EVERYBODY in the Blackall parish could rely on Trish Elliott.

A faithful Mass-goer, Trish was always there to make the altar flowers pretty or give a friendly pep talk to a stranger.

Even one teenage boy called Trish his “honorary aunty” at her funeral in April 2002.

Trish never had any children of her own; she was rendered infertile from her sex reassignment surgery.

Trish was born Kevin Elliott in 1947, one of seven children.

Two years before the first sex reassignment surgery in Australia, Kevin travelled to Egypt to undergo a life-changing operation.

Returning to Blackall after the operation as Trish, the shortened version of her mother Yvonne’s middle name, the entire town walked the transition with her.

Fr Kevin McGovern (pictured right) arrived in Blackall in 2002 and got to know Trish before the heart attack that took her life.

A Queensland priest who until late last year was the director of a health ethics centre in Melbourne, Fr McGovern only learnt about Trish’s transition when she died.

“Trish was an involved member of the parish,” he said.

“She was someone who disagreed with the Church but it didn’t allow it to stop her involvement.”

Fr McGovern is one of several ethicists and bioethicists who are trying to understand the phenomenon of transgender and gender dysphoria.

Making sense of transgender identity

ACCORDING to the Royal Children’s Hospital Melbourne, one of the leading gender dysphoria centres in Australia, the transgender condition, also known as gender dysphoria, refers to “the distress that a person may experience when there is an incongruence between their biological gender and their expressed gender”.

Transgender people may or may not have undergone surgery to match their expressed gender, but all transgender people experience gender dysphoria.

In 2014, using a statistic from a youth survey in New Zealand, which claimed 1.2 per cent of students identified as transgender, the ABC estimated Australia’s number would be close to 18,000, though others say the number should be more like 44,000.

The rise in transgender indicates that the number of students experiencing gender dysphoria is increasing; much of the data is based on a rise of referral reports from state-based gender dysphoria clinics.

Transgender people of all ages are also prone to increased health risks.

The National LGBTI Health Alliance claims transgender people aged over 18 are nearly 11 times more likely to attempt suicide, and six times more likely to self-harm.

Surgery and hormone treatments are the most common treatments for those diagnosed with gender dysphoria.

In 2015 the Royal Children’s Hospital Melbourne’s Gender service reportedly received 104 referrals of young people under 17 struggling with gender dysphoria.

Children diagnosed with gender dysphoria can undergo hormone therapy and “puberty blockers” at approved clinics.

Fact or fiction? What science says about gender dysphoria

THE increasing numbers of transgender students have raised various questions for the Catholic Church.

At present, the Church has little authoritative teaching to guide Catholic schools, students, parents and the wider community.

“The Church tends to have a view of transgender identity as a psychological disorder,” Fr McGovern said.

“It’s not a teaching that has enormous authority behind it, but the Church asks that we give this a respectful hearing and prayerful consideration.”

Western Australia bioethicist Fr Joseph Parkinson turned to science to understand transgender identity.

His research was off the back of three consultations with parents whose children were experiencing transgender issues.

These cases dealt with best management of transgender students going from primary to secondary school, that is, from Year 6 to 7 in Western Australia.

It triggered a research paper entitled Pastoral Care of Transgender Students in Catholic Schools, which is yet to be released.

After reading mountains of “robust” peer-reviewed, academic research on the topic, Fr Parkinson reached his own conclusion of how to define this transgender experience – one that reflects the Church’s view.

“What reliable research there is on the topic indicates the phenomena of transgender is almost entirely psychological,” Fr Parkinson said.

“Reliable science doesn’t bear out in the popular rhetoric.

“The position on the results of research from people who report good results and satisfaction of people who transitioned in the ’70s, ’80s and ’90s, even across hormone treatment and surgery tends not to settle the dysphoria.

“Solid research shows trans adolescents (young people up to their twenties), that not only does gender transition therapy – hormones and potentially surgery – not only does the dysphoria not settle but the unhappiness was there before they raise the question of transgender.”

In fact, Fr Parkinson (pictured below), who gave an address at the National Catholic Education Conference in Perth last year, would not recommend surgery to anyone with gender dysphoria, let alone for children.

“My stance on this, is all people who present as trans at whatever age, the only treatment is psychotherapy counselling,” Fr Parkinson said.

“I don’t believe surgery helps.

“The thing that the data shows is counselling is the best therapy.”

Fr Parkinson also scrutinised the reported figures of people experiencing sex dysphoria, saying while there were genuine cases, much of the statistics were inflated by thousands.

“The generous figure would be one in ten thousand, maybe less, but that’s quite a generous number,” he said.

It’s equivalent to 0.01 per cent of adults.

Translating that into the possible number of genuine trans students in Catholic schools, Fr Parkinson said out of 700,000 students in the Catholic sector across Australia, no more than 60 or 70 would classify as transgender.

Fr Parkinson said the popular rhetoric appeared to overstate the figures through “purely subjective reporting”.

Rather than accepting the phenomena is increasing, Fr Parkinson advocates more scrutiny and constant questioning of experiences shared by media outlets, and learn the scientific research on transgender identity.

“The reason more are coming out is it is there in the public eye,” Fr Parkinson said.

“It’s plastered across the news every week. It’s an easy answer.

“Transgender is floating around as a neat scapegoat, and in fact, what kids are going through is quite complex and not merely transgenderism.

“If left alone, most kids grow up fairly well.”

Instead, the popular method undertaken by several counselling groups is one of affirmation and choice.

But Fr Parkinson says giving young people the ability to choose their gender could also be dangerous.

“For me that makes no more sense than letting kids figure out how to cross the road by themselves,” he said.

