The CEO of the Australian Psychological Society (APS) has responded to media reports suggesting the organisation was pushing for children to be allowed sex change surgery without parental consent or mandatory counselling saying the reporting has misrepresented the organisation’s statements.
Earlier this week The Australian newspaper reported that the organisation had called for children under 16 to be allowed to access gender reassignment surgery without parental consent or mandatory counselling. The news reported centred around a previously unpublished response the APS had supplied to the Tasmanian Law Reform Commission.
CEO of Australian Psychological Society, Frances Mirabelli, responded to the report saying the reports were a misrepresentation of the submission.
“To claim that we’ve proposed minors should be allowed to consent to surgery against the wishes of their parents & without mandatory counselling is simplistic, inaccurate and damaging to transgender young people, their families and the psychologists who work with them.” Mirrabelli posted to Twitter.
The APS said the reporting took their submission out of context and gave a misleading interpretation.
“The APS submission notes that surgeries have been performed on transgender minors for a number of years, with Family Court approval.
“It states that in cases where parents are not in approval of intended surgery, minors are entitled to access mechanisms that involve the oversight and assistance of suitably qualified medical professionals. The APS submission proposes this mechanism could be initiated by the treating hospital and managed through the Family Court.
“Media reporting further claims that the APS submission stated that counselling for transgender minors pre-surgery should not be required. This section of the submission has been taken out of context and the interpretation of it is misleading.
“Counselling is different to assessment, which the APS and many other bodies clearly support as necessary. The APS submission notes that transgender young people are unlikely to receive treatment without considerable medical oversight and that such oversight should adopt an affirming approach.” The APS said.
In response to the criticism journalism Bernard Lane, who focuses on reporting on transgender issues for The Australian, amended the story to include the a PDF copy of the submission.
In the submission the APS answer a series of questions from the Tasmanian Law Reform Commission in relation to the legal recognition of sex and gender.
The APS, which represents 24,000 psychologists around Australia, addresses how people who are intersex, and people who are transgender are transgender, are treated under the law and makes several suggestions on what they believe to be the best approach from a psychological standpoint.
In both the cases of intersex people and people who are transgender the APS advocates for a model where people are involved in the decision making about their treatment.
“The lack of engagement with gender diverse people has resulted in research and clinical guidelines that have resulted in the unnecessary gatekeeping of access to services, has contributed to the pathologisation of gender diversity, and has thus contributed to the poor mental health experienced by gender diverse people excluded from services.” the report states in its introduction.
When it comes to consent for the treatment of transgender youth, the APS acknowledges that there have been a small number of cases where it has been recognised that performing surgery at a younger age has been deemed in the subject’s best interest.
“The APS would argue that for some gender diverse young people medical treatments are necessary.” they respond.
“It is already the case in Australia that stage 1 (puberty suppression) and stage 2 (hormones) treatment for gender diverse young people no longer requires Court approval. There have also been cases where surgery has been approved for minors. This is especially true for minors who have entered into puberty and for whom the changes that have occurred in their bodies (such as in regards to the chest) are experienced as deeply distressing. For these minors surgery may be entirely appropriate, and indeed has been sought by the children themselves.” the submission notes.
The submission notes that for a small number of transgender youth there is a barrier to accessing the treatment they need if they do not have supportive parents or guardians. The APS suggests a range of strategies that may be used in this scenario including advocacy work to gain parental support, hospitals being able to petition the courts on the child’s behalf, and legal representation being supplied to children.
When it comes to mandatory counselling, the APS state they they are never in favour of counselling being mandatory.
“…counselling should never be a requirement as it imposes an additional and often unnecessary burden on a person (both in terms of time and cost). However, it should by all means be offered, preferably free of cost.” the submission states.
The APS notes that it is unlikely that someone could enter a pathway to accessing surgery relating to gender dysphoria without engaging with psychological professionals, they say it is important that psychological support is available.
The APS refer to their best practice model of affirmative care, saying while oversight is necessary, there should not be gatekeepers to accessing the treatment that people need.
