The divide over care for transgender children | Four Corners

This show contains content that may concern some viewers, including references to suicide and eating disorders. There is a bitter war underway for control of young people's bodies. the body I'm in, I don't want to be in this anymore, she was born with a boy's body and she has a girl's heart and mind Transgender

children

are at the center of a polarizing debate over medical intervention to help deal with their distress the recognized treatment in australia includes drugs to trigger puberty its not a session and you get hormones its a total misconception about what we do opponents warn the drugs are dangerous do you think there is ever a case for a teenager make a medical transition?

My personal opinion is that it would be good not to allow the prescription of puberty blockers to

children

with gender dysphoria now that the conflict is being played out. in the hospitals and at the center is Westmead Children's in Sydney we called Westmead Children's Hospital, no matter how empathetic they were with our situation, they could not help us. Waiting lists for gender

care

are growing. I am very distressed, we have to do something and it is the children who are at risk. I was negotiating with God. I wanted you to come back. I was praying about all of this against a wave of anti-trans sentiment sweeping the world.

The leftist genre. The madness is being driven in our children it is an act of child abuse we will not let our children be lied to thank you I want to understand why medical interventions for

transgender

youth have become a battlefield is it right to provide hormones and hormone blockers puberty? this model is the lifesaver in support of saying this I'm Brock Wilcox I'm a 14 year old trans girl and I live in Western Sydney. I started realizing I was different mainly in elementary school. I always like to imagine like I have long hair put on makeup and wear dresses and I would always say oh I wish I was a girl yeah but I'd be disappointed to know oh you're a boy you have to stay like that I guess the first thing we do I realized that at preschool he would come pick her up and she was a princess and dressed up and pushed a stroller and wore fake high heels and wasn't really your typical Rough House type of kid when puberty hit the flamboyant, confident kid.

I became withdrawn and depressed. I tried going to therapy to try to explain this and try to say: why do I feel this way? It's not about going to therapy to solve it. How do you know you weren't influenced? I was not influenced by a trans person I didn't know any trans people growing up, not a single trans person, not even anyone on any kind of social media, I was skeptical about

transgender

issues hearing all these different things in the media when the debate about, you know. one point you know with the pronouns and I, pretty much yeah, I said, you know why we should serve these people if they are identifying, if I can see biologically that they are men, I'm going to say that they are a man in the year certain, Brock found the courage to tell his mother via text that she opened the door to my room and I saw that she was crying and she started apologizing to me and the reason she apologized to me was because in the past, she He wasn't the most accepting person about being trans and he was just crying and apologizing for everything he had said, everything and anything, it was the first time he had really seen Brock show what he had been going through.

Um and it was really hard to watch because it was such a raw emotion and she just hates her body and she can't stand to look at herself when I try something. Renee was determined to support Brock but she struggled to find help. I want to make different flavors. We called Westmead Children's Hospital, they couldn't help us, so even though Brock is a boy, they draw a line in the sand for certain developmental milestones. In Brock's case, it was because Brock's voice had already broken, of course. Do you want Renee went to another Maple Leaf clinic run by New South Wales Health in Newcastle when I spoke to them on the phone and they said they could help me despite the milestone the rocket had already achieved.

I broke down and cried, such a relief that a psychiatrist diagnosed Brock with gender dysphoria. Gender dysphoria refers to the psychological distress experienced by those whose gender identity does not match their biological sex. Brock began a treatment known as gender-affirming

care

, which is an established medical practice throughout Australia. Start with multiple treatment. disciplinary evaluation and may progress to medical intervention. Brock was prescribed puberty blockers to prevent him from developing into a young man. Obviously, you wouldn't want to rush into treatment when you're just finding out that your child is transgender. For us, the fact made sense.

That Brock has been going to a psychologist for quite some time was comforting to know that you know it's not a phase, so to speak, but when you know that you're 13, development is rapid, do we spray them with olive oil or something, It doesn't say that in the tic tac video, yes, that's where I got the recipe from. Oh my goodness, Maple Leaf doctors told Brock's family that the blocking effects are reversible, but warned of possible side effects that could include a reduction. bone density the fact that Brock is now 14 years old and won't have to take blockers for a long period of time, I guess that alleviates a lot of the concerns that we had, but it's definitely something that we've had to weigh and we're okay with that. , we're okay with that risk, these are just all my rings and my earrings, um, and then I have Brock who will soon be getting his third shot of puberty blockers, she says she's relieved to have stopped developing into a body that does not have.

