Re: Ashley

[2015] FamCA 373

FAMILY COURT OF AUSTRALIA

RE: ASHLEY [2015] FamCA 373

FAMILY LAW – CHILDREN – MEDICAL PROCEDURES – Where the applicant is the maternal grandmother and full-time caregiver of a child with Gender Dysphoria –where the applicant seeks a declaration that the child is competent to authorise his own Stage 2 treatment – where the child’s treating medical experts, grandmother and parents support the child commencing Stage 2 treatment – assessment of whether 17 year old child is Gillick competent to consent to medical treatment – child found to be competent to consent and authorised to make his own decision about Stage 2 treatment.

Evidence Act 1995 (Cth)
Family Law Act 1975 (Cth)
Family Law Rules 2004 (Cth)

Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112

Re: Jamie (2013) FLC 93-547
Re K (1994) FLC 92-461
Secretary Department of Health and Community Servicesv JWB and SMB (1992) 175 CLR 218

APPLICANT:    Maternal Grandmother

FIRST RESPONDENT:	Father
SECOND RESPONDENT:	Mother

FILE NUMBER: By Court Order File Number is suppressed

DATE DELIVERED: 22 May 2015

JUDGMENT OF: Thornton J

HEARING DATE: 29 April 2015

REPRESENTATION

By Court Order the names of counsel and solicitors have been suppressed

Orders

IT IS ORDERED THAT

1. Upon the Court being satisfied that the child ASHLEY formerly known as … born … 1998 (“Ashley”) is competent to consent to the medical treatment described in the application, the Court authorises Ashley to make his own decision in relation to that treatment.

2. The applicant grandmother be at liberty to provide a copy of the unanonymised orders and the unanonymised reasons for judgment to all persons involved with Ashley’s treatment.

3. The applicant’s Initiating Application filed 16 April 2015 be otherwise dismissed and the matter be removed from the list of cases awaiting hearing.

AND THE COURT NOTES THAT:

A.The treatment described in the application is the following treatment for Gender Identity Dysphoria:

(i)that under the guidance of Ashley’s treating medical practitioners including but not limited to Dr X (Paediatrician) and Associate Professor P (Consultant Psychiatrist), Ashely undergo treatment by way of monthly intramuscular injections of Sustanon 250 in a dose of 0.5mL monthly.  The dose may be increased to 1mL monthly depending on any adverse side effects experienced by Ashley.

(ii)that under the guidance of Ashley’s treating practitioners as set out as Notation (i) above and if considered appropriate by Ashley’s treating practitioners, Ashley be treated using long-acting Reandron 1000 injections every 3 months and Ashley continue with this treatment long-term, being monitored to adjust the frequency as is necessary depending on side effects and adequacy of the testosterone dose.

(iii)any other hormone and/or psychiatric or psychological treatment as recommended by Ashley’s treating Paediatrician or Psychiatrist from time to time.

IT IS NOTED that publication of this judgment by this Court under the pseudonym Re: Ashley has been approved by the Chief Justice pursuant to s 121(9)(g) of the Family Law Act 1975 (Cth).

FAMILY COURT OF AUSTRALIA

FILE NUMBER: By Court Order File Number is suppressed

Maternal Grandmother

Applicant

And

Father

First Respondent

And

Mother

Second Respondent

REASONS FOR JUDGMENT

Introduction

1. These are my reasons for making an order finding that a child, Ashley, aged 17, is competent to consent to medical treatment, being ‘stage 2’ or cross-sex hormone treatment for gender identity dysphoria.

2. Ashley was born a female but has identified as a male from an early age. He articulated this when he was about 14 and has attended school as a male. He has been diagnosed with gender dysphoria and wishes to undergo stage 2 treatment.

3. Ashley’s maternal grandmother brought an urgent application for a declaration that Ashley is competent pursuant to the decision in Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112 (“Gillick competent”) to consent to stage 2 treatment for gender dysphoria. By agreement with his parents, Ashley’s maternal grandmother has been his carer since birth. This arrangement has never been formalised by any court orders. The maternal grandmother has standing to make this application[1] as a person concerned with the care, welfare and development of the child.

   [1] Rule 4.08 (e) Family Law Rules 2004 (Cth)

4. There is no controversy about Ashley’s diagnosis, his wishes or his competence to provide informed consent for medical treatment. His parents, the relevant Government agency and the hospital where Ashley proposes to be treated have been served with the application in accordance with the Family Law Rules2004 (Cth). The Government agency have not sought to be heard on the application.

