Australian Trans Children Positive Support including by the Medical Association

[MishyJDI]

Lovely to see the ABC in Australia report a positive story around the treatment of transgender and gender diverse children, where the clinical regime there has the backing of the Australian Medical Association.

The lady running this is a true feminist and hero - from gym superstar to medical director. A fascinating story as she overrides intolerance and prejudice.

It's people like Michelle that have the clinical expertise to work with trans kids and work through their challenges.

www.abc.net.au/news/2021-05-24/michelle-telfer-trans-children-health/100137192

You can watch it here:

Interesting to see what a positive, affirmative model (where medically validated) can do for these kids, with safety medical guards in place. Well worthy of a watch!

[Helleofabore]

Yeah? Nah! You got me!

I put my hands up and admit that I have little knowledge about who is in power in Victoria. And I actually usually read only the Fairfax papers or aunty. And… I am in London currently, and have never lived in Victoria ever. Only the northern eastern states - the moves in between made Origin night interesting.

I am happy to be trounced on my comment on the political future of Dan Andrew’s.

However, I have been very concerned about how this conversion therapy legislation has been brought in. And hoping that the UK government takes an approach of separating it out. To not simply jam gender identity conversion therapy in with sexual orientation. But make it separate with a clear explanation of what is and isn’t conversion therapy.

I am also hoping that the reviews or studies, mentioned that are forthcoming in the RANZPC are able to be used to provide much light on the current situations for teenage transitioners and give much better guidance.

[timeisnotaline]

@learieonthewildmoor not just antivaxxers, the usual privileged liberal base. Business owners, who have certainly been under a lot of stress, ‘violation of my personal rights’ proponents from that liberal perspective, and also the usual very privileged crowd who despite being financially unaffected, and having a large house with separate study space, plenty of laptops, lovely gardens and pools still seemed to find lockdowns more mentally challenging than the rest of us . But nowhere near enough of any of these to oust Dan. He is a bloody good politician!

[learieonthewildmoor]

Helleofabore: you must be looking at Murdoch press which has relentlessly pushed a negative view of Daniel Andrews. The only people who are unhappy with Dan are anti-vaxxers. The state opposition turned over their leader because he “couldn’t get a hit” on Dan’s popularity and the best they can come up with is the man who lost against him last time. Very very unlikely Dan will not be Premier again.

The opposition was wanting to overturn the gender/ conversion ban, but wimped out. They don’t want to look like they’re against gay conversion. The man who was responsible for tagging gender affirmation into the bill has two trans children.
I understand parents wanting a solution to their child’s problems. Imagine how difficult it must be when they go down the medical path and then find their child’s distress continues. I can see how they then want to blame transphobia for it.
The wheels will come off the bus.

[timeisnotaline]

@Helleofabore I was with you until you said it’s doubtful this govt will remain in power. There is so much support for the Andrews govt, and just about no opposition at all. (That aren’t drink driving their cars into kids bedroom walls)

[Helleofabore]

So, @MishyJDI, it would seem that your celebrated Dr Tefler may be acting against best psychiatric practice if she only endorses ‘affirming only’.

And as you didn’t answer my question as to whether or not you are an Australian, I can assure you the current situation seems to be that the state of Victoria has gone wholly in on banning conversion therapy and self ID, but the balanced approach is being taken by New South Wales which is where that study I posted came from and since this Dr in the above article was published in the Sydney paper, I assume she practices there too. It may well be that laws passed during covid in Victoria will be over turned at the next state election as it is doubtful that this labor government will remain in power.

It helps to understand the political climate of the country from which you appropriated the iconic ‘fair go’ as some kind of misused cultural ‘gotcha’.

But that is on par with posting that a Stonewall founder should educate themselves on gay rights though, isn’t it?

Glad though you posted a thread for me to keep up to date with the recent updates in Australia. Thanks.

[Helleofabore]

Just adding this article to keep this thread updated for any people that stumble across it. Australian clinicians are fighting back against attempts to restrict treatment options to affirming only. Something the OP seem keen to advocate for, despite trans people and many experts stating that limiting treatment like this would be lowering the quality of health care for trans people.

But then, you cannot help posters who only ever regurgitate narratives designed to keep self identified social media influencers popular while neglecting expert opinion.

www.smh.com.au/national/nsw/now-i-m-hopeful-we-can-we-talk-about-teens-and-gender-20211031-p594q6.html

Now I’m hopeful we can talk about teens and gender

Dr Sandra Pertot

I found this very clear as an explanation

Although there is agreement across all clinicians working with gender-questioning adolescents that they typically report a history of mental health problems, increasingly some clinicians will consider the possibility that the client has come to the belief they are transgender as a way of providing an explanation for and resolving their pre-existing problems. In my experience, gender-affirming therapists strongly disagree, believing that anything other than immediately affirming the client’s expressed belief they are transgender will compound the harm. My view is that it is precisely because of the high rate of mental health problems in this group that a careful and comprehensive mental health assessment is required as a first step. Shepherding all of these vulnerable young people down the same pathway is poor clinical practice.