Identify yourself with this jacket I love I love this jacket she no longer hides the clothes she wants to wear and it simply makes you feel rich and fashionable. I really like theater and drama my coffee is cold you can pretend to be someone else, which is almost like what I've been doing my whole life in November. Hopefully I should start taking hormones, which is something I really feel like I don't need to want. I feel like I need you to have five minutes to prepare your game. Cross sex hormones are often the next stage of gender affirming care, daily pills or estrogen patches would mean that Brock would slowly start to look more feminine and develop breasts and hips.

The physical changes in hormones between sexes are irreversible. The choice was to allow Brock to live a life with true authenticity. a potentially very happy life and hopefully a long life when you weigh up the prospect and what the alternative is of potentially not having a child. Brock was literally planning her death, what choice do we have? I didn't choose to be born in this body and then I want to be born in another one like that, it's not a choice that I just made like I didn't wake up one day and say, yes, I'm trans, no, it was years of dysphoria and self-hatred that it took me to discover. that you are not on the right agency referrals to Australia's seven publicly funded gender services are increasing since they opened 10 years ago.

The Royal Children's Hospital in Melbourne has had more than 3,300 referrals, 62 per cent of them were female assigned at birth last year and had 1,095 patients, seven times more. As Westmead Children's Hospital gender service waiting lists show in Sydney Along with the latest figures, Queensland Children's Hospital's gender service has more than 600 patients waiting for a first appointment, a dispute over how to treat children with gender issues is unfolding at Westmead Children's Hospital in Western Sydney It is a dispute that the hospital hierarchy has tried to keep secret, but some former Westmead staff have been brave enough to help us tell this story.

We were told that when I started there were deep divisions about how to help children with gender distress. puberty I became very depressed I was very anxious about myself how people looked at me it was a very difficult time for me Westmead Hospital saw Ashley urgently and prioritized seeing him because he was self-harming his mental health had deteriorated rapidly To Ashley She was prescribed puberty blockers in 2015. Her mother agreed she could be part of emerging research on gender distress by doctors at the hospital. It was this research that laid the foundation for a series of peer-reviewed articles published between 2021 and 2023 recently.

Frontline gender service staff were not involved so it was very important to me that we were able to share this experience with the researchers so we could help with the way forward. Let's show that you know that trans children are a natural and normal part of every society. On Earth, Ashley's mother Lannon never anticipated how events would unfold, Westmead research papers would be weaponized by outside opponents of gender-affirming care in 2021. Westmead researchers released revised report peer-reviewed study examining the clinical characteristics of 79 youth seeking help from the gender service who noted complex family trauma among many of those examined High rates of adverse childhood experiences, including family conflict, parental mental illness, and loss of figures important through separation, a history of abuse was also common, they failed to find a causal link, they argued, they went straight to the The gender-affirming model is dangerous and said a mental health in trauma in all gender care clinics.

They said that doctors, including ourselves, are under increasing pressure to compromise their own ethical standards by engaging in a treatment process that checks the box, yes. Genetic pathologist Dr. Anja Ravine was watching from another part of the hospital as a transgender woman. She was curious about research showing family trauma among transgender youth. The implicit message I read in this, which wasn't actually said directly, but yes. Implicitly there and quite powerful is that in these children the transness and presentation with associated distress is really something that has arisen from a background of early childhood trauma poor parenting practices Associated impaired parent-child attachment patterns these documents have all the badges you expect to know credentials and people look at those credentials, so how do you feel about Ashley's mother, Lannon, reddish as a father, blaming?

Yes, the Westmead report seemed to allude to the children being trans because of their depression. The children are trans because of dysfunction in the home which was horrible to read because we had dysfunction in my home and Ashley had depression because we weren't getting help because he was trans late 2022. Anna started as a clinical psychologist in the gender service for Westmead children, was early in his clinical career and was committed to helping young people who were in trouble. I was very passionate about helping these trans youth who have one of the highest rates of suicide and difficulties and know social stigma and difficulties in school and I wanted to be able to provide them with ongoing support. support where I could really hear them validate them and help them on their journey.

