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Bioethicists urge psychiatry not surgery for gender identity treatment

Two Catholic bioethicists have hit out at the decision of Family Court Chief Justice Alistair Nicholson to allow a 13-year-old girl to take a course of drugs designed to make her a boy.

The Queensland girl, known only as "Alex", will take estrogen and progestogen until 16 and then testosterone, which will have irreversible effects. She cannot have surgery until her 18th birthday.

Ray Campbell, Brisbane Catholic spokesman on bioethical issues, said the condition should be treated with psychotherapy and not such drastic measures as surgery because it was a "stage a large percentage pass through".

Bioethicist Nick Tonti-Filippini also condemned the court move, which he said endorses experimental treatment of a psychiatric problem.

In his decision, Justice Nicholson said that as a child, Alex had worn nappies to school because she refused to use the girls' toilets or line up with them at school assemblies. As the only girl on the male cricket team, she believed she was a boy and wore male clothes and hairstyles.

"Anatomically, and in the eyes of the law, she is a 13-year-old girl diagnosed as having gender identity dysphoria - a purely psychiatric issue," Justice Nicholson said. "(But) the evidence speaks with one voice as to the distress that Alex is genuinely suffering in a body which feels alien to 'him' and disgusts 'him', particularly due to menstruation."

Australian and New Zealand College of Psychiatrists spokeswoman Louise Newman applauded the landmark court ruling as "sensible and conservative".

She said it was important because it acknowledged the severity of Alex's condition and allowed the appropriate treatment.

Tanssexual Gina Mather said it was vital such radical decisions were made when a crisis of gender identity arose in younger teenagers.

"Thirteen is an age when they do know, they do not necessarily identify as gay or lesbian but they know something's wrong," she said.

But Alan Finch, who had a sex change from male to female then back again after realising he'd made a mistake, attacked the court's decision.

"She is going to have a full beard and a hairy chest," Mr Finch said. "If she changes her mind, how is she going to get rid of that?"

Judge hits outdated gender laws (The Courier Mail 15/4/04)

Court approves teen's sex change (The Age 14/4/04)
Judge rules girl can become boy (The Australian 14/4/04)
Alistair Nicholson criticises mediation tribunal (ABC AM 14/4/04)

15 Apr 2004