Re: Eddie
[2017] FamCA 822
•9 October 2017
FAMILY COURT OF AUSTRALIA
| RE: EDDIE | [2017] FamCA 822 |
| FAMILY LAW – CHILDREN – Medical Procedures – Where the applicant is the mother of the child and seeks a declaration that the child is competent to consent to the administration of stage 2 treatment for gender dysphoria or in the alternative the court make an order authorising the administration of that treatment – Where orders are sought to maintain the confidentiality of the proceedings – Where an order is made dispensing the rule requiring service upon the prescribed child welfare authority – Where a finding is made that the child is Gillick competent to consent to stage 2 treatment for gender dysphoria – Where orders relating to confidentiality are made – Where the application is otherwise adjourned to await the outcome of the Full Court’s decision in Re Kelvin. |
| Family Law Act 1975 (Cth) Family Law Rules 2004 (Cth) |
| Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112 |
| APPLICANT: | The Mother |
| RESPONDENT: | The Father |
FILE NUMBER: By Court Order File number is suppressed
| DATE DELIVERED: | 9 October 2017 |
| JUDGMENT OF: | Justice Watts |
| HEARING DATE: | 9 October 2017 |
REPRESENTATION
By Court Order the names of Solicitors have been suppressed
Finding
The court finds that the child, Eddie born in 2002 is Gillick competent to consent to stage 2 medical treatment for gender dysphoria as classified in the Diagnostic and Statistical Manual of Mental Disorders 2015 (DSM-5).
Orders and Notation
The requirement of Rule 4.10 Family Law Rules 2004 (Cth), that the Initiating Application filed 29 September 2017 and other documents be served on the prescribed child welfare authority, be dispensed with.
These proceedings are adjourned to await the outcome of the Full Court’s decision in the case stated from Re Kelvin [2017] FamCA 78.
I note that I will conclude this matter by making an order in chambers once the outcome of the Full Court’s deliberations in Re Kelvin are known.
The name of the child, Eddie born … 2002, the child’s family members and their occupations, the child’s medical practitioners, this court’s file number, the State or Territory of Australia in which these proceedings were initiated and any other fact or matter that might identify the child shall not be published in any way.
Only anonymised Reasons for Judgment and Orders shall be released by the court to non-parties without further contrary order of a Judge.
No person shall be permitted to search the court file in this matter without first obtaining the leave of a Judge.
The applicants be at liberty to provide a copy of the un-anonymised finding and orders and un-anonymised reasons for judgment to all persons involved with Eddie’s treatment.
Note: The form of the order is subject to the entry of the order in the Court’s records.
IT IS NOTED that publication of this judgment by this Court under the pseudonym Re: Eddie has been approved by the Chief Justice pursuant to s 121(9)(g) of the Family Law Act 1975 (Cth).
Note: This copy of the Court’s Reasons for Judgment may be subject to review to remedy minor typographical or grammatical errors (r 17.02A(b) of the Family Law Rules 2004 (Cth)), or to record a variation to the order pursuant to r 17.02 Family Law Rules 2004 (Cth).
| FAMILY COURT OF AUSTRALIA |
| The Mother |
Applicant
And
| The Father |
Respondent
EX TEMPORE REASONS FOR JUDGMENT
Introduction
Eddie has been diagnosed as having gender dysphoria based upon DSM-5 diagnostic criteria.
Eddie is currently 15 years and five months old. He wishes to commence stage 2 treatment for gender dysphoria.
Eddie’s mother, by way of Initiating Application filed 29 September 2017, sought the following declaration, and in the alternative, the following order:
1. That the Court declares the child Eddie born in 2002 is competent to consent to the administration of Stage 2 treatment for the condition of Gender Dysphoria in Adolescents and Adults in the Diagnostic and Statistical Manual of Mental Disorders (2013) DSM-5.
…
In the alternative:
1. That the court authorise the administration of Stage 2 treatment for the condition of childhood identity disorder under s 67ZC of the Family Law Act on and from a date to be determined by the treating medical team of Eddie on the basis that it is in the best interests of Eddie.
In addition, Eddie’s mother sought orders seeking confidentiality and restrictions on persons who shall be permitted to search the court file.