This station was finding it difficult to do her job. I didn't feel supported. I felt that the environment was very difficult. I think you know one of The main problem was the long waiting list, the lack of staff, our care model was being developed to become a better care model, but it was never finalized, no action was ever taken on it, um, they told us. We had received funding for more staff, which would have been fantastic, but while I was there there was no change, same huge waiting list. Noah O'Brien was on that waiting list. Noah was 14 when he first told his mother that he identified.

When he was a kid, we thought maybe it was the influence of a friend or someone online or something, but the more time went by, we just saw that no, it was definitely just him, who he was. Noah was asked to go to the family doctor. Finding out about puberty blockers, we didn't realize at the time that he was already going through the beginnings of the eating disorder, so he was taking matters into his own hands to stop his own periods and stop the growth of her breasts by not eating. I'm not sure what exactly caused Noah's eating disorder, but research has shown that eating disorders are often associated with gender dysphoria.

Noah's refusal to eat worsened and he ended up in Westmead Children's Hospital. They discharged her the next day, they thought it wasn't an eating disorder. disorder that was perhaps gender related and they had put on their discharge papers that our GP needed to do areferral to the gender center. The GP sent the referral last October. Noah's family didn't know they would push him far down the waiting list. in the Western children's gender service because it deprioritizes children who were well into puberty, one informant told Four Corners that it could have been a year before they saw Noah, his son had a problem that should sorted out, you know, so Lauren called places.

She went to the doctor and tried to get help everywhere, but she was always like doors were shut in her face. You know, there was just no one to answer her call for help while Noah struggled with gender issues. His eating disorder also got worse. He was readmitted to Westmead Children's Hospital and treated for anorexia. There was still no gender-focused attention for Noah other than this, so this is the bag they gave Noah when he was in the hospital and he had some impressions from the Internet. Medical guidelines for diverse gender. and treatments, there is stuff about musicians of various genres, some stickers, a place in Blacktown you can go to Legal Services and just a few little things here, but nothing related to the hospital nothing that has given us any kind of direction on where to go next and again it's paper it's not a person saying this is what we're going to do to help we're here with you this found out it was a gender service social worker who visited Noah, the social worker then wrote an email saying this.

I met with Noah and provided him with supportive information from the community. He also mentioned that his cycles were causing him distress, so I asked if we could talk to him about menstrual management, but that discussion did not go forward, a senior member of staff outside the gender service told the social worker that he needed stop engaging with Noah because the eating disorder was the main focus. Noel was effectively denied specialist gender support, he was very, very confusing, you know. It was almost like they came in and said, okay, this is a gender thing, take this bag, do your research, and go from there after almost

four

weeks in the eating disorder unit.

Noel was sent home. his discharge summary included gender dysphoria. He was still on the waiting list. I think Noah should have at least seen someone who could help him with his gender and debt issues and, you know, set a course of action that could be followed and monitored, but there was nothing he could do. This year we were planning summer vacations. was coming to an end and Noah was eager to return to school, he would be wearing a boy's uniform for the first time, I think he was just worried about how people would react when he showed up at school as Noah.

I think he felt like they would see him. like the person who had been in his class before like Lily and that someone might say something or they might think he's a fraud. At a quarter past 12 the phone rang, you know? and I thought, oh, it's Lauren, who you know, so I picked him up and "Hey, you know what you're doing still awake and that's when he said it's Noah. My husband gave him CPR in the ambulance and the police arrived about

four

minutes after we called them from Westmead Hospital, where he stayed alive until six in the morning, that was around 11 o'clock, so we had seven hours to say goodbye.

I think Noah didn't want to be a girl, but I feel like. she didn't get any help or support to make that transition, becoming a man, I mean, we did, we did everything we could, Lauren did more than anyone, but we just didn't get any help from anywhere that could help us if there had been doctors on duty. gender that they would have been able to see Noah, I think that would have made a difference, I mean, we can't know definitively, I think if they had been talking to him and found out what he needed, I think it would have definitely changed things, it didn't happen. long before the news of Noah's death arrived. front-line doctors in the gender service.

