On Friday, 14 March 2025, a landmark seminar titled The Future of Youth Gender Medicine was held at New South Wales Parliament House. The event brought together a distinguished panel of seven speakers, each representing a field critical to the discussion of youth gender medicine, including clinical and academic psychiatry, psychology, evidence-based medicine, and the legal system.
The Proceedings of this seminar, now published in written form, offer an in-depth examination of the current models of care, emerging concerns, and future directions in this complex and controversial area of clinical practice.
The seminar focused on offering an alternative to the widely adopted gender-affirming model, instead presenting a model of care grounded in compassion, caution, and evidence-based practice. This alternative approach emphasises a holistic and exploratory framework aimed at helping distressed youth and their families navigate the often difficult and emotionally charged terrain of gender identity.
Associate Professor Peter Parry opened the seminar with a critique of the dominant gender-affirming care model. He noted that while most mental health diagnoses are guided by a bio-psycho-social framework examining predisposing, precipitating, perpetuating, and protective factors, this standard has been abandoned in the case of gender dysphoria. Instead, a positive reinforcement model has taken hold, often bypassing the complex interplay of psychological and social contributors. Parry
warned of the risks of overdiagnosis epidemics in psychiatry, linking them historically with groupthink and social contagion.
Professor John Whitehall provided a rigorous scientific review of the physiological and pharmacological effects of puberty blockers and gender-affirming hormones. He expressed concern over the significant and often irreversible adverse outcomes these medications can have on child and adolescent development, particularly in relation to brain function and cognitive performance.
Dr Andrew Amos examined the broader socio-political dynamics underpinning the gender-affirming paradigm. He argued that trans rights advocacy has aimed to institutionalise a redefinition of sex through the medical system, using the language and authority of healthcare to replace the biological reality of sex with the subjective notion of gender. Amos suggested that this strategy has enabled the implementation of medical interventions that the majority of the population fundamentally questions.
Dr Alison Clayton reviewed the literature on gender-affirming treatments, using a rigorous, holistic evidence-based medicine framework. She highlighted recent developments, particularly those stemming from the influential Cass Review, and found that there remains a striking lack of evidence supporting the long-term efficacy of gender-affirming interventions. Furthermore, the serious, life-long risks associated with such treatments remain insufficiently understood.
Professor Dianna Kenny addressed the psychological and developmental complexities of gender dysphoria, underscoring the vital role of psychotherapy. She described three competing models of care—gender-affirming, gender-reparative, and gender-exploratory—with a particular focus on the gender-exploratory approach. Kenny clarified that this method seeks to understand the roots of gender distress without imposing predetermined outcomes and should not be conflated with so-called “conversion practices.”
Professor Philip Morris AM contributed insights into the role of the National Association of Practising Psychiatrists (NAPP) in reshaping the clinical narrative around youth gender medicine. He drew comparisons between the histories of homosexuality and transgender identity while stressing their important distinctions. Morris reasserted the ethical and professional responsibilities of medical practitioners and detailed the principles underpinning the NAPP Guide to the management of gender dysphoria in young people.
Finally, Professor Patrick Parkinson AM offered a legal perspective on the complexities of consent in the treatment of minors, particularly in cases where parental agreement is absent. He recounted two recent legal decisions that reached opposing conclusions regarding the administration of gender-affirming hormones and outlined key learnings. He also explored the potential for civil litigation from individuals harmed by such treatments and identified the legal criteria likely to guide future cases.
The Proceedings of this seminar offer a crucial contribution to the ongoing debate around youth gender medicine. They present a deeply considered, interdisciplinary critique of the prevailing medical approach and suggest a more reflective, ethically grounded path forward. As the clinical, ethical, and legal implications of gender medicine continue to evolve, the insights presented in these Proceedings will serve as a valuable resource for practitioners, policymakers, and the wider community