5. Ashley’s maternal grandmother, his parents and the treating professionals, Associate Professor P, Professor N, Dr X, and Dr G are supportive of the application.

6. The application is essentially an application for determination by the Court as to whether Ashely is competent to consent to his own medical treatment. 

7. Ashley will be 18 years of age in 11 months when there would be no requirement for any court application. Ashely’s age, psychological state and his circumstances are the reasons for the urgency of the application.

The Application

1. Specifically the applicant sought the following orders:

   1.A declaration that [Ashley] is competent pursuant to the decision in Gillick v West Nortfolk A.H.A [1986] AC 112 (“Gillick competent”) to consent to the following treatment for Gender Identity Dysphoria:

   (a)that under the guidance of [Ashley’s] treating medical practitioners including but not limited to Dr [T] (Paediatrician) and Associate Professor [P] (Consultant Psychiatrist), [Ashley] undergo treatment by way of monthly intramuscular injections of Sustanon 250 in a dose of 0.5mL monthly. The dose may be increased to 1mL monthly depending on any adverse side effects experienced by [Ashley].

   (b)that under the guidance of [Ashley’s] treating practitioners as set out in order 1(a) herein and if considered appropriate by [Ashley’s] treating practitioners, [Ashley] be treated using long-acting Reandron 1000 injections every 3 months and [Ashley] continue with this treatment long-term, being monitored to adjust the frequency as is necessary, depending on side effects and adequacy of the testosterone dose.

   (c)any other hormone and/or psychiatric or psychological treatment as recommended by [Ashley’s] treating Paediatrician and Psychiatrist from time to time.

   There were other orders sought in the alternative which are not relevant.

The Law

‘Gillick’ competence

1. The term “Gillick” refers to the English case of Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112

2. In Secretary Department of Health and Community Servicesv JWB and SMB (1992) 175 CLR 218 (“Marion’s case”) the High Court said that the view of the House of Lords in the Gillick case represented the common law in Australia. 

3. In Gillick, Lord Scarman recognised the underlying principle in the case law that parental right yields to the child’s right to make his own decisions when he reaches a sufficient understanding and intelligence to be capable of making up his own mind on the matter requiring decision.  He referred to the spirit and principle of the law captured by Lord Denning MR[2] when he said that the common law can and should keep pace with the times and that it should declare, at 129:

   that the legal right of a parent to the custody of a child ends at the eighteenth birthday; and even up till then, it is a dwindling right which the courts will hesitate to enforce against the wishes of the child, the older he is. It starts with a right of control and ends with little more than advice.

   [2]  Hewer v Bryant [1969] 3 All ER 578 at 582

4. In Gillick, Lord Scarman said at 188-189:

   …I would hold that as a matter of law the parental right to determine whether or not their minor child below the age of 16 will have medical treatment terminates if and when the child achieves a sufficient understanding and intelligence to enable him or her to understand fully what is proposed. It will be a question of fact whether a child seeking advice has sufficient understanding of what is involved to give a consent valid in law.

5. In Re: Jamie (2013) FLC 93-547 (“Re: Jamie”) the Full Court held that stage 2 treatment of gender dysphoria (administration of testosterone or oestrogen) was a medical procedure that required court authorisation, unless the court found that the child was Gillick competent and thus able to fully understand and give informed consent to stage 2 treatment at the time it was to commence. The Full Court found that it was the court’s responsibility to assess whether or not a particular child was Gillick competent.

6. In summarising her conclusion in Re: Jamie (supra) Bryant CJ relevantly said (inter alia) at [140]:

   …

   c)In relation to stage two treatment, as it is presently described, court authorisation for parental consent will remain appropriate unless the child concerned is Gillick competent.

   d)If the child is Gillick competent, then the child can consent to the treatment and no court authorisation is required, absent any controversy.

   e)The question of whether a child is Gillick competent, even where the treating doctors and the parents agree, is a matter to be determined by the court.