I think the core team was incredibly distraught and felt completely helpless. You know I can't speak for them, but I know I felt helpless and felt extreme anguish and sadness for this family. You're on this waiting list, um, and that showed that yes, it happens. You know that suicidal ideation is high and sometimes ends in suicide. In the wake of Noah's death, a pediatrician on the gender service asked Westmead Children's Hospital to make changes to help high-risk patients, but saw no change. I think if that had happened and there had been a big change in service for the better and we were able to help more people in a more timely manner, it would have been great.

You know, there is a silver lining, but nothing changed, so we felt sad and helpless and couldn't make any positive changes in the future. West actually had Children's Hospital issue a statement offering our deepest condolences to Noah's family due to patient privacy and confidentiality. Sydney Children's hospital network is unable to provide further information about their specific care because they have refused to answer specific questions about the gender service. Four Corners has obtained freedom of information documents showing Westmead's children's gender service is taking on very few new patients until June this year. year has seen just three compared to 88 last year latest data shows Westmead service had 145 active patients last year Westmead Children's Hospital says it continues to provide comprehensive, culturally safe and affirming care to current patients thanks was published Westmead's latest research paper in February this year and this one would have the biggest impact, the paper highlighted rising rates of what is known as rapid-onset gender dysphoria, particularly among a small subset of teenage girls.

It's a controversial concept, the paper speculates that it's caused by some evolving social process if a young person has been exposed to the ubiquitous uh media Onslaught both on social media and the Internet and also, you know, in peer groups at school. , in Rainbow clubs, etc., there are the vulnerable young people who will be drawn into that sphere of thought that they You are a transgender psychologist Diana Kenny is an ambassador for Binary, a lobby group that campaigns against so-called gender ideology. She treats adolescents with gender distress in her clinical practice. The approach is essentially a psychotherapeutic approach that helps the young person and her family understand. all the complex dynamics that have resulted in the young person experiencing gender dysphoria is not conversion therapy, it provides a safe exploration space for children to look at themselves and gain greater understanding, relates one of the most controversial findings from the latest Westmead investigation.

Whereas the concept of desistance and the desistance rate is often used as an argument against gender-affirming care, Westmead research has defined care as the disappearance of the gender-related distress that brought the young person to care. clinic, they reported that gender distress eventually disappeared during 22 percent of those who studied for the general public, okay, Charles gave up, okay, they're not trans anymore, that would be what you'd think well, but when you read the articles , there are actually a variety of definitions when you look closely at how that 22 percent arrived. comes from it includes children who were originally evaluated and deemed not to meet the diagnostic criteria so they were never eligible to be referred for consideration of fundamental block and that was the majority of them and there were others as well In particular, this date has been presented is an outlier, in fact, if you look at the data that is in the document, it is entirely consistent with the opposite conclusion: it is very rare for real young people to completely decide to return to the gender assigned at birth .

The report also indicated that there was a 9.1 percent dropout rate among those diagnosed with gender dysphoria. The report concluded that the evidence base for the gender-affirming medical route is weak and that for young people who may regret their choice, the risks of potential harm are significant when the latest Westmead research was conducted. posted what their reaction was the researchers had gone out of their way to really convey the issues at hand it was clear to me that they really wanted to try and help Australia come to terms with this issue by explaining it all and that made me happy because I really wish we could talk about this because it is a child protection issue.

What happened within the culture of the clinic after that article was published. I think there was a lot of anguish. It felt chaotic because you know, instead of families calling. Say they called to make appointments, they called to tell you that they were expressing their concerns and anguish. It was also very difficult for the staff. Two months after the final investigation was published. Anna decided to quit. I left feeling defeated. I think there was a lot. I wanted to do it and it's an area of ​​great need that these kids and these teens are struggling with.

The research in the West landed amid an increasingly polarized global debate over gender-affirming care. At least 20 U.S. states are taking steps to ban or restrict gender-affirming care for young people. people this will be permanent Ban mutilation of minors Ban surgical procedures and experimental puberty blockers for minors the left-wing gender The madness that is being pushed in our children is an act of child abuse in the UK the gender service of long-standing London Tavistock clinic has been accused of rushing patients onto gender-affirming medications. Several doctors working there became very concerned about the treatment the young people were receiving, believing that they were not being adequately evaluated before being placed on a medicalized path.