Rule 4.10 of the Family Law Rules 2004 (Cth) provides that a medical procedures application and any documents filed in support of it must be served upon the prescribed child welfare authority. That has happened. The mother has provided an Acknowledgment of Service of the documents served on the child welfare authority. I am informed by the lawyer that the Department are still considering their position notwithstanding that they knew the matter was listed before me this morning. The Department does not appear before me this morning. The lawyer for the mother has made an application for dispensation of the requirements pursuant to Rule 4.10. Given the evidence filed in this case together with the fact that the Department haven’t attended this morning and also the fact that so far as I am aware in more than 60 cases dealt with by this court since the Full Court’s decision in Re: Jamie (2013) FLC 93-547 no child welfare authority has suggested to the court that a finding should not have been made on the evidence in those cases that a child was Gillick competent to consent to stage 2 treatment. In all the circumstances in this case it is appropriate to dispense with the requirement of Rule 4.10.
Eddie’s mother filed an affidavit on 29 September 2017 which is said to have been affirmed on 26 September 2017. The jurat page was not completed. An affidavit in identical terms properly affirmed was filed on 5 October 2017. Filed in court this morning was an additional affidavit of a solicitor employed by the lawyers for the mother sworn on 9 October 2017 relating to the father’s knowledge about this application. Eddie’s mother also relies upon affidavits filed by Dr L and Professor F.
The affidavit filed on behalf of the mother on 9 October 2017 contains an acknowledgment of service signed by the father, a letter from the father in which he indicates his full support and agreement to what is being proposed in the application and a statutory declaration that was previously also annexed to the mother’s earlier affidavit. In a statutory declaration dated 30 March 2017 attached to Eddie’s mother’s affidavit, Eddie’s father states his support and consent for Eddie’s desire to commence stage 2 treatment.
The Law
A Gillick competent child is one who has achieved “a sufficient understanding and intelligence to enable him or her to understand fully what is proposed” (Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112 at 189 and see 169, 194-195; Secretary, Department of Health and Community Services v JWB and SMB (1992) 175 CLR 218 (“Marion’s case”)).
I am aware that in Re: Kelvin [2017] FamCA 78 a Full Court of five judges are reserved on questions relating to whether or not Re: Jamie was correctly decided; whether or not the interpretation of Re: Jamie as set out below is correct and whether or not once a finding has been made that a child is Gillick competent to consent to stage 2 medical treatment for gender dysphoria, applications such as those made in this case should be dismissed or whether or not orders or declarations should be made.
The Full Court in Re: Jamie determined:
10.1Stage 2 treatment for gender dysphoria is a special medical procedure which required the court’s authorisation pursuant to s 67ZC of the Family Law Act 1975 (Cth) (“the Act”), unless the child was Gillick competent to give informed consent.
10.2The court’s authorisation is not required if the child is Gillick competent and in those circumstances the decision is left to the child (Bryant CJ [139 – 140(d)]; Finn J [188] although at [140(d)] Bryant CJ adds the words “absent any controversy”).
10.3The court and not the child’s treating professionals should determine whether a child is Gillick competent as a threshold question (Bryant CJ at [136-137, 140(e)]; Finn J at [186] and Strickland J at [196]).
In Re: Jamie at [139], Bryant CJ explicitly said, “That application however would only need to address the question of Gillick competence and once established the court would have no further role”. At [188] Finn J said, “If the court was completely satisfied of the child’s capacity to consent to stage 2 treatment, it would be unnecessary for it to have to authorise the treatment”. At [192] Strickland J said that he agreed with the outcomes and generally for the reasons set out by the other two judges in the case.
The inquiry embarked upon is to establish or deny whether or not the court has jurisdiction to authorise stage 2 treatment for gender dysphoria. If the child is not Gillick competent, then the court has jurisdiction (s 67ZC of the Act) and power (s 34(1) of the Act) to authorise the treatment. If the child is competent, then the jurisdiction and power is not enlivened and I interpret Re Jamie to mean that the appropriate outcome is that:
12.1 A finding in respect of Gillick competence is recorded; and
12.2An order is made dismissing the application for authorisation of the treatment.