7. In that same case Finn J, whilst expressing reluctance to impose upon the child and her parents the costs and stress of further court proceedings, particularly when the court may ultimately reach the same decision which the child and her parents had already reached with the child’s doctors, stated at [186]:

   Nevertheless, I have concluded that at least the question of the child’s capacity to consent to treatment which has the irreversible effects of stage two treatment must remain a question for the court. I have reached this conclusion because of the requirement by the High Court majority in Marion’s case for court authorisation for irreversible medical treatment in circumstances where there is a significant risk of the wrong decision being made as to the child’s capacity to consent to the treatment and where the consequences of such a wrong decision are particularly grave, as they would be in this case.

8. In the same case Strickland J stated at [196] :

   Whether the child is able to fully understand and give informed consent to stage two treatment… is a threshold issue that the court must decide.

Jurisdiction

1. This application is brought under Part VII of the Family Law Act 1975 (Cth) (“the Act”).

2. Section 69H(1) of the Act provides that jurisdiction is conferred on the Family Court in relation to matters arising under this Part.

3. Section 67ZC of the Act provides additional jurisdiction under Part VII of the Act to make orders relating to the welfare of children. It was inserted by an amendment to the Act in 1995 and reads:

   1.In addition to the jurisdiction that a court has under this Part in relation to children, the court also has jurisdiction to make orders relating to the welfare of children.

   2.In deciding whether to make an order under subsection (1) in relation to a child, a court must regard the best interests of the child as the paramount consideration.

4. Sections 60CB to 60CG of the Act deal with how the court determines a child’s best interests.

5. The court has power to make an order under s 67ZC of the Act to authorise medical treatment. In the circumstances of this case it is not necessary to do so because, for reasons set out below, I am satisfied that Ashley is Gillick competent.  

Procedure and Evidence

1. At paragraph 139 of Re: Jamie Bryant CJ held that in an application with respect to Gillick competence, the material in support would not need to be as extensive as an application for the court to authorise treatment. Her Honour stated that in the absence of some controversy, she could see no reason why any other party needed to be involved and that it would be an issue of fact to be determined by the court on the material presented.

2. Section 68L of the Act allows for the appointment of an Independent Children’s Lawyer in proceedings under the Act in which a child’s best interests are, or a child’s welfare is the paramount, or a relevant consideration. It is a discretionary matter for the court as to whether a child’s interests in the proceedings ought to be independently represented by a lawyer.

3. Having regard to all the circumstances of this case, including Ashley’s age and the urgency of the proceedings, I am satisfied that the appointment of an Independent Children’s Lawyer is unnecessary. In Re K (1994) FLC 92-461 at 80,773 the Full Court issued guidelines as to the circumstances in which an Independent Children’s Lawyer should usually be appointed. One of the categories referred to in those guidelines were applications in the Court’s welfare jurisdiction relating in particular to the medical treatment of children where the child’s interests are not adequately represented by one of the parties. In the circumstances of this case, I am satisfied that the child’s interests are adequately represented by the maternal grandmother who is the applicant. I am fortified in that view by the evidence of both parents and the expert witnesses.

4. Under s 60CE of the Act, there is nothing in this part of the Act that permits the court or any person to require the child to express his or her views in relation to any matter. However, in this case, the child’s views have been clearly expressed through his grandmother and various professionals who have assessed Ashley.

Evidence and Standard of Proof

1. The rules provide that evidence may be given in the form of an affidavit or orally with the court’s permission.[3] The documentary evidence relied upon for this hearing is listed in Annexure A.  No party sought to cross-examine any witnesses.

   [3] Rule 4.09(3) Family Law Rules 2004 (Cth)

2. The standard of proof applicable is on the balance of probabilities under s 140 of the Evidence Act 1995 (Cth).

The Nature of the Proposed Medical Treatment

1. It is proposed that Ashley would commence treatment with testosterone and the effects of this treatment are partially reversible although some of the desired changes such as male hair growth pattern, voice change and muscle changes may be very difficult to reverse. The effect on his reproductive capacity (conception from successful ovulation) in the longer term is not certain.

Evidence in support of the application

1. I accept the unchallenged evidence of the applicant who deposes that Ashley came into her care after his birth because his parents were very young and had relationship problems.  She deposes to the following matters regarding Ashley’s circumstances:

   ·Ashley has three siblings aged 13, 10 and two from his mother and he spends one night each weekend with them.

   ·At 10 years of age in 2008 Ashley spent five weeks in a hospital for the treatment of anxiety.

   ·Ashley refused to use the toilets at school or in public from about grade 2 and started refusing to attend school when he was seven. This was a difficulty until he publicly identified himself as male during his secondary school years, at which time he commenced using male toilets.

