Court allows teens to begin gender re-assignment.
Courtesy Sydney Morning Hearld
September 9, 2013, Court Reporter, Paul Bibby
The Family Court has granted two 16-year-olds permission to take gender reassignment hormones that will permanently transform their bodies and put them at high risk of serious health problems, finding that the dangers are outweighed by the crippling psychological trauma of living as the ''wrong gender''.
The teenagers, ''Terry'' and ''Sam'', are suffering from the condition known as gender dysphoria - where a person identifies with a different gender to the one they were born with.
The pair were formally represented and supported by their respective parents, and successfully applied to the court for permission to immediately undertake both stage one and stage two treatment of the condition.Under the law, people cannot undertake such treatment until the age of 18 without a court order because it is considered that until they reach adulthood they cannot give informed consent for such a transformation.
For Terry - who was born as a female but identifies as a male - the injection of large doses of testosterone will be done with the aim of inducing male puberty, increasing muscle mass, facial hair, deepening of the voice and increased libido.
It is likely to render him at least temporarily infertile, and place him at a significantly increased risk of breast or uterine cancer and severe liver dysfunction.
Sam will undertake a course of large oestrogen injections to induce female puberty, including the development of breasts and loss of facial and body hair. Such treatment carries a major increased risk of blood clots - although this is treatable - gallstones, cardiovascular disease, type 2 diabetes and breast cancer.
In his judgment, Justice Peter Murphy acknowledged the potentially devastating health consequences for the teens, and their inability to give informed consent, but found that the severity of their dysphoria and the tragic consequences meant that treatment could not be postponed.
''Those risks and changes must be considered in the context of the risks of delaying treatment,'' Justice Peter Murphy said in relation to Sam.
''The experts are agreed that delay in treatment carries the attendant risk of suicidal ideation and self-harm.''
The judgment sets out the heart-wrenching experiences of the two youths, much of it in their own words and those of their parents.
Terry described feeling "like a boy … for as long as I can remember''. He recounts attempting suicide when his periods began. ''Five days of torture every month … I hate who I am … I pray that it won't happen, then I get depressed for five days … Nature playing a cruel joke every darn month.
''I'm here today, waiting for the treatment to be approved so I can go on and live my life like a normal teenage boy."
Terry's parents changed his school in late 2012 and since that time, Terry has been attending his new school as a male and "all his peers believe he is male".
Sam's parents first became aware of her gender dysphoria following a serious self-harm incident at school.
''In April 2012, Sam's father received a phone call from Sam's then-school to notify him that Sam was not at school,'' Justice Murphy said.
''Sam's father found Sam outside the school grounds. He arrived 'as the ambulance and police were arriving'.''
Sam's mother told the court that a month later, during their drive home from school, "[Sam] asked her 'if I would help her if we had lots of money'. I said that 'of course I would'. I recall [Sam] then saying 'I feel like I am a girl' and 'I am a girl'.''
Two psychiatrists and a GP agreed that Terry and Sam should begin the hormone treatment as soon as possible as there was a serious risk of suicide.
''The nature and severity of the manifestations of the condition in each of Terry and Sam persuade me that there is urgency attaching to the administration of treatment and that postponing stage two treatment until either adulthood … is reached by either child would run contrary to the expert medical evidence before me,'' the judge stated.
''The proposed treatment is in their best interests.''
This article reviews two recent decisions in the Family Court in which the Court has allowed two teenage children to receive hormone treatment to commence transgender change. The Law relating to medical procedures of this nature to be performed on children is governed under the Family Law Act (see Section 67ZC). In these types of cases, a Court Order is required even in the circumstances where the child’s parents/guardian consent to the treatment. One of the leading cases in this area is Re: Alex  FamCA 1292 In this case, the Court found that it was necessary to regard the best interests of the child as the paramount consideration.
In determining the best interests of the child, the Court looks at a number of factors including the wishes of the child and his/her degree of maturity as well as the nature of the procedure (whether it is reversible) and whether the procedure will advance the physical, psychological, emotional and relational development of the child.