Advocates for Australia’s transgender, non-binary and gender diverse children say access to psychologists and hormone therapy is becoming increasingly difficult, leaving those affected at risk of severe mental health issues.
- Wait times for gender dysphoria services have extended as demand has increased
- People in Adelaide are currently unable to access services in Melbourne
- SA Health is considering a business case for an “enhanced” service
In South Australia, the number of young people trying to access gender dysphoria services has doubled in three years, and the average wait time for an initial psychiatric appointment at the state’s Women’s and Children’s Hospital is now 15 months.
That has prompted the hospital to start outsourcing urgent referrals to private psychologists and community mental health services.
The state’s Commissioner for Children and Young People, Helen Connolly, said she was becoming increasingly concerned by the lack of action on gender dysphoria services.
Gender dysphoria is a condition in which a person experiences extreme distress due to the mismatch between their biological sex and gender identity.
“In the timescale of a child’s life, 12 months is a long time, it’s a long time developmentally — it’s a long time in terms of relationships — so anything that slows this process of getting a response is actually pretty serious,” Ms Connolly said.
“Practitioners and doctors have told me they used to get a few referrals a year. They’re now getting hundreds of referrals.
Ms Connolly acknowledged the topic was divisive, but said it was crucial that those affected got the support they needed.
“These issues are controversial — they bring out people who have opinions not necessarily based on fact or medical evidence — but let’s leave it to the experts: they can make those clinical decisions about what’s needed for this particular child,” she said.
“I need to ensure [children] have got a system they can access to actually get that advice.”
‘We just want to be ourselves’
Adelaide’s Olivia Purdie, who is non-binary and was recently featured on the ABC’s Four Corners program, was diagnosed with gender dysphoria at the age of nine.
The 12-year-old attends the Women’s and Children’s Hospital every few months to medically delay puberty.
Olivia, who does not use pronouns, said staff were supportive but accessing the services had been difficult.
“There’s nothing wrong with being a girl, a boy, transgender, non-binary. You can be whatever you want, we just want to be ourselves,” Olivia said.
“If they want to lower the suicide rates of children, this could actually quite help.
“A lot of kids attempt suicide because the parents don’t know what’s happening; they’re not listening because there’s no sustainable information about it and they just need a safe space.”
South Australia does not have a dedicated public gender dysphoria clinic offering medical treatment options.
The ABC understands many gender-diverse young people used to travel to the Royal Children’s Hospital in Melbourne to access services but, with demand increasing in that state, interstate referrals are no longer accepted.
Additionally, because of the coronavirus pandemic, only essential travellers and people who live within 40 kilometres of the border are allowed into South Australia from Victoria.
Current services underfunded: mother
Olivia’s mother, Jane Russo, said building a gender clinic was long overdue and the current services were severely underfunded, with appointments often being cancelled or postponed due to resourcing restraints.
She said SA Health had taken little action, despite drafting a business case to build a gender dysphoria clinic two years ago.
“These services are critical for families in South Australia — it’s not a fad, it’s not going to go away. Young people need the support particularly around their mental health,” she said.
“A clinic and meeting the needs of gender diverse young people I think is going to help that and mitigate hopefully a lot of the anxiety young people have, meaning mental health is going to be a lot better.
“That’s the frustrating bit, that it’s been going for so long — obviously a need has been identified, the need is there, we know that wait times have been getting steadily longer.
“They’ve got an idea of the need so we need to get on with it.”
Ms Russo’s concerns are echoed by the Commissioner for Children and Young People, who wants a specific gender dysphoria clinic to be established at the Women’s and Children’s Hospital, similar to what exists in Melbourne, Brisbane and Perth.
“We’re the state that doesn’t have a discrete gender clinic at the Women’s and Children’s Hospital,” Ms Connolly said.
“We’ve got some great practitioners who are doing great work with huge waiting lists, but they’re doing it as individuals and we’re saying we need a system response, we need a clinic and it needs to be staffed.”
SA Health looking at business case
In a statement, SA Health said it was reviewing a business case for an “enhanced” gender service.
It also acknowledged it had seen a rise in referrals “due to a better understanding of gender diversity” and that the increased demand was being seen across Australia.
There are 100 patients accessing gender dysphoria services at the hospital, compared with 59 patients in 2017.
“Our psychiatrists and paediatricians work collaboratively to ensure that decisions about treatment support the young person’s needs,” SA Health said.
“We recognise that there is a greater demand for gender dysphoria services in South Australia.”
For Olivia Purdie, a gender clinic would help improve mental and physical health for the 12-year-old and other gender-diverse young people.
“With a clinic there’s also going to be more research which means less not knowing about it and it just becomes a normal thing,” Olivia said.
“They might be getting bullied or ‘down-shamed’ at school because they’re different and it could actually [help them] make trustworthy proper friends who actually care about them and understand them.”