   ·Ashley was first referred to the Child and Adolescent Mental Health Service for school refusal and continued to attend until approximately mid-2013.

   ·Ashley had significant difficulties during his secondary schooling due to extreme bullying and moved schools frequently, spending periods of time refusing to attend school.

   ·Ashley has made numerous attempts to take his own life which resulted in an admission to hospital in 2012, one admission in March 2013, four admissions in April 2013, and an admission in May 2013.

   ·Ashley first told the applicant that he identified as male on 8 January 2012 when he was nearly 14 years old and he was referred for assessment for a diagnosis of gender identity dysphoria.

   ·Ashley changed his name in February 2012 and was issued a new birth certificate on 4 June 2014.

   ·Since receiving his formal diagnosis and attending for treatment at the hospital, Ashley finds his appointments very informative and has built a good relationship with his treating medical practitioners.

   ·Ashley has “expressed in extremely strong terms for an extended period of time that he is unhappy in his current physical form and that receiving treatment to begin the masculinisation process will address this by allowing him to live within a body that is consistent with his gender”.

   ·The applicant has had many discussions with Ashley about the proposed treatment and is confident that Ashley understands the nature and the consequences of the proposed stage 2 treatment to commence male development.

   ·The applicant is confident that Ashley understands the effects of the stage 2 treatment and he has told her that when he is administered testosterone he understands that the changes which will occur will be deepening and changing of the voice, growth of the Adam’s apple, body hair growth, stopping the development of ova, muscle development and possible bone growth changes.

   ·The applicant has discussed with Ashley the effects of the treatment on his fertility and he has told her that he feels that it is not an option for him to carry and give birth to a child. Ashley has told her that the idea of becoming pregnant disgusts him.

   ·Ashley has informed the applicant that he is aware of other options such as surrogacy arrangements should he decide to have a family.

   ·The applicant has not had any conversations nor witnessed any behaviour from Ashley which suggests that he may change his mind and identify as female.

   ·The applicant is fearful about the impact on Ashley’s mental health if he does not undergo stage 2 treatment.

2. The evidence of the parents is that each agreed with the contents of the maternal grandmother’s affidavit to the extent that they were within each parent’s personal knowledge. Both parents depose that they support Ashley seeking treatment for his Gender Identity Dysphoria and in the terms of the orders sought by the maternal grandmother.

Gillick Competence

1. The evidence of the applicant, the parents and Ashley’s treating doctors supports a finding that he is Gillick competent. The evidence of Ashley’s treating doctors is summarised below.

The Evidence of Associate Professor P

1. Associate Professor P is a consultant child and adolescent psychiatrist with 34 years of practice at the hospital where Ashley proposes to be treated.  Associate Professor P has considerable experience working with children and adolescents with a range of gender identity developmental problems having seen approximately 80 children and adolescents experiencing gender dysphoria.

2. He met with Ashley on approximately eight occasions from October 2012.

3. It is his opinion that Ashley meets the criteria for a diagnosis of Gender Dysphoria of Adolescence under the DSM-V (DSM-V is the updated version of DSM-IV), (previously known as Gender Identity Disorder under the DSM-IV). Gender dysphoria refers to the distress that may accompany the incongruence between one’s experienced or expressed gender and one’s assigned gender (natal gender).

4. In terms of his opinion as to whether Ashley is capable of making an informed decision about the procedure, Associate Professor P deposes that Ashley definitely agrees to commence the treatment and has been asking for this over the previous 18 months.  He deposes that he has talked with Ashley about the risks and benefits of the treatment and that he believes that Ashley clearly understands the consequences of the treatment upon his body and his mental health and that although steps may be taken to minimise the impact on subsequent fertility, Ashley is aware that he may not be able to carry a child himself. Associate Professor P deposes that Ashley has expressed the view very clearly that he would not feel able to have a child himself. Associate Professor P confirms Dr G and Dr X’s opinion that there is no less invasive treatment than testosterone administration to induce the changes required in Ashley’s body. 

1. He deposes that Ashley is very capable of making an informed decision about commencing the treatment and clearly understands the risks and benefits both short and longer term.

2. Associate Professor P outlines the significant number of mental health problems experienced by Ashley through his childhood and early adolescence and concludes that many of the symptoms “are related to the consequences of [Ashley] not feeling able to tell his family and friends about his gender dysphoria and identity as a boy.”