This is the new guidance The Royal Australian and New Zealand College of Psychiatrists have released as mentioned in the article .

And this too is worth highlighting from there, particularly in light of this OP.

They are now warning that there is NOT ENOUGH evidence to recommend affirming only treatments or indeed any particular treatment plan. They now say that underlying health issues should be treated at the same time. And warn that medicalisation of children and teens be very careful and thoroughly explored considering the ‘paucity’ of evidence at this time.

Interestingly, they indicate that there are a couple of long term studies under way which will be interesting to see when they are published. One is a longitudinal study on trans patients in Australia.

www.ranzcp.org/news-policy/policy-and-advocacy/position-statements/gender-dysphoria

[Campervan69]

This is an interesting development as well...

www.gdalliancecanada.com/post/trans-men-fight-back

"(AGP males) are behind the “conversion therapy” bans, because AGP is a sexual orientation that likely can’t be changed through talk therapy, unlike the homosexual subtype, which is best understood as a developmental stage for many LGB people. Most children with this type of GD resolve it as they become adult gay/lesbians. Only a tiny percentage don’t, complicated by things such as homophobia. Developmental psychotherapy can help resolve that. When AGP males control the narrative, banning all psychotherapy for “gender identity”, they are denying those of us with the other types of GD options for appropriate treatment – leaving us with medicalization as the only legal option"

[Helleofabore]

Sorry. I pressed by accident.

So, I am very interested to see what she has to say. It would be egregious to think any clinician who has experience to say that this affirming only approach does not work is being silenced.

Who would that benefit?

So, it may very well be that Michelle Tefler, and others like her, are ignoring the efforts of others in their push to provide a single ‘fits all’ approach. The recent study from NSW shows that this all need to be significantly rethought. As does the judgment in the Bell case and the Swedish changes.

Seems Michelle Tefler is not looking like she is providing the best options for her patients, after all. And as I mentioned, the legislation for some states and territories have been brought in under the radar during a pandemic. Which is never an honest and open approach. in fact, that approach is fucking nothing like giving it a ‘fair go’ at all, but please do continue to make broad cultural statements.

Thanks again for highlighting this Mishy. And providing us a thread to discuss it on. Love it.

[Helleofabore]

Interesting to see a psychotherapist who feels she can now blow the whistle on the silencing tactics of the Psychologists in Australia. Now, she may not have anything relevant and be grandstanding. But I am interested to hear what she says.

Apparently she is feeling confident to come forward with the changes to treatment paths now that a judge needs to be involved in the clinic she seems to work at.

The clinic mentioned in this article.

archive.is/gWxDo

So, I am very interested to see what she has to say. It would be egregious to think any clinician who has experience to say that this affirming only approach does not work that


twitter.com/taniaamarshall/status/1417610950052433920?s=21

[macj1]

Think of Keira Bell....and other young women like her. "Gender medicine was once an obscure specialty. Patients with gender dysphoria were typically middle-aged men wishing to live as women. Things are different now."

Now patients are gay kids, autistic kids, traumatised kids, kids who don't fit snug in gendered boxes. Just stop. twitter.com/will_malone/st…

[Artichokeleaves]

Women express concerns about this practice. And the reply is “well you don’t care about equality!”

Quite.

Leaving aside that to say this, you have to have quite a unique and blinkered view of what the word 'equality' actually means. Because there's nine characteristics, not just one. And they aren't a hierarchy.

[WeeBisom]

I’ve noticed a trend on here recently. People who are not gender critical will start a thread which is basically just: “ [trans topic] isn’t this WONDERFUL? So lovely to see real equality instead of hate! [emoji of heart or flowers]. And then they refuse to engage in any substantive debate or real discussion- it’s just “you’re bigots” without ever explaining why. And it baffles me. Women are gender critical and disagree with certain elements of trans gender theory for reasons. But here we see no engagement at all with reasons - it’s just “this thing is amazing!” with no recognition of women’s concerns. It is really rhetorically counterproductive to keep chanting that something is great when everyone else is saying “well we disagree because x,y,z.”

So for instance, in this thread we are treated to a gushing pean about this doctor who engages in an increasingly controversial practice. Women express concerns about this practice. And the reply is “well you don’t care about equality!” Come on ... this doesn’t engage with the concerns at all!

