Treatment of gender dysphoria in children

1. Purpose
2. Scope
3. Principles
4. Outcomes
5. Mandatory requirements
6. Compliance
7. Human Rights
8. Aboriginal and Torres Strait Islander considerations
9. Related or governing legislation, policy and agreements
10. Supporting documents
11. Business area contact
12. Approval and implementation
13. Review
14. Definitions of terms used in this directive
15. Version control

1. Purpose

The purpose of this Health Service Directive (HSD) is to specify a restriction on the provision of stage 1 (puberty blocking hormone) treatment and stage 2 (gender affirming hormone) treatment to children and adolescents under 18 years of age with Gender Dysphoria.

2. Scope

This HSD applies to all Hospital and Health Services (HHSs).

3. Principles

• Patient safety – optimise patient safety, quality of clinical care and outcomes.
• Appropriateness of treatment - patients receive treatment that is reflective of best practice.

4. Outcomes

HHSs included in the scope of this HSD shall achieve the following outcomes:

• Current Patients may continue to receive Stage 1 Treatment or Stage 2 Treatment for Gender Dysphoria as clinically indicated.
• No New Patient is to commence on Stage 1 Treatment or Stage 2 Treatment for Gender Dysphoria.
• Puberty Blockers or Sex Hormones will continue to be prescribed for a medical condition other than Gender Dysphoria.

5. Mandatory requirements

All HHSs will:

• Continue to support the prescription of Stage 1 Treatment or Stage 2 Treatment to Current Patients for Gender Dysphoria where clinically indicated.
• Ensure Stage 1 Treatment and Stage 2 Treatment is not prescribed or otherwise given to a New Patient for Gender Dysphoria.
• Continue to permit the prescription and delivery of Puberty Blockers or Sex Hormones for medical conditions other than Gender Dysphoria.

6. Compliance

HHSs are responsible for ensuring compliance with this HSD.

7. Human Rights

This HSD may limit the right of children and adolescents to protection in their best interests, as well as their right of access to health services.  However, those limitations are justified in circumstances where the restriction is needed to protect a vulnerable cohort while appropriate investigations are made.

8. Aboriginal and Torres Strait Islander considerations

This HSD applies equally to all cultural groups and is protective in nature.

9. Related or governing legislation, policy and agreements

Legislation

• Hospital and Health Boards Act 2011 (Qld)
• Human Rights Act 2019 (Qld)

Guidelines

• Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents, version 1.3

10. Supporting documents

N/A

11. Business area contact

• Patient Safety and Quality Branch, Clinical Excellence Queensland Division

12. Approval and implementation

Directive Custodian

Executive Director, Patient Safety and Quality, Clinical Excellence Queensland

Approval by Chief Executive

Issued under section 47 of the Hospital and Health Boards Act 2011.

13. Review

This HSD must be reviewed by 28 January 2026.  The review must involve consultation with all HHSs.

14. Definitions of terms used in this directive

15. Version control