Fr Parkinson questioned the medical realm for jumping too quickly into transitioning young people to manage their distress rather than looking at “hard, reliable research”.

He said this was the area where the Catholic Church could grow.

“It’s so important that as a Church we don’t just rely on theology; I don’t question the theology but we do need to have people in the Church reading the science to interpret for us what the hard, reliable research is indicating,” Fr Parkinson said.

The Australian Catholic Bishops Conference confirmed transgender identity issues in Catholic schools would be on the agenda of two bishops’ commissions in 2017.

Man, I feel like a woman: Qualifying the transgender experience

For those genuine cases of trans people, the existential question still begs: how can a man who believes he’s a woman trapped in a man’s body know what it’s like to be a woman, and then try to pursue that?

Former Queensland Bioethics Centre director Dr Ray Campbell said these experiences were impossible to measure.

“Knowing what it means to be a woman is a bodily experience and the man has no experience of that,” Dr Campbell said.

“He hasn’t experienced puberty as a female, he hasn’t experienced very key events in a woman’s life that continue for all her life, like monthly periods …

“His experience of feeling like a woman is a conjectured feeling coming from within but it can’t be a real feeling because he hasn’t experienced the female body.

“A woman saying she’s a male has never gone through male puberty – she doesn’t know the embarrassment of an erection as a young child, all those kind of things.

“And so it’s a fantasy, it’s a projection of what it might feel like to be male.”

An even greater problem arises when these fantasies or stereotypes become the basis for transitioning, which consists not only of surgery to remove or add genitalia, but also hormone therapy, speech therapy, relationship counselling, cosmetic surgery or facial hair management, among others.

“Now if we go down the path of the therapy, which is so prominent today, we’ll go back to the experience of someone like Dr Paul McHugh, founder of, or one of the early initiators of transsexual surgery at John Hopkins Hospital,” Dr Campbell (pictured right) said.

“And they discontinued it. Why? Because they found it had no benefit; the rates of a suicide after surgery is still as high as without.”

Dr Campbell said the problem with popular counselling methods was the reliance on “feelings and affectivity”.

“Generally speaking it’s totally dissociated with biology,” he said.

“And so it’s not grounded in science; it’s ideology.”

If the person’s feelings fit in with symptoms of gender dysphoria, the common treatment is affirmation in these feelings and a “treadmill” of therapies.

“Now part of the problem, especially when it comes to young people, the studies show that over two-thirds of people who consider themselves as young people, to be transgender, grow out of it,” Dr Campbell said.

“So in ten or fifteen years’ time, they no longer believe they are.”

Diving straight into therapy without recourse to biological factors would mean a string of adults who regret their sex change.

So what is the appropriate therapy for a person suffering from a genuine case of sex dysphoria and transgender identity?

“I think there needs to be a lot of counselling, but I think the bigger issue is just how simplistically do we accept this sudden upsurge in young people being supposedly transgender,” Dr Campbell said.

Additionally, Fr Parkinson recommends cases be dealt with in a controlled environment, where one staff member, if possible the principal, deals with individual student and parents.

“The first thing is the school should nominate an independent physician – a psychiatrist or endocrinologist – to review the child’s medical records,” he said. “That person advises the school – how dinkum is it, how serious, and if the school needs to co-operate.

“The school should not just take the parents’ word for it.”

When it comes to educating students on sexuality and the human person, the teachings of the Catholic Church are a school’s best bet.

“I believe our focus needs to be in affirming what is good and positive,” Dr Campbell said.

“We (the Catholic Church) have to say what’s not good.

“We have good news about the human person, about sexuality, we have Good News about the love.

“That’s what we need to be promoting and the better we can do that the better we have a counter-influence on the impoverished views of human sexuality.”

This does exclude some programs, with Dr Campbell questioning the effectiveness of the Safe Schools program, saying it included some “totally inappropriate” resources.

“Safe Schools program as understandable was put forward as an anti-bullying program but it seems to be much, much more than that – a Trojan horse,” he said.

Fr McGovern is also unconvinced about the Safe Schools program and its teaching on gender as choice, an ideology even Pope Francis called “terrible”. “There is the Safe Schools program that I think has gone too far the other way,” Fr McGovern said.

“They say gender is a matter of choice … for folks who’ve got this condition, it’s not a choice; it’s what they’ve discovered about themselves.”

Accompaniment not abandonment

Is the Catholic Church then calling for people who identify as being transgender, that is, their biological sex is in opposition with their conjectured gender identity, to leave the Church to find fulfilment and a holy life?

Ethics leader Fr McGovern hopes the Church would never get to that point.

He agreed genuine transgender cases were “quite rare” but it did not mean dismissing those who truly experienced the condition.

Thinking back on his experience with Trish Elliott, Fr McGovern agrees with the Holy Father’s approach to accompanying people on their journey.

Inspired by the story of Pope Francis personally calling transgender man Diego Neria Lajarraga, Fr McGovern is learning the power of accompaniment for those with genuine gender dysphoria is like attracting flies with honey, not vinegar.

“Diego wrote to the Pope and the Pope phoned him up,” Fr McGovern said.“And the Pope said, ‘Soy el Pope Francis’ which is ‘I am Pope Francis’.”

Fr McGovern believes it was no coincidence that the Holy Father’s phone call happened on December 8, 2014, the feast of the Immaculate Conception.

“In 2015 we began a Year of Mercy, and 12 months before … we have the parable of Mercy,” he said.

“My hope above all is the Church can be what Diego encountered with Pope Francis, a place where people can have the encounter.

“I’d like to think our Church would be the sort of place that is like Pope Francis, of accompaniment and not abandonment.”