Following this, the UK's National Health Service has restricted puberty blockers to children in clinical trials stating that there is insufficient evidence to support their safety or clinical effectiveness as a routinely available treatment. What went wrong with the Tavistock Clinic is getting stuck on one particular treatment. From my point of view, what happened, the people who work there just said it's more complex and we need to have services that understand that complexity and also respond in real time. We can't just do the same thing on a cookie cutter for all the kids it's not about. that the approaches were inherently wrong, it was poor management of the complexity of children coming forward and I think it is an important learning in Tavic Stock how to do it wrong.

European countries such as Norway, Sweden and Finland, which once adopted puberty blockers, have also hurt them. return I just returned from Finland from an international conclave on psychotherapy of children with gender dysphoria and in 2020 they withdrew their support for gender affirming treatment as a first line of treatment for this group of young people and have returned to a psychotherapeutic approach. Global scrutiny of medical intervention is putting increasing pressure on Australian gender clinics to demonstrate that what they do is evidence-based. Dr. Stathis, thank you for agreeing to speak with us. Thank you, it is an important topic.

The state oversees the gender service at Queensland Children's Hospital, which last year had 922 active patients, about 80 per cent of the research on gender-affirming care has been published in the last 10 years, so the base of evidence is emerging and is changing, so we constantly review that evidence base and adapt our model of care to take into account taking into account new evidence, for example, there is increasing evidence that puberty blockers impact in bone mineralization problems, so we are adapting our recommendations and our consent forms to take that into account. Thank you, Sapphire is receiving care in the gender service at Queensland Children's Hospital.

I am in fifth grade and I see myself as a very energetic and happy person. I want people to see me as a proud transgender girl. I am a girl and that is what I am and that is what I will always be. My youngest daughter from a very young age. her young age demonstrated what I now know as gender nonconformity she was born a male assigned male at birth and was always attracted to stereotypically feminine clothing activities she knew she wanted to be a girl she was a girl but she didn't really want it she knew what say or how to say it or if it was true back then the family lived in Sydney in third grade.

Sapphire was struggling due to bullying at school and her mother noticed that she was becoming more sad and withdrawn. Alison sought help at the children's centerWestmead. gender service, in fact there were no mental health services available at the clinic, which was very distressing and illustrated that the Westmead Clinic did not offer a comprehensive model of care, so when I researched the gender clinics on Interstate, both in Melbourne as in Brisbane, the comparison between the services are day and night Alison decided to move her family to support her youngest son we were forced to move to the states we were forced to leave New South Wales to go to Queensland so I can continue to get affirmative care I'm going to be on puberty blockers soon and that's just It's going to be like really stopping my body from growing into what I don't want it to be and I think throughout my life I felt more and more that this It is not me, the body I am in.

I don't want to. I don't want to be in this anymore. One of the criticisms of affirmative care is that it's too affirmative, if I can be frank, it doesn't explore enough what your response to that is in terms of your lived experience. I believe that transgender children explore themselves daily and that level of introspection is present every day of their lives and that if they are given unequivocal love and support, then that internal dialogue that they have been having with themselves they will then be able to have with trained health professionals. It is an ever-present problem that we face every day.

It is the very core of my son's being and it is unbreakable. How is your afternoon? yes here's some apple darling these families need our support are you ready for netball tomorrow? yes what's up? What the gender affirmation model says is that we affirm where a young person is, it doesn't mean we're stuck in treating a young person with puberty blockers or hormones, it doesn't mean we're stuck in some ideology, it does mean is that we are curious and eager to explore the reasons why you have presented there is a high profile case of a psychiatrist at your hospital who is under review in relation to her views on the care of transgender children, what is happening in Well, I can't comment on the details of that case, what I can say is that I welcome open debate throughout the psychiatric community and with hospital consultants on a wide range of views on the fact that the Queensland Children's Hospital has retired as senior psychiatrist. of clinical duties pending an investigation into a complaint from a young transgender patient Dr Jillian Spencer is contesting the allegations and has lodged a complaint with the Queensland Human Rights Commission saying as a doctor she should have the right to object to the affirmation model.

