Childhood demand for gender transition treatment surges to record high

Updated

The number of children seeking transgender treatment in Victoria will surge to 300 this year alone, according to new public hospital figures.

Key points Transgender treatment for kids hits record high

Appointment wait times down

Taxpayers foot the $5,000-a-year bill for each patient

Some barriers to treatment remain

It comes on the back of a 200 per cent increase over the past decade in new patients seen by the Gender Service at the Royal Children's Hospital.

There were 253 patients identifying as transgender referred to the service last year, with another 300 expected by the end of this year, according to Gender Service director Michelle Telfer.

"What's really interesting is that it's not just the Royal Children's Hospital," she said.

"It's very similar and mirrored really by other services internationally."

Just three patients were referred to the service Associate Professor Telfer leads between 2003 and 2007.

But by the end of this year, more than 1,000 children will have been seen.

Wait times for first appointments blew out to 14 months as the hospital struggled to cope an influx of patients.

But now the wait is down to four months with nurse consultants and junior doctors doing initial assessments.

From there, paediatric and psychological approval is still required to begin puberty blockers and hormone therapy.

Transgender treatment about 'living my best life'

Korra, 16, has been on hormone therapy for a year.

Growing up she always had an affinity for stereotypically girlie clothing and toys, and by age seven had begun to question her gender.

That made primary school particularly tough, with peers suggesting she was "weird" for wanting to live as a girl.

"Somebody would always come up to me and be like, 'Are you a boy or a girl?' And I was like, well if I could choose I would be a girl," she said.

Korra's mental health suffered until she found gender reassignment documentaries on YouTube, which she showed to her mum.

"This was a big moment for us where we'd just figured out this was real, this is what we could do. We were bawling our eyes out," she said.

A short time later Korra came out as transgender and got help from the Royal Children's Hospital.

"I just feel more alive and living my best life," she said.

"The end step for me is probably sexual reassignment surgery."

Surgical-intervention foreshadowed

The public hospital does not offer gender-reassignment surgery.

"Bottom surgery" — that is, anything below the waist — is not recommended for children and teenagers because of its effect on sexual and reproductive function, according to Associate Professor Telfer.

But she said "top surgery" needed to be considered by the children's hospital.

"We've come a long way in terms of gender care in Australia in quite a short period of time," she said.

"I think that everyone needs to be ready for further change, so it's something that we are thinking about."

Associate Professor Telfer said there was growing evidence of the benefits of "top surgery".

"When you still have prominent breasts it's very distressing and actually leads to quite a lot of discrimination, stigma, bullying at school," she said.

"The evidence that we have from a medical perspective is that it can be really helpful, it's therapeutic."

Barriers to treatment remain

A Family Court ruling last year means children and teenagers no longer need court approval to begin hormone therapy.

Hormones are covered by the Pharmaceutical Benefits Scheme, but puberty blockers are not.

Victorian taxpayers foot the $5,000-a-year bill for each patient, according to Associate Professor Telfer, who added that Commonwealth funding could free up hospital resources.

"What we could do is request that the GPs give ongoing prescriptions and injections," she said.

"That would take the load off the public hospital system … because they're not coming in every three months for an injection at the hospital."

Associate Professor Telfer and her team were responsible for drawing up new guidelines for treating transgender children and teenagers, which were recently published in the Medical Journal of Australia.

She said access to treatment was still lacking in many parts of Australia.

"Darwin, for example, doesn't have adequate services and doesn't have any services for children or adolescents and that severely disadvantages that population," she said.

Topics: community-and-society, family-and-children, maternal-and-child-health, health, child-health-and-behaviour, australia

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