Since 2003, a publicly funded clinic at Melbourne’s Royal Children’s Hospital has treated 39 children and adolescents for gender identity disorder – a condition where a person feels trapped within a body of the opposite sex.
Seven of these children successfully applied to the Family Court to suppress puberty so they had more time to consider sex-change treatments in late adolescence or adulthood. Others have court applications pending, while some could not afford the legal costs or wanted to continue counselling.
All seven adolescents who had puberty suppressed went on to receive cross-sex hormone treatments at age 15 or 16 so they felt more like the sex they identified with. Surgery is only available to people over 18.
For biological males, oestrogen treatment encourages breasts and other female characteristics while softening testicles and making them smaller. For females, testosterone suppresses menstruation and encourages hair growth, muscle bulk and voice deepening, with the latter being irreversible. It also increases the size of the clitoris and increases erections.
Negative side effects of the cross-sex hormones are rare but can include migraines and liver problems. The long-term rate of regret with reversal of gender identity for adolescents is unknown, but researchers say less than 1 per cent of adults who have sex change surgery after thorough assessment regret their decision.
Writing in the Medical Journal of Australia, the doctors who run the clinic, Jacqueline Hewitt and Campbell Paul, said all patients received mental health assessments and support, and in cases of unrelenting cross-gender thought and behaviour, hormone treatments were considered. They said puberty could exacerbate distress for children with some expressing revulsion towards parts of their bodies and becoming suicidal.
Growing awareness of the service meant patient referrals had increased from one in 2003 to eight last year and they said the clinic had become the main service for children and adolescents across Australia having hormone treatments. ”We’d like to see clinics in other major cities,” said Dr Paul, a psychiatrist and director of the clinic. ”It’s important to provide the right support and access to experience.”
A Victorian mother whose biological son attended the clinic at age seven said she felt immense relief to find specialist help for her child, who is now having hormone treatment to suppress puberty. She said that from about 2½ years old, her son behaved like a girl and told her he was a girl.
Her child received many sessions with a psychiatrist before starting to identify as a girl before the age of 12.
”All up, it took about two years for our daughter to make what is called a full social transition, but for her, it was an absolute affirmation,” the mother said.