More than 100 Australian clinicians have signed an open letter calling on national health bodies to cease the use of puberty blockers, cross-sex hormones, and surgical interventions on children and adolescents with gender-related distress.
The letter, addressed to Australia’s peak medical institutions, highlights the mounting global consensus that the so-called “gender-affirming” medical model is not supported by robust evidence and carries serious risks. Citing the landmark UK Cass Review – the most comprehensive independent review of paediatric gender medicine to date – the clinicians warn that current practices in Australia are placing vulnerable young people in harm’s way.
The Cass Review found that the evidence base for youth medical transition is "weak and uncertain", echoed by findings from systematic reviews across Europe and most recently the United States. Countries such as the UK, Sweden, Finland, and Norway have significantly restricted these interventions in response to the emerging data. Yet in Australia, the medical establishment continues to endorse a model that prescribes invasive treatments without adequate evidence, rigorous assessment, or consideration of long-term outcomes.
The letter notes that these treatments can result in irreversible harm, including sterility, sexual dysfunction, and negative impacts on bone, brain, and cardiovascular health, and that Australian clinical standards ignore data showing that around 85% of children with gender dysphoria resolve their distress naturally through puberty.
The letter also references the recent Family Court case Re Devin, where Justice Andrew Strum found the risk of harm from puberty blockers “unacceptable”, criticised blind affirmation practices, and underscored the failings of Dr Michelle Telfer and the Royal Children’s Hospital Gender Service – Australia’s leading gender clinician and clinic.
In light of this growing body of international and domestic evidence – and the serious ethical and legal implications for clinicians – the signatories are demanding an urgent shift away from harmful medical interventions and a return to cautious, evidence-based care. They call for psychosocial support to be reinstated as the first-line response for young people with gender-related distress, and for professional and regulatory bodies to provide unambiguous advice in this regard.
It is encouraging to see, that just last week, the National Association of Practising Psychiatrists released new guidance in line with this approach.
Women’s Forum Australia stands with these clinicians in urging a return to science, ethics, and common sense in the treatment of vulnerable children and young people.
**If you are a clinician who would like to sign this letter, please reach out to [email protected] and we will pass on your details. Or alternatively, anyone can sign our open letter to Prime Minister Anthony Albanese calling for an immediate halt on youth gender interventions and an urgent, independent national inquiry.**
Read the clinicians' full letter here or below:
OPEN LETTER TO AUSTRALIAN HEALTH BODIES REGARDING GENDER-AFFIRMING INTERVENTIONS
As clinicians, we call on our professional bodies and regulatory authorities to urgently acknowledge and respond to recent international and local developments in the field of youth gender medicine. These developments indicate that what is known as the “gender affirmative treatment” model (GAT), currently used in Australian public youth gender clinics, risk the health and well-being of vulnerable children and adolescents.
The UK Cass Review[1], widely recognised as the most comprehensive review of paediatric GAT, and a growing number of systematic reviews[2] conclude the evidence for puberty blockers and cross-sex hormones for young people with gender dysphoria is weak and uncertain.
Invasive treatments such as puberty blockers, cross sex hormones and surgery hold known and potential risks of harm. These include sterility, urogenital and sexual dysfunction, effects on bone, brain and cardiovascular health.
Due to the above, countries including Finland, Sweden, Norway, Denmark, Brazil and the UK have all recommended their use be restricted in minors.
Current Australian standards ignore evidence supporting a normally timed puberty leading to resolution of symptoms in approximately 85% of children with gender dysphoria[3].
A guideline review undertaken as part of the Cass Review (2024)[1] rated the ‘Australian Standards’ 19/100 for rigour of development.
The Federal Circuit and Family Court of Australia recently relied on the findings of the Cass Review1 and clinical expert evidence in Re Devin[4].
In his judgment, Justice Strum:
- Endorsed the Cass review.
- Regarded the risk of harm from puberty blockers as “unacceptable.”
- Rejected the idea that gender identity is innate and immutable.
- Criticised the gender clinic’s policy of unreserved affirmation.
- Found that a senior gender-affirming clinician had failed in her duty of impartiality as an expert witness.
- Found the gender clinic lacking in its approach to assessment, diagnosis, and therapeutic options.
The judiciary has set an example of considered, evidence-based, developmentally appropriate analysis, which Australian health bodies have so far failed to adopt, leaving Australian clinicians in legal jeopardy.
A US Health and Human Services review of treatment for paediatric gender dysphoria[2], released 1st May 2025, found that there has been a “rapid expansion and implementation of a protocol that lacked sufficient scientific and ethical justification” and “when confronted with compelling evidence that this protocol did not deliver the health benefits it promised, and that other countries were changing their policies appropriately, the US medical professionals and associations failed to reconsider the “gender-affirming” approach.”
Australian health bodies need to respond to this compelling evidence to avoid the same error.
