The state government has been accused of having a Trojan horse political agenda to permanently ban the therapy.
Medical experts have slammed the Queensland government’s decision to pause hormone therapy for public patients under the age of 18 years while it conducts a clinical review.
Brisbane GP Dr Fiona Bisshop, who has a special interest in gender medicine, told Health Services Daily she believed the move was politically motivated and part of a plan to ban the services permanently.
“It has a very Trumpian, autocratic feel to it, because it’s coming on the back of a recently completed independent review, and they’re saying that review wasn’t independent because they didn’t like the outcome,” Dr Bisshop said.
She warned the fallout from the ban – even if temporary – would be devastating.
“My receptionist has been bombarded today with phone calls from parents in tears, distraught, incredibly anxious people asking to speak to the doctor,” she said.
“Everyone thinks it means their children are going to stop receiving care. So this is terror. This is huge fear.
“It’s appalling, and the fact that it was announced to the press without even discussing it with the service providers or letting them know or giving them any warning at all – it makes it so clearly a political move, but the implications are that it’s going to lead to a massive downturn in mental health.
“For people who don’t get the care they need, we know it increases the overall level of suicidality,” Dr Bisshop told HSD.
“There will be more suicide attempts.
“There will be more hospitalisations for mental health. We’re talking about young people who can do impulsive things because they feel the world is against them and that they don’t matter and that their life isn’t worth living if they can’t get the treatment that they need.
“It’s not mental health treatment they need because they don’t have a mental disorder. They develop severe anxiety and depression and suicidality because of the way society treats them, because they can’t get access to care.
“These are the tragic things that are going to happen within days of these announcements going up.
“This government and this health minister will have to bear the responsibility for that. It’s actually terrifying to see how things like this can just suddenly happen.”
The ban, announced on Monday by health minister Tim Nicholls, coincided with news that a wide-ranging investigation had been launched into paediatric gender health services provide at the Cairns Sexual Health Service.
This investigation follows a preliminary review conducted by the Cairns and Hinterland Health and Hospital Service 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 the Cairns issue, as well as international evidence, had raised concerns about paediatric gender therapies across the state and prompted him to order the broader review of the evidence for hormone therapy treatment for children.
Earlier this month the Queensland government also announced that it did not support expansion of the Queensland Children’s Gender Service (QCGS).
“There is contested evidence surrounding the benefits of Stage 1 and Stage 2 hormone therapy for children and adolescents with gender dysphoria emerging from studies throughout the world,” said Mr Nicholls.
“Following the directive to the director-general of Queensland Health regarding the operation of the Cairns Sexual Health Service, I have also directed the director-general to commission an independently-led broad review of the evidence for Stage 1 and Stage 2 hormone therapies for children in Queensland.”
However, Dr Bisshop said an independent review of the state’s paediatric gender services last year had already determined they provided safe, evidence-based care that was consistent with national and international guidelines.
The evaluation, led by Associate Professor John Allan, included clinical representatives from across Australia from disciplines such as psychology, general practice, child and adolescent psychiatry and paediatric endocrinology. It also included representatives of from the Queensland Paediatric Quality Council and a lived-experience representative.
The external evaluation examined clinical service delivery, the adherence to best practice guidelines, care pathways, service funding and workforce profiles, and data collection methods. It also considered international and national evidence.
This report was accepted by the Queensland government and in July 2024, then health minister Shannon Fentiman issued a statement that included high praise for the services.
“Queensland is home to a proud and vibrant trans and gender diverse community, and the Miles Government is committed to ensuring that they have access to safe, responsive, contemporary healthcare services,” she said.
“I welcome the findings of this report, which shows based on the best available evidence, that our Queensland Children’s Gender Service is considered one of the best in the country.”
Children’s Health Queensland (CHQ) currently operates the Queensland Children’s Gender Service (QCGS), established as a state-wide service in 2017. As of June 2024, the service had 547 children and adolescents actively receiving care.
Dr Clara Tuck Meng Soo, a Canberra GP with a special interest in transgender medicine, said she too believed the ban was politically motivated and not in the best interests of transgender children and teens.
“I think this is obviously a terrible thing for all trans young people in Queensland,” she said.
“Queensland was one seen as the most progressive state (for transgender health) – now it is one of the worst. It does seem to me to be politically motivated.”
Dr Tuck Meng Soo said the decision had the potential to be “very damaging to the mental health” of affected young people.
“The rest of the country will be watching this very closely,” she told HSD.