Queensland’s ban on puberty blockers and hormones left Liam devastated. A Victorian doctor stepped in | Queensland

A 40-minute video call was all it took to transform 15-year-old Liam’s* mental health.

With the support of his dad, Chris*, the transgender Brisbane teen had finally completed the months-long journey to being prescribed hormone replacement therapy.

It did not come without obstacles. Liam had been waiting around a year to access the treatment in Queensland when last month, the Crisafulli government announced an immediate ban on doctors in the public system prescribing puberty blockers and hormones such as testosterone and oestrogen to treat gender dysphoria in minors.

When Liam saw the news, his father said he had never seen him more distressed. Chris stayed up all night to be with his son.

That distress turned to elation after the family found a doctor in Victoria – sexual health specialist Darren Russell – willing to treat Liam remotely and held their first consultation via telehealth this week.

“You could see the instant change in his mental health,” Chris said of the appointment.

“He’s the happiest he’s been in a very long time, interacting, talking about future dates, talking [about] going out for Valentine’s dinner with a friend. There’s all sorts of future plans.”

Russell, a former Queenslander who was Cairns hospital’s director of sexual health, said he had already been contacted by several parents with children in a similar position to Liam.

“I’m sure other doctors around the country are already receiving inquiries. So yep, we certainly expect to get [a] bit busier as a result of [the state’s ban],” he said.

Being able to provide medical care that would otherwise be denied is “reassuring to a young person and to their family, and that’s what we’re aiming to do in this situation,” Russell said.

Some of Queensland’s private clinics were at capacity and had closed their books even before the state government announced the health service directive banning public clinics from prescribing stage 1 and 2 treatment to children with gender dysphoria while an independent review into their use is conducted.

There are about 491 children on the waiting list at the Royal Brisbane and Women’s hospital’s gender clinic, which can now not prescribe puberty blockers or gender-affirming hormones.

Access to psychiatric and psychological support will remain available, and children already on a treatment plan involving blockers and hormones – nearly 600 – can still access the services. Doctors will still be able to prescribe puberty blockers to children to treat precocious puberty.

Dr Fiona Bisshop said many had turned to her clinic, Holdsworth House, for care. It had recently closed its books before the ban, but staff decided to work overtime to increase capacity.

She said children were often desperate, and the ban had increased concern.

“I’ve seen a number of young kids come in who are patients of mine already, who are sobbing, terrified, just couldn’t stop saying, ‘Will I, will I be able to access treatment?’ or ‘Will I have to stop my treatment?’” she said.

“And the other people we’ve been fielding calls from are people who aren’t our patients, who are desperate to find somewhere to help them.”

Bisshop said there were relatively few clinicians who provided the treatments, particularly in regional parts of the state.

The Australian Professional Association for Trans Health (AusPATH) list of providers includes just 10 general practitioners in the entire state, with only two outside Brisbane. Other specialists are even rarer.

AusPATH chief executive Eloise Brook said the organisation was working to establish a national referral pathway for the children on Queensland’s waiting list and others, called Project 491.

Much of the work of gender-affirming care is done in teams of multiple different types of specialists.

Dr Brook said the team could use telehealth and include interstate doctors working alongside Queenslanders.

She also hoped the public systems in New South Wales and Victoria would help bear some of the burden.

“Essentially, what AusPATH is trying to do is to increase the number of our healthcare professionals who can step in,” she said.

“When there’s a crisis, and when there’s been past crises, we get doctors coming into the space … and they burn out, they give everything.”

Rachel Hinds, chief executive of LGBTIQ+ youth service Open Doors, said the idea of Queenslanders needing to look interstate for care was an echo of past bans on treatment for HIV patients in the state, forcing many to travel south to receive care.

“When we look back historically at the way that we can for HIV patients in the 80s in Queensland, we can see that that approach was wrong … and I think that we are seeing that again in this attack on trans and gender diverse young people,” she said.

A spokesperson for Children’s Health Queensland said the state’s children’s gender service “does not make referrals to GPs or other private healthcare providers”.

“If a patient chooses to leave the care of the QCGS to seek private care, the QCGS would, with patient/family consent, provide patient information to the private clinician on request. This is the standard approach followed by the Queensland Children’s Hospital for all medical conditions or injuries,” they said.

“Queensland Health’s priority is to ensure the safe and effective delivery of public health care to children and adolescents in Queensland.”

* Names have been changed to protect the identity of a child.