Sydney (AFP) – Hormone therapy for transgender children in Australia should no longer be withheld from those under 16 because of their age, according to new medical guidelines released Monday that experts say are among the most progressive in the world.
The advice, published in the Medical Journal of Australia, said doctors should base the decision to recommend cross-sex hormone therapy on individual circumstances — calling into question international guidelines, last updated in 2011, which say the treatment should be reserved for patients aged 16 or above.
The change in approach reflects significant developments in clinical care since the global advice was published, moving “away from an aged-based system” towards holistic treatments, said the researchers who wrote the guidelines.
“Ours, I feel, are the most progressive (guidelines in the world),” lead author Associate Professor Michelle Telfer, director of the Royal Children’s Hospital’s gender service in Melbourne, told AFP.
“They most closely represent what is best clinical practice that takes in the multidisciplinary approach that I think is really vital when it comes to providing care for children and adolescents,” she said.
Australia has no laws dictating at what age transgender children can undergo hormone treatment to alter their bodies, but the new guidelines mean that in practice children could receive the therapy at earlier ages if they meet certain criteria.
These include a teenager’s “capacity and competence to make informed decisions”, how long they take medicine that suppresses puberty, mental health, other medical issues and family support, the researchers said in the report.
Telfer, the acting president of the Australian and New Zealand Professional Association for Transgender Health, said a Dutch study which looked at patients from 1972 to 2015 found that the rate of regret among hormone treatment patients was low, at about 0.6 percent.
In some cases, taking hormones such as oestrogen or testosterone sooner could allow children to go through puberty at a similar time to their peers, and help reduce depression and anxiety, she said.
Under a recent ruling by the Family Court of Australia, children no longer have to seek approval from a judge to undergo hormone therapy if they have the support of their parents and doctors.
The international guidelines on transgender care and treatment are issued by the World Professional Association for Transgender Health. There have been seven updates to the original guidelines published in 1979.
The current edition states that in many countries, 16 is the age where parental consent is not required for making medical decisions.