I can't comment on my own situation due to the code of conduct, but what I can tell you is that I believe the vast majority of Nellis children and psychiatrists have serious concerns about the affirmation model, transitioning children is deeply abusive When anti-trans activist Kelly J Keane held a rally in Canberra earlier this year, Dr Jillian Spencer joined her at the podium to warn about gender-affirming care for young people, their friends and healthcare professionals. health will encourage anyone's children, yours or mine, to consider their gender in online school during extracurricular activities. The hospital has told Dr Spencer she allegedly breached the Queensland Public Services code of conduct through her public service. statements that she refutes and says she was speaking privately, that these experimental drugs and surgeries carry enormous health risks, we need to talk about the harm we see gender ideology causing to women and children, I think after years of pressure and not being able to express these concerns, I felt I couldn't miss the opportunity to say them out loud.

It's very difficult as a doctor to be in a position where you feel like you need to do an intervention that you don't. I don't agree with being able to talk a lot about it, it was a relief. Dr. Spencer is calling for a federal investigation into the gender-affirming model for youth. She worries me about the harm to children and what worries me is knowing that this is the case. It is much more common for children who later become gay or lesbian to show cross-identification and gender dysphoric childhoods, so there is concern that we are changing the trajectory of these children.

My main concern with puberty blockers is that they stop healing. of gender dysphoria through the course that occurs naturally during the course of adolescence that we know from ancient studies. Dr. Spencer points to the prevalence of other issues such as autism, ADHD, and depression rather than medical intervention. She urges what is known as watchful waiting. a medical term that tended to describe taking time to see if a problem is resolved before intervening, but in terms of a watchful waiting approach for children with gender dysphoria that would involve engaging with them to treat mental health comorbidities and participate in therapy and family therapy if it is necessary to optimize their school functioning and participation and try to connect them with their peers and with active activities that help them feel good about who they are.

There is no evidence that exploratory therapy, simple psychological therapy, is a legitimate alternative to what is offered through most schools. our specialist clinics in Australia respiratory psychological therapies family therapies instead of watchful waiting are not based on evidence, they are the sense of intrinsic beliefs of different professional groups there is a new battle front over gender affirming care and it involves those who eliminate transition also from woman to man to woman D transitionist and on this channel we try to find out what the hell is happening to me in this episode, why I wanted to be a man.

It suggests to me that Courtney Coulson started testosterone treatment when she was in her early twenties. She shares her story on her YouTube channel. I think you can go so far in believing that these things start to become real and this other identity becomes real. I just went through the trans production line there and continued living as a man for five years. Her indoor confinement meant that she was unable to go ahead with planned chest surgery and she eventually stopped taking cross hormones. I stopped taking testosterone and then my brain and body just balanced themselves out, whatever I was going through when I wanted to transition.

It seemed like we were over it and we are over it, we don't have good data on the number of people in transition D, but what we do know is that there is a flood of young people coming out and talking about their experiences and people between 18 and 19 years old and early of the 20s are warning their young people. My colleagues don't make the mistake I made. I'm going to regret this for the rest of my life. Research on those who regret transitioning is still emerging. Supporters of gender-affirming attention put it at around one percent, but the voices of those.

Those who regret medical intervention grow increasingly stronger before committing to this for the rest of their life. Don't you want to see all the insights I should have been able to do and didn't? The Royal Children's Hospital in Melbourne pioneered gender-affirming care in Australia. Over the last few years, service leaders have kept their heads down as anti-trans sentiment has become fiercer and more politicized, they decided they can't stay quiet any longer, so there is a lot of misinformation out there and it affects Young. We see that we have nothing to hide because we are very strong in what we do and the evidence behind this is that some of those who are critical of the gender affirmation approach almost assume that we just blindly look at gender and don't.

People are complex and we look at all aspects, we take a biopsychosocial history and a developmental history and really consider what the co-occurring physical and mental health aspects are and what are we trying to address all of them or what is the most prominent. and Urgent at that time, so we all know that our waiting list is still long and it is kind of a difficult responsibility and burden that we all have and we are working very hard to develop supports for those on the white list. The multidisciplinary team includes psychiatrists, psychologists, pediatricians and nurses. It is not a single session and hormones are obtained.