The report from The Australian was repeated by online publisher Daily Mail Australia and became a talking point on Sky News programs.
On The Bolt Report, Andrew Bolt interviewed Professor Dianna Kenny, formerly of the University of Sydney, who is leading a campaign for a national review into the treatment of transgender youth.
Professor Kenney said the submission from the Australian Psychological Society was ill-considered.
“I’m dismayed and disappointed that the peak body for Australian psychologists could make such an ill-considered statement that would result in quite young children, often very immature, often with psychological disturbance, making such decisions for themselves without proper oversight. It’s very disturbing.” Professor Kenny said.
Professor Kenny said the majority of young people experiencing gender dysphoria had other mental health issues and have a background of serious psychological issues including autism, depression, anxiety and social isolation.
“They are struggling with these underlying issues, and then to be given the freedom to make decisions about irreversible life changing surgery that could seriously impact the quality of their life from that point onwards is verging on totally irresponsible.” Professor Kenny said.
Professor Kenny said the Australian Psychological Society was ignoring that Rapid Onset Gender Dysphoria was a reality.
“What we’re mainly dealing with at the moment is a relatively new presentation called Rapid Onset Gender Dysphoria, and it’s had an incredible increase in the last five to ten years, and in particular young female adolescents, who have never shown any sign of gender dysphoria in early childhood suddenly declaring themselves transgender.” Professor Kenny said.
Last week AusPATH, Australia’s official body representing transgender health care highlighted that there is actually no recognised condition of Rapid Onset Gender Dysphoria, and it is not recognised by any major health organisation.
The phrase was first coined in 2018 by US health researcher Lisa Littman who published a descriptive study that suggested that “social contagion” may be the cause of a increasing numbers of young people identifying as being transgender.
Littman’s study was widely criticised because her data came from the parents of transgender youth, not interviews with the young people themselves.
While the phrase has become popular amongst campaigners and media commentators, AusPATH note that there is only the single report published last year.
“The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves.” AusPATH said.
Professor Kenny said she believed many young people reporting to be transgender were simply trying to get their parent’s attention about other issues.
“Young people sometimes feel disempowered or have difficult relationships with their parents, often feeling like they are not being heard, and so they have to come up with something fairly dramatic for parents to stop and listen, and to accept that their child is in trouble – but we don’t immediately jump to the conclusion that these people are transgender and mutilating surgery that is irreversible is going to resolve all of the issues that are current in that young person’s life.”
Professor Kenny said what she has learned via the children she has been treating for rapid onset gender dysphoria, is that they have a problem of “core identity”.
“It’s not a problem a gender identity, it’s an issue where the young person is struggling to find their core identity, it is a psychological issue and not an issue that can be repaired or corrected with cross sex hormones and mutilating surgery.” Professor Kenny said.
The Australian Psychological Society has followed up with a detailed position statement on the issue saying they were never advocating for youth being allowed to access surgery without any oversight.
“Medical procedures have been authorised for transgender minors by the Family Law Court for a considerable period of time. However, it does not follow, nor does the APS advocate, that minors can consent to such procedures absent of assessment by a clinical care team and potential subsequent Court approval where required.
Rather, in those instances where parents do not approve treatment, the APS believes minors should have the right to access the opinion and guidance of suitably qualified medical professionals, including psychologists.
This is consistent with Australian law and international conventions. Independent assessments with regard to transgender minors should always operate from a position of respect, factual awareness and understanding – for example, what are the expressed wishes of the young person and what are the consequences and risks of treatment and affirmation of a young person’s rights to explore and express their gender.” the APS said in its second statement.
The report from The Australian is the latest in a long line of reports on transgender people in recent months. The newspapers coverage has been criticised by the ABC’s Media Watch program.
Last week the newspaper was awarded the Golden GLORIA, a tongue in cheek award for the most homophobic and transphobic statements made in the last year.
Graeme Watson
The Australian Newspaper has been approached for comment regarding this article and did not respond.
