Re Alex

Last updated

Re Alex
Coat of Arms of Australia.svg
Court Family Court of Australia
Full case nameRe Alex: Hormonal Treatment for Gender Identity Dysphoria
Decided13 April 2004
Citation(s) [2004] FamCA 297
(2004) 180 FLR 89;
(2004) 31 Fam LR 503
Court membership
Judge(s) sitting Nicholson CJ

Re Alex [1] was a legal case decided in the Family Court of Australia on 13 April 2004. It examined the rights of a thirteen-year-old adolescent affirming his maleness and seeking hormonal medical treatment "Sex Affirmation Treatment."

Contents

Case

An application was made concerning a thirteen-year-old referred to as "Alex". Alex was a ward of the State of Victoria. Alex was diagnosed as experiencing the condition called "gender identity disorder" (often experienced by transgender people) controversially contained in the Diagnostic and Statistical Manual of Mental Disorders ("DSM IV") maintained by the American Psychiatrists Association.

The key issue was whether the Victorian State Government Department having the responsibility for Alex's care and welfare or the Family Court of Australia should have responsibility for the authorisation of medical treatment involving the administration of hormonal therapies to assist Alex to have a body with secondary sexual characteristics most appropriate to his innate affirmed maleness and, in so doing, relieve him of the extreme suffering he was experiencing as a result of female pubertal development.

At birth and, at the time of the case, Alex was, in the eyes of the law, a female.

Judgment

Chief Justice Nicholson ruled as follows: [2]

Subsequent case

In 2004, it was not contemplated that Alex would undergo any surgical intervention while he was under the age of at least 18 years. [1] In 2007 when Alex was 16 years old, the State guardian made a further application to the Family Court of Australia to obtain the court's authorisation for a double mastectomy. Chief Justice Bryant authorised the procedure in October 2007 however her reasons for judgment were not published until 2009. [4] [5]

Related Research Articles

The legal status of transgender people varies greatly around the world. Some countries have enacted laws protecting the rights of transgender individuals, but others have criminalized their gender identity or expression. In many cases, transgender individuals face discrimination in employment, housing, healthcare, and other areas of life.

Gender dysphoria (GD) is the distress a person experiences due to a mismatch between their gender identity—their personal sense of their own gender—and their sex assigned at birth. The term replaced the previous diagnostic label of gender identity disorder (GID) in 2013 with the release of the diagnostic manual DSM-5. The condition was renamed to remove the stigma associated with the term disorder.

The Standards of Care for the Health of Transgender and Gender Diverse People (SOC) is an international clinical protocol by the World Professional Association for Transgender Health (WPATH) outlining the recommended assessment and treatment for transgender and gender-diverse individuals across the lifespan including social, hormonal, or surgical transition. It often influences clinicians' decisions regarding patients' treatment. While other standards, protocols, and guidelines exist – especially outside the United States – the WPATH SOC is the most widespread protocol used by professionals working with transgender or gender-variant people.

Gender dysphoria in children (GD), also known as gender incongruence of childhood, is a formal diagnosis for children who experience significant discontent due to a mismatch between their assigned sex and gender identity. The diagnostic label gender identity disorder in children (GIDC) was used by the Diagnostic and Statistical Manual of Mental Disorders (DSM) until it was renamed gender dysphoria in children in 2013 with the release of the DSM-5. The diagnosis was renamed to remove the stigma associated with the term disorder.

<i>Secretary of the Department of Health and Community Services v JWB</i>

Secretary of the Department of Health and Community Services v JWB and SMB, commonly known as Marion's Case, is a leading decision of the High Court of Australia, concerning whether a child has the capacity to make decisions for themselves, and when this is not possible, who may make decisions for them regarding major medical procedures. It largely adopts the views in Gillick v West Norfolk Area Health Authority, a decision of the House of Lords in England and Wales.

<span class="mw-page-title-main">LGBT people in prison</span> Lesbian, gay, bisexual, transgender and queer people in prison

Lesbian, gay, bisexual, transgender and queer (LGBTQ) people face difficulties in prison such as increased vulnerability to sexual assault, other kinds of violence, and trouble accessing necessary medical care. While much of the available data on LGBTQ inmates comes from the United States, Amnesty International maintains records of known incidents internationally in which LGBTQ prisoners and those perceived to be lesbian, gay, bisexual or transgender have suffered torture, ill-treatment and violence at the hands of fellow inmates as well as prison officials.

<span class="mw-page-title-main">Transsexual</span> People experiencing a gender identity inconsistent with their assigned sex

Transsexual people experience a gender identity that is inconsistent with their assigned sex, and desire to permanently transition to the sex or gender with which they identify, usually seeking medical assistance to help them align their body with their identified sex or gender.

In the United States, the rights of transgender people vary considerably by jurisdiction. In recent decades, there has been an expansion of federal, state, and local laws and rulings to protect transgender Americans; however, many rights remain unprotected, and some rights are being eroded. Since 2020, there has been a national movement by conservative/right-wing politicians and organizations to target transgender rights. There has been a steady increase in the number of anti-transgender bills introduced each year, especially in Republican-led states.

<span class="mw-page-title-main">Transgender youth</span> Children and adolescents who are transgender

Transgender youth are children or adolescents who do not identify with the sex they were assigned at birth. Because transgender youth are usually dependent on their parents for care, shelter, financial support, and other needs, they differ in challenges compared to adults. According to the World Professional Association for Transgender Health, the American Psychological Association, and the American Academy of Pediatrics, appropriate care for transgender youth may include supportive mental health care, social transition, and/or puberty blockers, which delay puberty and the development of secondary sex characteristics to allow children more time to explore their gender identity.