We call on Australia’s peak medical and professional bodies and institutions to cease the use of puberty blockers, cross-sex hormones, and surgery for children and adolescents due to the lack of evidence of benefit and known risks of serious harm. We request unambiguous advice to the profession that clinical practice should align with the Cass Review[1] and the National Association of Practising Psychiatrists (Australia)[5], which recommends psychosocial support as the first-line intervention for young people with gender-related distress.
References
[1] Cass, H. (2024). Independent review of gender identity services for children and young people. NHS England. https://webarchive.nationalarchives.gov.uk/ukgwa/20250310143633/https://cass.independent-review.uk/wp-content/uploads/2024/04/CassReview_Final.pdf
[2] Treatment for Paediatric Gender Dysphoria: review of evidence and best practices. Department of Health and Human Services 1 May 2025. https://opa.hhs.gov/sites/default/files/2025-05/gender-dysphoria-report.pdf
[3] Singh, D., & Zucker, K. J. (2021). A follow-up study of boys with gender identity disorder. Frontiers in Psychiatry, 12, Article 632784. https://doi.org/10.3389/fpsyt.2021.632784
[4] Federal Circuit and Family Court of Australia. (2025). Re Devin (FedCFamC1F 211). https://www.fcfcoa.gov.au/judgment?field_judgment_type_target_id=187&page=0
[5] Morris, P. Managing gender dysphoria/ incongruence in young people: a guide for health practitioners. National Association of Practicing Psychiatrists 8th June 2025. https://napp.org.au/napp-statement-on-gender-dysphoria-in-young-people/
Signatories
Dr Louise Kirby MBBS(Hons1) FRACGP, Dip RANZCOG
Dr Catherine Llewellyn MB BChir (Cantab), AMC, FRANZCP, Cert, Child Adol, Psych.(RANZCP)
Dr Stewart Oxley Doctorate Clinical &Health Psychology, BPsych( Hons), MAPS
Dr Alison Clayton MBBS MPM FRANZCP
A/Prof Peter Parry MBBS PhD FRANZCP Cert Child & Adolescent Psychiatry
Dr Jillian Spencer MBBS FRANZCP Cert Child & Adolescent Psychiatry
Dr Andrew Amos MBBS(UQ), FRANZCP Senior Lecturer, James Cook University
Dr Roberto D’Angelo PsyD, MBBS, M.Med (Psychotherapy) FRANZCP
Dr Eamonn Mathieson MBBS FANZCA
Dr Aniello Iannuzzi MBBS FRACGP ACCRM
Prof Dianna Kenny PhD MAPsS, University of Sydney Association of Professors
Dr Patrick Clark MBBS FRANZCP
Dr John Whitehall MBBS BA DCH MRCP (UK) FRACP MPH and TM.
Dr Christopher Davis MBChB MBA MMed FRACP FAMA
Dr Shannon Morton MBBS(Hons1) FRANZCP Adv Cert Child and Adolescent Psychiatry
Dr Yekaterina Polyakova-Nelson MBBS FRANZCP
Dr Nicholas Rosoman BPsych (Hons), MBBS(Hons), MRACGP MADF
Dr Randy Juanta BMBS/GP/Emergency Medical Officer
Jane Clarke RN private practice
Dr Leena Chaugule MBBS, FRANZCP
Dr Neilson Wright MBBCh FRACS
Dr Karen Smit MBBCh FRACGP
Dr Ben Symon MBBS, FRACP PEM
Dr Frances Wilson MBBS FRANZCP
Dr Don Bornstein MBBS, DPM, FRANZCP
Dr Melinda Boyd MBBS, FRANZCP, Cert Child and Adol. Psychiatry, MPH
Dr Philip Morris AM MBBS, BSs med, PhD, FRANZCP, FAChAM (RACP)
Dr Jacqueline Condon BMedSc, MD, FRANZCP, MHL, Specialist Cert. in Forensic Psychiatry
Dr John Warlow MBChB, FRANZCP, Adult, Child and Family Psychiatrist
Dr Shannon Abeywardena MD FRACGP
Siobhan Cokell Former RMN/ Mental Health Practitioner (retired)
Dr Rachel Bradley MBBS FRACGP
Dr Rachel Hannam Phd Psychology, University of Queensland
David Pirie M Soc Work, Grad Cert Health Studies, B Soc Work UQ
Stacy Barnes, MS Provisional Psychologist
Patricia Weerakoon MBBS (Sri Lanka); MS(Hawaii); MHPEd (UNSW)
Martin Feckie former RN (retired), MSc Health Services Management
Dr Simon Barritt MBCHB, FRANZCP
Dr Al Griskaitis MBBS (Sydney), FRANZCP
Shannon Clarke MPsych (Clin) Registered Clinical Psychologist
Dr Wakinyjan Tabart MBBS FRACGP, MTH, DCH.
Barbara Bantos BSocSc, MSW
Inger Richardson Bachelor of Applied Science (Diagnostic Radiography), Grad Dip Sonography.
