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Medical: Gender incongruence / dysphoria & best interests of the child.

By Bill Madden on April 15, 2025
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Re: Devin [2025] FedCFamC1F 211 (Link to AUSTLII).

This decision is perhaps of interest as a contrast to earlier decisions on similar issues.

The proceedings concerned Devin, a biologically male child, born in 2013. Whether the child’s biological (or, as the mother and her experts would say, assigned) sex, accords with the child’s gender or gender identity is at the heart of this case. The mother contended that the child is gender dysphoric or incongruent; the father, supported by the Independent Children’s Lawyer, contended that the child is gender exploratory, expansive or fluid. ([6]).

The child was aged 10 years at the commencement of the trial and 11 years at the conclusion thereof. There was no suggestion that the child was Gillick competent: see Gillick v West Norfolk & Wisbech Area Health Authority [1968] AC 112. ([22]).

In relation to the parties (and to some extent the expert witnesses) the court commented at [10]:

Despite my repeated exhortations to the parents and, to some extent, the experts who supported their respective cases, as well as the lawyers who represented them, to recall that the Court was deciding a case involving the best interests of the child and not the cause of transgender people, that occasionally seemed to fall on deaf ears.

The court was not satisfied that the mother had proved, on the balance of probabilities, that the child is, in fact, gender incongruent or gender dysphoric and/or that Dr N’s diagnoses thereof are correct. ([131]).

The court nevertheless went on to consider treatment options and concluded at [187]:

I am not satisfied that, given the current levels of symptoms or distress expressed or manifested by the child, even if gender incongruent or dysphoric, the purported benefits of puberty blockers outweigh the identified risks thereof. I do not accept that the child’s desire for puberty blockers can be determinative, or even of significant weight, given, not only the child’s age but, equally so, the concessions by Dr N that the information given to the child thus far was “rose tinted” (Transcript 28 May 2024, p. 51 line 31) and by Associate Professor L that this could influence the child’s desire for such treatment (Transcript 30 May 2024, p.20 lines 1–5). Further, on the evidence, I do not accept that the child, at this age and pre-pubertal stage in life, can properly understand the implications and potential risks of puberty blockers. 

And at [189]:

In the circumstances, I conclude that, even if, contrary to my findings above, the child were gender incongruent or gender dysphoric, given the evidence regarding the risks, balanced against the alleged benefits, of puberty blockers (as well as Stage 2 treatment, namely, the administration of cross-sex hormones), I would not, as between the parties, permit the child to continue gender affirming treatment at the CHGS (or elsewhere) and, in particular, Stage 1 medical treatment. It is of considerable concern that, notwithstanding the weight of the evidence, including, but not limited to, the Cass Report, the CHGS continues to represent to parents and children that puberty blockers are fully reversible and relatively risk-free and yet, through practitioners such as Dr N and Associate Professor L, to concede the lack of evidence to support that position.

In conclusion remarks at [382] the court said:

This is a case about a child, and a relatively young one at that; not one about the cause of transgender people. As this child grows, develops and matures, and explores and experiences life, the child might, with the related benefits of the passage of time and the acquisition of balanced understanding, come to identify as a transgender female and might elect to undergo some form of medical treatment, to affirm and/or align with that identity. But, similarly, with those benefits, the child might not do so, and for a variety of reasons. At this stage in the child’s life, all options should be left open, without any unacceptable risk of harm to the child. That, I have concluded, will most likely occur if the father has sole parental responsibility for the child and the child lives with him, whilst nevertheless spending regular and frequent time with the mother.

[BillMaddensWordpress #2380]

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