Gender Care in Australia

For a long time, Australia, like the Netherlands, was considered one of the most explicitly gender-affirmative countries in pediatric gender care. Since 2024, that picture has begun to shift. In January 2025, Queensland suspended the initiation of puberty blockers and hormones for new minor patients in public care, pending its own independent inquiry, and extended that pause at the end of 2025 until 2031. The New South Wales health service has announced its own review, and in early 2025 the federal government asked the National Health and Medical Research Council (NHMRC) to develop new national guidelines. The Cass Review has therefore also made a clear impact in Australia.

Historical context: Family Court case law

Until 2013, court approval was required in Australia for both puberty blockers ('Stage 1') and cross-sex hormones ('Stage 2') for minors. In the case of Re Jamie, that requirement was removed for puberty blockers in 2013. In 2017, the Full Court of the Family Court ruled in Re Kelvin that court approval for cross-sex hormones was no longer required when the young person, parents, and treating professionals were in agreement. This simplified the process and led to a sharp increase in referrals.

Royal Children's Hospital Melbourne

The Royal Children's Hospital (RCH) in Melbourne developed the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents (2018) and has been a leading institution for many years. The RCH guideline explicitly embraces the gender-affirmative model and is followed by many Australian clinics. Since 2023, however, the guideline has come under pressure: critics in Australia point out that the RCH approach conflicts with the Northern European shift in direction and with the findings of the Cass Review. trans-nederland.nl describes how the Dutch model of puberty blockers was adopted internationally and is now being rolled back.

The policy shift in Queensland (2025)

In January 2025, the Queensland government suspended the initiation of puberty blockers and cross-sex hormones for new minor patients in public care. The move followed reports concerning the gender clinic in Cairns, where children had been treated without proper assessment; see the review of the gender clinic in Cairns. The state commissioned psychiatrist Ruth Vine to examine the evidence. Her report described the evidence as limited, and in December 2025 the government decided to extend the pause until 2031. Queensland is therefore the first Australian state to halt these treatments for new minor patients.

Other states

As in the United States, there is considerable variation between Australian states. New South Wales announced its own review of pediatric gender care in 2024. Victoria and the Australian Capital Territory (ACT) continue, for the time being, to follow the older RCH model, with broadly accessible gender-affirmative care.

National review (NHMRC, 2024–)

In early 2025, the Australian federal government announced a national evaluation through the National Health and Medical Research Council. The NHMRC is working on new national guidelines for pediatric gender care, drawing on systematic evidence reviews and consultations with patients, parents, clinicians, and detransitioners. Interim advice on puberty blockers is expected by mid-2026; the entire process is expected to run until 2028. Until then, the RCH guideline remains the de facto standard; see the report on the national review of the puberty blocker guideline.

Critical voices within the Australian profession

A growing number of Australian pediatricians, psychiatrists, and endocrinologists — united, among other organizations, in the Society for Evidence-based Gender Medicine (SEGM) and the National Association of Practising Psychiatrists, and followed by the newsletter Gender Clinic News — have spoken publicly in favor of a more cautious, evidence-based approach. In 2021, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) published a statement emphasizing caution and the need for extensive differential diagnosis — a notable departure from the affirmative mainstream position of other Australian professional organizations.