Dr Marcus Tabart MBBS FRANZCP
Dr Peter Seha General Practitioner (VR)
Timothy Fischer M.Psych (clin) clinical psychologist.
Tony Bradley Nurse Practitioner
Dr Peter Nesbitt MBBS, FRACGP, FACRRM, Dip (Adv) RANZCOG
Dr Linda Thomas BSc (Hons), MSc (Hons), PhD
Jasmine Sussex Breastfeeding Advocate BA (Public Relations) MA (Politics)
Dr Michael Paul Burt MBBS, FRANZCA, FCICM
Roshanak Vahdani BA(Psych), MA(Psych) MAPS
Kelly Wright RN/registered psychiatric nurse grade 3
Elizabeth Gillanders Bachelor Social Work
Jane Flanagan Occupational therapist, Master’s in public health
Dr Carl B Scott MBBS, FANZCA, FCICM
Assoc Prof Mike Sladden MBChB, MAE, MRCP(UK), FACD, FRACGP, MRCGP, DRCOG
Dr Belinda Doherty MBBS FRACGP AFRACMA MHA
Vivienne Chapman Registered Nurse, Clinical Nurse Consultant Emergency
Dr Guy van Hazel Clinical Professor of Medicine, School of Medicine and Pharmacology, UWA
Dr Vincent Keane MBBS, DipRACOG, MPH&TM, FAFPHM (RACP) Retired
Dr Kerrie MacDonald MBBS FRACP
Helen Shanahan Registered Psychologist
Dr Gabrielle Elliot Mental Health Nurse Practitioner
Dr Dylan Wilson MB BCh MRCPCH FRACP
Dr Diana Whitehead MBBS FRANZCP
Dr Jennifer Wells MBBS FACD
Dr Robert Brennan BSc (Hons1) MBBS
Dr Serene Lim MBBS
Professor Gerald B Fogarty BSc MBBS FRANZCR PhD
Dr Terrence Neal Kent MBBS (Qld) FRACGP NFPMC
Dr Deirdre Little MBBS FRACGP
Dr Mary Walsh MBBS FRACGP
Dr Julian Fidge BPharm, MBBS, FRACGP, MMed (Pain Management)
Dr Umberto Paolo Villa, MBBS
Dr Michael Knight BSc, MBBS, FRACS Orthopaedic Surgeon
Dr Eugene D’Souza. MBBS (Hons), FRACP.B.Physio, MHlthServMt, AFCHSM
Ms Margaret Morton RN RM BN BEd Grad Cert Emergency Nursing, CNC
Annmarie Hosie PhD RN Assoc Profess, School of Nursing & Midwifery, UNDA
Dr Peter Duffy MBBS (Hon), DDR (Syd), DDU, DRACR, FAMA, FAICD, MRCR, FRANZCR
Dr Johnny Khoury, GP BSc (Med) MBBS FRACGP DCH DRANZCOG
Dr Benjamin McOwan BBiomed MD
Dr Pamela Jean Ho MBBS, BSc (Med), FRACP, PhD
Dr Richard McMahon, MBBS, FANZCA
Dr T John Martin AO MD FRACP FRCPA FAA FRS Emeritus Professor of Medicine UO Melbourne
Dr David Chee MBBS, DipRACOG, FRACGP
Dr Peter Hanley MBBS BSc. FRACGP
Roger Bowen Advanced Diploma in Health Science, Paramedic (retired)
Dr Joanne Wright MBBS MGerMed FRANZCP Cert
Dr John Obeid MBBS FRACP
Dr Mark Patterson MBBS(Hons) SpecCertClinLead FACEM
Dr Caitlin Byrne MBBS, MScMed(RH&HG), BSc
Dr David Kardachi BMed, BSc(Hons) RACGP member
A/Professor M. McDonough FAChAM-RACP (Life Fellow).
Dr Paul E Adams MBBCH, FRACP, FCPaed, DCH, MMEd, FSCAI
Dr Mark Hanley BSc(USyd), MBBS(UQ), FRACGP, Master Health, Prof.Ed(UNDA)
Dr Jonathan Chia GP MBBS, FRACGP
Dr Rhonda Buskell MBBS FRANZCP
Dr Frank New MBBS FRANZCP FFPMANZCA.
Dr Larry Hermann MBBS MPM FRANZCP Cert Child Psychiatry
Dr Mary Stavropoulou MBBS FRACGP
Dr Julie Sladden, MBBS BMedSci PGCertMedEd, Retired Medical Doctor
A/Prof Luke Torre MBBS (hons) FANZCA FCICM
Dr Stephen Myers MB BS BSc (Med) JCCA FRACGP Dip Child Health
Margie Stuchbery MA(Psych) FCCLP MAPS
Women’s Forum Australia is an independent think tank that undertakes research, education and public policy advocacy on issues affecting women and girls, with a particular focus on addressing behaviours and practices that are harmful and abusive to them. We are a non-partisan, non-religious, tax-deductible charity. We do not receive any government funding and rely solely on donations to make an impact. Support our work today.
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