[VortexofBloggery]

From that second link from The Australian "In NSW, gender clinicians at The Sydney Children's Hospital in Westmead have just published internationally significant research that raises multiple concerns about the "gender affirmative" treatment model advocated by Dr Telfer and AusPATH."

Ouch. Probably best to watch and wait, OP. Sometimes Drs are on a mission and get it wrong ( Andrew Wakefield, John Money, the guy who came up with Lobotomies, the other guy who promoted false memory psychotherapy .... Telfer).

[Sophoclesthefox]

@sanluca

Interesting article.

www.abc.net.au/austory/statement-from-bernard-lane/13352410

Seems all is not well....

That’s very interesting. What do you make of those comments, mishy?

Also, with complex health and social issues, there is almost never a one size fits all model. It may be appropriate to affirm some children with issues around their gender, but your approach suggests that it is the only way, and that to want to explore alternatives or question the efficacy can only be motivated by transphobia. What would an ethical dissent from this model look like, to you?

[334bu]

Both Sweden and Finland have stopped the use of puberty blockers because if potentially harmful side effects.
segm.org/Sweden_ends_use_of_Dutch_protocol

[macj1]

Appreciate, OP, that you 'think I'd trust her stats that less than 1% of children they treat detransition are more valid then items from an anti transgender group such as transgender trend.

Bit different to a theoretical 80% being gay instead. But they can still be trans and gay, so perhaps its valid.

Ill stick with the medical professionals I

OK - if medical articles cited on transgender trend are invalid because the website is not acceptable, (I thought the site was pro-vulnerable children, didn't realise it was considered anti-anything) what about the opinion of the UK High Court verdict re: Keira Bella?

think!www.spectator.co.uk/article/the-damning-verdict-on-puberty-blocker-treatment-for-trans-children

And re: your acceptance of the Dr's belief that 1% of children de-transition - the High Court verdict criticised the Tavistock for keeping no records of de-transition rates; the Tavistock itself does not know what percentage of children do this. Studies into de-transitioning have been blocked by some lobbyists - but sadly, evidence is emerging - and the lawyers are circling.

[bitheby]

Are you projecting your own life experiences on to other children or are you jumping on a bandwagon?

We are all different. I was a gender non-conforming kid that grew up to be a gender non-conforming same sex attracted autistic woman. Anything in childhood that had suggested I should transition would have been a disaster for me.

Not all gender non confirming kids are trans. Why do you think they are. There are millions of us and we are being shut down on social media. Why is your voice more important than mine?

[Helleofabore]

Dr Telfer says her early career as an elite gymnast helped build the stamina and drive needed to do such a high-profile job. As a 16-year-old, Dr Telfer won a bronze medal in the uneven bars at the 1990 Auckland Commonwealth Games.

"In my final year of gymnastics, I spent so much time with the sports physicians, and I saw the power of what they could do, and that made me want to go on to be a doctor," she says.

I'd also be really interested in just whether Dr Telfer believes that males should compete against women in gymnastics or whether she is happy to pull the ladder up behind her own success.

I have found this video interesting. So even if a transitioned male who had the advantage of male puberty or even partial, lost the advantages as suggested by the reviews of transitioned male's sports results, they would still be likely to perform some of these routines due to their physique that would be unaffected by hormones such as twitch muscles and other musculature, the proportions of their skeletons and of course, their pelvis structure, and their lungs capacity and heart size etc etc .

[Helleofabore]

This study is well worth a read. I have posted a long excerpt.

journals.sagepub.com/doi/full/10.1177/26344041211010777

Published April 22, 2021
Kasia Kozlowska, Georgia McClure et al

Australian children and adolescents with gender dysphoria: Clinical presentations and challenges experienced by a multidisciplinary team and gender service

Part of the conclusion

Our findings indicate that engagement with families, a trauma-informed model of mental health care, and ongoing discourse pertaining to the effects of unresolved trauma and loss need to be part of all gender dysphoria clinics and the services with which they collaborate. Because of their impact on subjective well-being and the development of the self, specific loss and trauma events present crucial opportunities for both long-term psychotherapy and more immediate, targeted treatments. The move to a more comprehensive, holistic model of care—one that takes into account the individual’s developmental history and the experiences that make up that history—has also been echoed in the work of other clinician-researchers (D’Angelo, 2020a; Entwistle, 2019; Giovanardi et al., 2018; Kozlowska et al., 2021; Williamson, 2019).

Our study found that the children and families who came to the clinic had clear, preformed expectations: most often, children and families wanted a diagnosis of gender dysphoria to be provided or confirmed, together with referral to endocrinology services to pursue medical treatment of gender dysphoria. Parents (vs. children) also largely came with the same expectations, though they were more likely to be interested in incorporating holistic (biopsychosocial) elements, including treatment of mental health comorbidities, family support/therapy, and long-term psychotherapy for the child. It was our impression that these expectations had been shaped by the dominant sociopolitical discourse—the gender affirmative model. It will be interesting to track the expectations of children and families in the years to come as sociopolitical discourses become more varied and diverse and as the voices are heard of both those who have done well and those who not done well via the medical pathway.