Puberty blockers are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the production of sex hormones, including testosterone and estrogen. In addition to their use in treating precocious puberty, which involves puberty occurring at an unusually early age in children, puberty blockers are also used for transgender children to delay the development of unwanted sex characteristics, so as to allow transgender youth more time to explore their gender identity.

Transgender hormone therapy, also called hormone replacement therapy (HRT) or gender-affirming hormone therapy (GAHT), is a form of hormone therapy in which sex hormones and other hormonal medications are administered to transgender or gender nonconforming individuals for the purpose of more closely aligning their secondary sexual characteristics with their gender identity. This form of hormone therapy is given as one of two types, based on whether the goal of treatment is masculinization or feminization:

Transgender health care includes the prevention, diagnosis and treatment of physical and mental health conditions, as well as sex reassignment therapies, for transgender individuals. A major component of transgender health care is gender-affirming care, the medical aspect of gender transition. Questions implicated in transgender health care include gender variance, sex reassignment therapy, health risks, and access to healthcare for trans people in different countries around the world.

Transgender rights in Australia have legal protection under federal and state/territory laws, but the requirements for gender recognition vary depending on the jurisdiction. For example, birth certificates, recognised details certificates, and driver licences are regulated by the states and territories, while Medicare and passports are matters for the Commonwealth.

<span class="mw-page-title-main">Intersex rights in Australia</span> Overview of intersex peoples rights in Australia

Intersex rights in Australia are protections and rights afforded to intersex people through statutes, regulations, and international human rights treaties, including through the Sex Discrimination Act 1984 (Cth) which makes it unlawful to discriminate against a person based upon that person's intersex status in contexts such as work, education, provision of services, and accommodation.

Detransition is the cessation or reversal of a transgender identification or of gender transition, temporarily or permanently, through social, legal, and/or medical means. The term is distinct from the concept of 'regret', and the decision may be based on a shift in gender identity, or other reasons, such as health concerns, social pressure, or discrimination and stigma.

<i>Bell v Tavistock</i> 2021 UK case regarding puberty blockers

Bell v Tavistock was a case before the Court of Appeal on the question of whether puberty blockers could be prescribed to under-16s with gender dysphoria. The Court of Appeal said that "it was for clinicians rather than the court to decide on competence" to consent to receive puberty blockers.

<span class="mw-page-title-main">Arkansas House Bill 1570 (2021)</span> 2021 Arkansas state law

Arkansas House Bill 1570, also known as the Save Adolescents From Experimentation (SAFE) Act or Act 626, is a 2021 law in the state of Arkansas that bans gender-affirming medical procedures for transgender people under 18, including puberty blockers, hormone therapy, and sex reassignment surgery. The law also bans the use of public funds for and prohibits insurance from covering gender transition procedures, while doctors who provide treatment in violation of the ban can be sued for damages or professionally sanctioned. The measure makes Arkansas the first U.S. state to make gender-affirming medical care illegal.

<span class="mw-page-title-main">Genspect</span> Organization opposing transgender rights

Genspect is an international group founded in June 2021 by psychotherapist Stella O'Malley that has been described as gender-critical. Genspect is known for criticizing and opposing gender-affirming care, as well as social and medical transition for transgender people. Genspect opposes allowing transgender people under 25 years old to transition, and opposes laws that would ban conversion therapy on the basis of gender identity. Genspect also endorses the unproven concept of rapid-onset gender dysphoria (ROGD), which proposes a subclass of gender dysphoria caused by peer influence and social contagion. ROGD has been rejected by major medical organisations due to its lack of evidence and likelihood to cause harm by stigmatizing gender-affirming care.

<span class="mw-page-title-main">Society for Evidence-Based Gender Medicine</span> Organization opposing transgender rights

The Society For Evidence-Based Gender Medicine (SEGM) is a non-profit organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. The group routinely cites the unproven proposal of rapid-onset gender dysphoria and has falsely claimed that conversion therapy techniques are only practiced on the basis of sexual orientation rather than gender identity. SEGM is often cited in anti-transgender legislation and court cases, sometimes providing evidence briefs themselves. It is not officially recognized as a scientific organization by the international medical community.

Quentin Van Meter is a pediatric endocrinologist and president of the American College of Pediatricians, a socially conservative advocacy group which is known for opposing gay marriage, gender reassignment surgery, and abortion. He has advocated and referred his clients to conversion therapy and is known for rejecting the medical consensus on the efficacy and safety of transgender health care.

References

  1. 1 2 Re Alex: Hormonal Treatment for Gender Identity Dysphoria [2004] FamCA 297 , (2004) 180 FLR 89; (2004) 31 Fam LR 503, Family Court (Australia).
  2. "Chapter 4. The current test for competency", Young people and consent to health care [2008] New South Wales Law Reform Commission Reports 119.
  3. Atkins, Kim. "Re Alex:Narrative Identity and the Case of Gender Dysphoria" (PDF). (2005) 14(1) Griffith Law Review 1.
  4. Bell, Felicity (2015). "Children with Gender Dysphoria and the Jurisdiction of the Family Court". University of New South Wales Law Journal. (2015) 38(2) University of New South Wales Law Journal 426 .
  5. Re: Alex [2009] FamCA 1292 , (2009) 42 Fam LR 645(6 May 2009), Family Court (Australia).