3. Associate Professor P deposes that Ashley presents in a mature, articulate and intelligent manner when discussing the issue of his gender dysphoria and possible treatment. He is of the opinion that Ashley does have the insight and maturity to understand the nature of the treatment proposed, is aware of the perceived positive changes that will result and knows that his bone density will increase. He notes that Ashley has undertaken independent research and formed support networks between transgender people and professionals working in the area to further educate himself. He concludes that Ashley experiences profound gender dysphoria and the treatment will alleviate much stress, in addition to inducing the physical changes consistent with his gender identity. Associate Professor P warns that Ashley will remain at severe risk of increasing depressive mood and possible self-harm if denied treatment.

The Evidence of Professor N

1. The evidence of Professor of Developmental Psychiatry, Professor N is that she had met with Ashley on three occasions (being 24 April 2012, 23 January 2013 and 14 October 2013) in relation to his diagnosis of gender identity dysphoria. Her report is dated 5 May 2014. Professor N outlines the contact she has had with Ashley and noted that he had previously been treated for depression and anxiety by Child and Adolescent Mental Health Services. She records that Ashley has been raised by his grandmother and has a supportive relationship with her. She notes that Ashley had longer term difficulties managing anxiety and distress related to difficult family issues including rejection by his biological mother and lack of contact with his father. Professor N records that Ashley disclosed his desire to be male to his grandmother and has sought advice from his GP about hormonal treatment. It is her opinion that “In retrospect [Ashley] has experienced cross-gender feelings since primary school and feels these have contributed to his feeling different from his peers and his difficulties in attending school.”

2. This evidence is corroborative of the supportive relationship between Ashley and his grandmother, Ashley’s wish to identify as male and Ashley’s history of mental health issues.

The Evidence of Dr X about the Proposed Medical Treatment

1. Dr X is the current head of the Gender Dysphoria Service at the hospital where Ashley proposes to be treated. She saw Ashley in her capacity as a subspecialist Adolescent Physician. She is a current member of the hospital’s Vulnerable Children’s Committee. Dr X has worked in paediatrics since 2003.

2. In her affidavit Dr X reports that her colleagues in the multidisciplinary team practising in Adolescent Medicine confirm that Ashley meets diagnostic criteria for gender identity dysphoria. Dr X proposes treatment with testosterone to masculinise the body and proposes a 0.5 mL (125 mg) dose of Sustanon 250 as a monthly intramuscular injection. Subject to adverse effects, this dose would be increased to 1 mL (250mg) monthly, which would be sufficient to suppress female hormones. Dr X reports that there is no way of inducing the masculine changes required other than by testosterone administration.  Ashley’s long-term treatment would be through Reandron 1000 injections every three months, which would begin at a later stage.

3. Dr X notes that Ashley’s mood may be affected and that he may become aggressive if the testosterone dose is increased too rapidly. She also notes that the effect of testosterone on the ovaries and other female organs is not yet well understood, and further says that the female reproductive organs can either be removed by surgery at a later stage, or retained with specialist monitoring for any changes which may require treatment.

4. Dr X lists a series of physical and physiological changes that would occur in Ashley’s body as a result of the injections, and warns that his emotional state would deteriorate if the treatment were not carried out. She says that there is a significant risk of self-harm. Dr X says that this treatment would allow Ashley to “maximise his emotional, social and educational potential by allowing him to live within a body that is consistent with his male gender identity”.

5. Dr X deposes that Ashley is capable of understanding the nature and consequences of the testosterone treatment. According to her, he is well apprised of both benefits and risks of the recommended medication, and was able to explain the options for maximisation of fertility preservation and the effects of testosterone on reduction of fertility in the longer term.

The Evidence of Dr G 

1. Dr G is the Director of the relevant Department of the hospital where Ashley proposes to be treated. She met with Ashley and his grandmother on 1 October 2014 about his diagnosis of gender identity dysphoria and the effect of the proposed treatment on his reproductive organs. Her professional opinion is outlined in a report dated 1 April 2015.

2. It is her opinion that Ashley is well aware of the impact of testosterone on the development of facial hair, voice deepening and increasing muscle bulk. In her affidavit she deposes that Ashley understood the procedure and is keen to proceed with testosterone treatment. She states that she was primarily responsible for ensuring that Ashley understood the potential impact of testosterone on future fertility (which on current evidence is minimal) and that she was comfortable to conclude that Ashley was Gillick competent in his understanding and thus in making a decision about this treatment. She reports that Ashley presented as a capable, intelligent young person who has carefully considered his options and who has managed his complicated situation with remarkable maturity.