Our study also found that despite the high rates of family conflict, relationship breakdowns, parental mental illness, and maltreatment (see Table 3)—and our own clinical perspective that both individual and family work were indicated for the majority of families—few families rated themselves as being in a clinically severe range on self-report (SCORE-15). Coupled with the dominant sociopolitical discourse—the gender affirmative model that prioritizes the medical treatment pathway—it is not surprising that the large majority of children and families were not motivated to engage in or to remain engaged in ongoing therapy. These data bring three important phenomena into focus. First, when children and families were given the space and structure to tell the child’s developmental story—nested in the story of the family—they were able to identify and provide a detailed narrative of the key issues that had contributed to the child’s presentation and distress. Without this space and structure, the issues remain undeclared and unaddressed. Second, some families—but also some clinicians—function within a non-holistic (non-biopsychosocial) framework where the child’s developmental experiences are disconnected from their clinical presentation. This non-holistic framework is likely to promote a healthcare delivery model that dehumanizes the child (by not examining the child’s and family’s lived experience) and that promotes medical solutions (correcting the identity/body mismatch) for a problem that is much more complex. Third, as noted earlier, our experience suggests that, insofar as the gender affirmative model is taken as equivalent to medical intervention, clinicians (including ourselves) who work in gender services are coming under increasing pressure to put aside their own holistic (biopsychosocial) model of care, and to compromise their own ethical standards, by engaging in a tick-the-box treatment process. Such an approach does not adequately address a broad range of psychological, family, and social issues and puts patients at risk of adverse future outcomes and clinicians at risk of future legal action.

[Helleofabore]

I think that to show just how quickly Australian women are waking up I am posting a few interesting links.

www.noconflicttheysaid.org

These interviews with Katherine Deves discussing the impacts on law recently.

And while you might discount these interviews based on who was conducting the interview, you cannot discount Katherine Deves' knowledge on this. Or if you do discount her knowledge, do you have more experienced in interpreting Australian law?

[Helleofabore]

The vast majority of Australians support a fair go and equality - unlike the UK where it seems progressive thinking is being unwound based on fear.

Are you Australian Mishy? I am an Australian, I also know that Australian's hate feeling their MPs have done a sleight of hand trick in setting up legislation. They also get very upset with the feeling that they have been lied to. And while they are very happy to give people a 'fair go', they really do not take well to being patronised.

I also know that some politicians are very keen to be seen as progressive after the fiasco of same sex marriage (even though couples were recognised as defacto relationship) so there has been some scrambling done here. I also know that women are very quickly becoming aware of issues around this movement and are now getting very vocal. The McIver's Ladies Baths, and sports (particularly Hubbard's wins) really have started bringing it all into focus. There is 'fair go' and there is 'taking the piss' and it is being recognised just which groups are which.

I also know there are studies from Europe that have shown detransition rates after a decade of 8+% for both male and female transitioners. So, I think that that 'clinic' you refer will be soon seeing the effects. And considering this doctor even points out the huge increase recently, I guess that the rate of detransitioners are probably about to increase as well.

Please stop ignoring the fact that early transition has many problems and that the current cohort that has a majority of young females is very unsupported by research.

And stop ignoring the fact that medical transition has a huge impact on the female body. Something that this doctor certainly has not addressed in her 'everything is very rosy' approach.

And unless you too are Australian, please don't tell me what Australian's support. It smacks of your clanger the other day of telling Matthew Parris to get 'educated' about LGB history and Stonewall.

[sanluca]

Interesting article.

www.abc.net.au/austory/statement-from-bernard-lane/13352410

Seems all is not well....

[AdHominemNonSequitur]

There have been multiple independent studies looking at desistance. Whereas repeating what a private gender clinic claim in their propaganda material is not evidence. Transition regret seems to kick in in the early 20's, so they wouldn't have the data yet.

[Artichokeleaves]

It also has to be recognised that the strongest voices for children being provided with an affirmation only approach, and easy access to life altering treatment are those from adults who transitioned as adults, who have not themselves chosen these surgeries, and many of whom have enjoyed the full sex life, fertility and opportunity for parenthood that these transitioning children may never be able to have.

To not dig down into this and consider why is plain irresponsible.

[OldCrone]

Unlikely, when as the clinic head says - 99%+ of their patients don't desist.

Don't desist in what time frame? How long is the follow-up period? Would someone like Keira Bell have been counted as someone who didn't desist (while being treated at the clinic)?