The Government of Queensland, Australia has suspended the prescription of drugs that inhibit the onset of puberty in children and adolescents.
Queensland Health announced the suspension of new prescriptions of puberty blockers saying that the purpose of the new Health Directive is to “specify a restriction on the provision of stage 1 (puberty blocking hormone) treatment and stage 2 (gender affirming hormone) treatment to children and adolescents under 18 years of age with Gender Dysphoria.”
The directive applies to “all Hospital and Health Services” with “patient safety” concerns cited alongside a desire to “optimise quality of clinical care and outcomes” and that “patients receive treatment that is reflective of best practice.”
Queensland Health says that patients currently in receipt of related treatments “may continue to receive Stage 1 Treatment or Stage 2 Treatment for Gender Dysphoria as clinically indicated” while “No New Patient is to commence on Stage 1 Treatment or Stage 2 Treatment for Gender Dysphoria.”
“Puberty Blockers or Sex Hormones will continue to be prescribed for a medical condition other than Gender Dysphoria,” it said.
Mandatory requirements of the directive state that clinics “Continue to support the prescription of Stage 1 Treatment or Stage 2 Treatment to Current Patients for Gender Dysphoria where clinically indicated.”
Practitioners must, “Ensure Stage 1 Treatment and Stage 2 Treatment is not prescribed or otherwise given to a New Patient for Gender Dysphoria” and “Continue to permit the prescription and delivery of Puberty Blockers or Sex Hormones for medical conditions other than Gender Dysphoria.”
It says that the Health Directive “may limit the right of children and adolescents to protection in their best interests, as well as their right of access to health services. However, those limitations are justified in circumstances where the restriction is needed to protect a vulnerable cohort while appropriate investigations are made.”
As Gript previously reported, over 200 Irish children were sent to the now disgraced Tavistock gender clinic in the UK.
Last March the Clinical Lead at the National Gender Service in this country has said there is ‘no requirement’ for the development of Ireland’s care on gender healthcare services ‘to be aligned with any particular organisation’, after a TD raised the NHS said it would no longer prescribe puberty blockers for children.
As reported on Gript, the statement from Dr Karl Neff at St Columcille’s Hospital in Loughlinstown came in the context of a reply to Deputy Carol Nolan after she had sought to establish if the HSE or its gender dysphoria treatment services were aware of the policy change implemented in the UK’s NHS whereby children in England will no longer be prescribed puberty blockers at gender identity clinics.
Investigation into Paediatric gender health services provided in Cairns
Also in Queensland, an investigation is to be instigated into paediatric gender health services delivered at the Cairns Sexual Health Service.
The Queensland Government says a “preliminary review by the Cairns and Hinterland Hospital and Health Service (CHHHS) exposed issues relating to clinical governance and compliance with endorsed clinical guidelines.”
Speaking in relation to the investigation, Minister for Health and Ambulance Services, Tim Nicholls, announced that at his direction, Queensland Health Director-General David Rosengren is to “commission a Part 6 clinical review and a Part 9 health service investigation into paediatric gender health services provided by the Cairns Sexual Health Service.”
The move follows a preliminary review conducted by the Cairns and Hinterland Health and Hospital Service (CHHHS) in late 2024, after the Queensland Government says concerns were raised about “apparently unauthorised paediatric gender services provided by the Cairns Sexual Health Service (CSHS), adherence to treatment guidelines and clinical governance.”
The Queensland government says that Stage 1 hormone therapy (“puberty blockers”) and Stage 2 hormone therapy (“gender affirming hormones”) “were being delivered in a way that may not have aligned with the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents or complied with standards for clinical documentation.”
It says that last May, a Public Interest Disclosure (PID) was received regarding prescribing of a puberty blocker to a 12-year-old and concerns with clinical decision making.
“Concerns included the lack of multi-disciplinary consultation, in accordance with best practice, which must be held for all young people 14 years and under who seek to commence treatment with puberty blockers.” it said.
Health Minister Nicholls said, “The Cairns Sexual Health Service delivered an apparently unauthorised paediatric gender service without an agreed model of care. The service was delivered to 42 paediatric gender services clients, 17 of whom were prescribed Stage 1 or Stage 2 hormone therapy,”
“A recent internal review undertaken of the CSHS identified deficiencies relating to credentialing and scope of practice and medico legal concerns relating to patient and parental consent.
“Clinical variation and delay was identified, including delayed blood tests or bone mineral density tests in some patients.
“The client records did not meet minimum standards for documentation around multidisciplinary team discussions or consensus. Reference to fertility discussions and referral to private fertility specialists was inconsistent.
“In short, assessment, diagnosis and treatment may not have aligned with Australian treatment guidelines,” he added.
On 7 November 2024, any further intake of clients under 18 years of age into the service was suspended and referrals were waitlisted.
On 20 January 2025, the local government received advice regarding the next steps to be taken in relation to disclosure to patients and families regarding consent matters and clinical concerns.
The investigation into the clinical governance and services within the Cairns Sexual Health Service is to include “a clinical review (Part 6) and a health service investigation (Part 9) under the Hospital and Health Boards Act 2011.”
Minister Nicholls, “The Part 6 clinical review will focus on the health services delivered to patients through the service.
“It’s critical that children and adolescents with gender dysphoria receive appropriate diagnosis, care and treatment.
“The Part 9 health service investigation will examine the governance framework and pathways of clinical care processes for paediatric gender services.
“The findings of the investigation and clinical review will be used in the assessment of paediatric gender services across Queensland, not just for the Cairns and Hinterland HHS,” he concluded.
The Part 6 clinical review is due to be completed by 30 April 2025 with the Part 9 health service investigation report due 30 June 2025 with the Queensland Government saying these reports will be released “in line with the Crisafulli Government’s commitment to transparency.”