The service’s chief executive also explains how the investigation will affect services
The Cairns and Hinterland Hospital and Health Service has welcomed the state government’s decision to launch an investigation into its paediatric gender health services.
Chief executive Leena Singh told Health Services Daily the CHHHS’s “foremost goal is to ensure the safety and wellbeing of the young people seeking support for gender care services”.
“We welcome the independent external investigation into paediatric gender services at our HHS and the opportunity it presents to improve delivery of our services,” she said.
The investigation, announced by Queensland health minister Tim Nicholls on Monday, follows a preliminary review conducted by CHHHS in late 2024, after concerns were raised about apparently unauthorised paediatric gender services provided by the CSHS, adherence to treatment guidelines and clinical governance.
Stage 1 hormone therapy (“puberty blockers”) and Stage 2 hormone therapy (“gender affirming hormones”) were being delivered in a way that may not have aligned with the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents or complied with standards for clinical documentation, the review found.
Mr Nicholls said a Public Interest Disclosure (PID) was made to the department in May last year regarding prescribing of a puberty blocker to a 12-year-old and concerns with clinical decision making. Concerns included the lack of multi-disciplinary consultation, in accordance with best practice, which must be observed for all young people 14 years and under who seek to commence treatment with puberty blockers.
“The Cairns Sexual Health Service delivered an apparently unauthorised paediatric gender service without an agreed model of care,” said Mr Nicholls.
“The service was delivered to 42 paediatric gender services clients, 17 of whom were prescribed Stage 1 or Stage 2 hormone therapy.”
On 7 November 2024, any further intake of clients under 18 years of age into the service was suspended and referrals were waitlisted.
Ms Singh said the CHHHS’ own preliminary review late last year had identified governance issues around the delivery of paediatric gender services and where improvements could be made to processes “to ensure alignment with the model of care endorsed by the Queensland Children’s Gender Service”.
“We have shared the findings of that review with the Director-General,” she said.
“We identified areas where the HHS could improve to ensure a holistic patient and family approach is taken for children who are seeking gender care services.
“Our preliminary review did not find any evidence of patient harm, but it did identify areas we could improve our processes.”
Ms Singh said that while the independent investigation was underway, existing clients of the paediatric gender service at the Cairns Sexual Health Service would continue to receive assessments, care and treatment supported by a multidisciplinary team including an endocrinologist and psychiatry support.
“The service will continue to work closely with the Queensland Children’s Gender Service based in Brisbane,” she said.
The investigation into the clinical governance and services within the CSHS will include a clinical review (Part 6) and a health service investigation (Part 9) under the Hospital and Health Boards Act 2011.
The Part 6 clinical review would focus on the health services delivered to patients through the service, while the Part 9 health service investigation would examine the governance framework and pathways of clinical care processes for paediatric gender services.
The Part 6 clinical review is due to be completed by 30 April 2025 with the Part 9 health service investigation report due 30 June 2025. Findings are expected to be made public.