3. She states that Ashley understood the consequences of the treatment and the small possibility that there might be an impact on his future fertility. She states that he is also aware that there are “transgendered FTM adults who have ceased their testosterone and successfully carried pregnancies – even here in [this state].”

4. She states that it is her opinion that it is highly unlikely that Ashley would change his mind in the future because he fulfils the guidelines for Gender Identity Dysphoria but that the risk from the use of testosterone lies primarily in the setting of whether Ashley changes his mind with regard to his gender.

5. Dr G is clear in her opinion that to achieve male secondary sexual characteristics, there are no other options apart from testosterone therapy.

6. As to the question of the considerations for Ashley if the procedure is not carried out, Dr G refers to international data that demonstrates high rates of depression and increased rates of suicide in young people who are not supported in their efforts to resolve their Gender Identity Dysphoria. She states that if the procedure is not carried out, from a future fertility perspective, it is not possible to guarantee fertility in any event.

7. Dr G reports that in the event that Ashley ceases treatment in the future, many of the effects of stage 2 treatments are reversible whereas some are irreversible such as the voice change that occurs, the development of an Adam’s apple and skeletal changes.

8. In terms of whether the procedure is necessary for Ashley’s welfare, Dr G reports that delaying this intervention will likely delay the further maturation and social development of the young person and that allowing physical transition to the gender they identify with allows the young person to then continue with normal development and socialisation. She reports that she has seen the negative impact on the social development and interaction with peers where a young person’s development is not in line with those in the gender that they identify with and at an appropriate age. 

9. Regarding the likely long-term physical, social and psychological effects if the procedure is carried out, Dr G states that the impact of treatments on fertility was the focus of her consultation with Ashley and his grandmother. She reports that she discussed the options available regarding other choices from a fertility preservation perspective. In summary Dr G states that there is no evidence of any long-term negative impact of testosterone on the uterus in terms of an impact on future fertility.

Findings and Conclusion

1. I accept the unchallenged evidence of the expert witnesses and the applicant and note that the respondents and treating professionals are supportive of the application. Ashley has demonstrated the intellectual capacity and sophistication to understand the information relevant to making the decision and to appreciate the potential consequences.  His views are clear and have not changed.

2. On the basis of all of the evidence, I am satisfied on the balance of probabilities that Ashley is competent to fully understand the nature and consequences of the treatment described in the application and to make his own decision in relation to treatment. Ashley is in the transition phase from childhood to adulthood referred to in the Gillick case and is competent to consent to treatment.

3. I am satisfied that it is appropriate to make a finding that Ashley is competent to make his own decision regarding the proposed treatment.

The Nature of the Relief Sought and Form of the Order

1. The relief initially sought was framed in terms of declaratory relief and in discussions with counsel for the applicant during the hearing, I indicated that I had reservations about whether declaratory relief was an appropriate remedy in the circumstances.

2. There would appear to be some controversy about whether the court has the power, absent a statutory conferral of power, such as in s 78 of the Act, to make a declaration regarding these types of applications.

3. Despite carefully crafted written submissions from the applicant and discussion in court, upon further reflection I adhere to my view that it is unnecessary to make a declaration.  Accordingly, I do not propose to frame the order in terms of a declaration but to make a finding that Ashley is competent to consent to the medical treatment described in the application and to authorise him to make his own decision in relation to that treatment. 

4. Counsel for the applicant indicated that this form of order would not present a hurdle for Ashley in his dealings with the hospital.

I certify that the preceding sixty-one (61) paragraphs are a true copy of the reasons for judgment of the Honourable Justice Thornton delivered on 22 May 2015.

Associate: 

Date:  22 May 2015

Annexure A

Documents relied upon by the applicant grandmother:

·Affidavit of the Applicant filed 16 April 2015

·Affidavit of Respondent Mother filed 16 April 2015

·Affidavit of Respondent Father filed 16 April 2015

·Affidavit of Dr X filed 16 April 2015

·Affidavit of Associate Professor P filed 16 April 2015

·Affidavit of Professor N filed 16 April 2015

·Affidavit of Dr G filed 16 April 2015