It's a total misconception about what we do. People can come to us and it can take months and years depending on the age and stage of development they are at. before there is any medical treatment, if any, we talk at length with both the doctor and mental health professional about reversible and irreversible effects, we talk about fertility, we talk about regret, we talk about changing our mind, we do not shy away from any treatment . Of those difficult questions, pediatrician Ken Pang is leading long-term research examining the outcomes of young people who attend the Melbourne Clinic. Our goal is to look at your long-term physical and mental health outcomes after you have received gender-affirming care in our hospital.

We are also looking at things like bone health, we are looking again at things like mental health, before and after, blockers. of puberty, before and after, you know, gender-affirming hormones in the form of estrogen and testosterone, there's a war on real research. How do you navigate that and provide the best standard of evidence? I don't feel like there's a research war when it comes to rigorous, robust, you know, evidence-based research. I think in terms of you know the war of opinions you know. with many problems, many people have opinions, but the problematic thing is that sometimes you know that the people expressing those opinions don't actually have any experience in the area;

There's been a lot of stuff in the media and on social media right now that really has it. t align with our practice here at the gender service Dr tram Newman fears the needs of transgender young people are being misunderstood. She is especially concerned about the impact of the recent Westmead Children's Hospital research - perhaps that is something we can then take to the rest of the world. community in terms of the education we provide, yes absolutely, Dr Newen is one of seven senior adolescent doctors from across Australia who have published a critique rejecting the conclusions of the Westmead research.

We are not a group of doctors or researchers who do this regularly. but for us we just felt there was a moral obligation. These are high-level doctors who have done long-term research, which makes you social, that their conclusions are wrong. A number that has been cited in other media outlets is 22 percent of young people in that country. The study gave up and 22 is a really alarming number, it's alarming for young people, parents, collisions and doctors who don't work in the field, but when we look at the raw numbers, 22 percent is actually incorrect, you together with other doctors from all over the country signed. a letter sharing your concerns about the Westmead investigation, why did you do that?

Because I think we need a balanced investigation and I think there were flaws in that article that need to be corrected. Four Corners has attempted many times to raise these concerns. Westmead researchers, but all declined to speak to us in a statement, the Sydney Children's Hospital Network said there is a need to communicate research findings, whether favorable or unfavourable, in a way that allows for scrutiny and contributes to public knowledge and understanding in 2021, the New South Wales Government. It allocated an annual budget of $1.5 million to open a new gender center for those under 25 years of age.

The service will be run by the Sydney Children's Hospital Network and another Health partner, but after two years and more of funding, the service has yet to open. New South Wales Health has told Four Corners it is in development. The last item on the agenda is a discussion on Westmead. I know that the Westmead doctors were certainly not partners in the research and indeed these Sydney parents, some of them with children at the Westmead children's gender clinic, are concerned. about the future of caring for their children, the investigation has generated an enormous amount of stress, consequently, we have lost really important people who have been part of our children's journey.

A pediatrician from the gender service left earlier this year distraught over Noah's case. and the impact of the controversial investigation for some staff to consider leaving because they do not find it a supportive environment to do what they know needs to be done for trans young people is really distressing for the families of trans young people who desperately need that support, what is going to happen to them? Lenin's son, Ashley,She eventually sought private medical care to undergo breast surgery and cross hormones. I'm 22 years old. I am a marketer and I want people to know that trans people are here, we exist and have existed and will continue to exist.

I'm not really into any activities. I'm just going to work. I do my job. I come back home. That is my life. I'll go out with my friends on the weekend, but that's it. I'm not an activist. I'm not good with my words so I'm not good with um you know, persuading people why they should change um I know it's best left to people who are better at it, some people can test if it should happen in Absolutely they say that children are too young they say that it is gender activists who impose these things on children and make them question their gender what is their response to that makes me angry.

I have lost my son because there was no support to say that. It is the gender activists who put pressure on children again, why would children choose this if it is so difficult? Why would anyone choose something if it's so difficult, but not for themselves, being their authentic selves as adults? I look happy, with a complete transition, healthy and I feel comfortable with my own body, I call myself a woman and I hope that by then many more people decide to come and see me as a woman. Furthermore, if the foreigner has raised any problem that concerns him, he can contact one of these services.