The WPATH Files are damning. In their wake, WPATH president, Dr Marci Bowers released a statement claiming that, “we are the professionals who best know the medical needs of trans and gender diverse individuals and stand opposed to individuals who misrepresent and delegitimise the diverse identities and complex needs of this population through scare tactics. The world is not flat. Gender, like genitalia, is represented by diversity.” Melbourne’s Royal Children’s Hospital still lists WPATH as one of their professional affiliations, alongside AusPATH.

In an opinion piece accompanying the release of the Cass Review, Dr Hillary Cass described the pillars of gender medicine as having been built on shaky foundations. It’s starting to feel like 2024 is the year that those shaky foundations might finally crumble.

One final note. Dr Michelle Telfer is no longer the head of the Melbourne Gender clinic. She’s been promoted to the Royal Children’s Hospital Chief of Medicine.

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Thanks for listening to Desexing Society. Written and produced by me, Stassja Frei. 

Thank you to everyone who participated in this series, for sharing your stories and expertise, sometimes under difficult circumstances. In order of appearance, thank you to Judith Hunter, Dr Dianna Kenny, Sandra Pertot, Julie (not her real name), Dr Michael Biggs, Bernard Lane, Dr Jillian Spencer, Dr Dylan Wilson, Moira Deeming, Dr Elisabeth Taylor, Victoria (not her real name), Jane (also not her real name), Dr Michael Bailey, Phil Illy, Courtney Coulson, Dr John Whitehall and Anna Kerr. Thanks also to those who generously agreed to an interview but weren’t included in the final cut. 

Thank you to my script editor Edie Wyatt and to those who read through a script or two and provided feedback. Your time and effort are much appreciated. And thank you to Dr Jillian Spencer and Courtney Coulson for your informal fact checking assistance. Thank you to Bernard Lane whose comprehensive reporting made this project far less difficult than it could’ve been. A big thank you to those who hosted me in their homes when I travelled the East Coast of Australia doing interviews, in particular, Kit Kowalski and Edie Wyatt and their lovely families. Thank you to my sound technician, Matthew Friend, for your time and patience. And finally, thank you to those who helped in the background, with financial support, moral support and importantly, tech support. 

For more information or to donate towards this project which I paid for myself, please visit desexingsociety.com. There you’ll find references, links to source material and music used in this series. Stay tuned for Season 2 where we’ll explore the impact of gender identity laws on women’s rights, women’s sports and more.