When conducting this inquiry, given the provisions of s 67ZC(1) of the Act are not yet enlivened, the court is neither required to have regard to the best interests of the child as the paramount consideration (s 67ZC(2)) nor consider all the matters in s 60CB – s 60CG of the Act, although there may be an overlap between the facts relevant to making a finding about Gillick competence and some of the s 60CC(2) and (3) considerations, particularly s 60CC(3)(a) of the Act.
As Bryant CJ says at [139], the focus of the hearing is “the proposed treatment and its effects, and the child’s capacity to make an informed decision”. Nonetheless, any assessment of the child’s competence does not take place in a vacuum and is made having regard to the child’s welfare.
Views differ as to whether, in light of what the Full Court said in Re: Jamie, it is appropriate to make a declaration rather than a finding that a child is Gillick competent to consent to stage 2 medical treatment for gender dysphoria (see Re: Jason [2016] FamCA 772, Austin J said at [25] and Re: Kelvin at paragraphs [15] and [16]). It is anticipated that those controversies will be resolved when the Full Court delivers its judgment in Re: Kelvin.
Background
The mother says Eddie was born M in 2002. He has a brother who was born in 2004. Eddie is close to his brother.
In December 1989 Eddie’s parents married. They separated in September 2012. There are no current parenting orders in place but Eddie’s parents have an agreement about the care of the children. Eddie has chosen not to communicate with his father. Eddie’s mother has re-partnered with a man who is a stepfather to Eddie and whom Eddie calls “dad”.
At preschool age, Eddie played with gender-neutral or male-typical toys and generally wore boys’ clothing. Eddie played with both boys and girls but showed a preference for physically active girls as playmates as the boys played too roughly. Until puberty, Eddie did not think of himself in a gendered way.
At the age of 10, Eddie commenced developing breasts and wore baggy clothing to hide his chest. He read about transgender identity on social media and felt that it explained how things were for him. The following year, Eddie started to feel sick when referred to by female pronouns, became withdrawn and depressed.
When menstruation commenced at the age of 12, Eddie felt that it was “wrong” and he “was a mess” because he subjectively identified as a boy.
In year 6 Eddie became school captain and started to suffer from performance anxiety. He felt that he was forced to wear a dress to school due to the expectations of his leadership position. Dr L reports that at about this time “There was also a distressing incident of repeated sexual assault (breast fondling) by an elderly male neighbour”.
In 2015 Eddie commenced year 7 at Suburb C High School. Eddie actively engaged in internet research to understand his gender identity. He told his mother and school friends that he was “agender” and wanted to be referred to with neutral pronouns but this was not taken seriously. He was teased and bullied at school and felt pressured to appear more like a typical girl. After commencing high school he became highly anxious and severely depressed, engaging in self-harm in the form of cutting his arms and legs and developed eating disorder symptoms. He had expressed that he wanted to go to sleep and not wake up. That is he harboured thoughts about wanting to die. Eddie’s school performance became less stable and he ceased participating in extra-curricular activities due to his anxiety. These issues coincided with the onset of Eddie’s experience of puberty and his romantic relationship with a girl although he could not comfortably identify as a lesbian.
Throughout 2015 Eddie experienced issues with sleeping and anxiety which led to difficulties when it came to him coping with school. Eddie’s school classes had also been disruptive in 2015 which resulted in Eddie being unable to concentrate and experiencing panic attacks when dropped off at school.
In late December 2015 Eddie made contact with Headspace, a national youth mental health foundation. He had his first appointment in December 2015. Since this time he has been working on his sleeping and anxiety issues with the assistance of professionals he has attended upon at Headspace. He has participated in a Suicide Prevention Program with a suicide prevention counsellor and has also been referred to a few medical practitioners.
From February 2016 Eddie decided that he needed to be a boy in his expressed gender as this reflected his inner state of gender identity.
On 26 February 2016 Eddie attended upon his family general practitioner due to his increasing anxiety and was prescribed with medication.
On the Easter weekend of 26 March 2016 Eddie told his mother that he was male in gender.
In March 2016 Eddie’s girlfriend ended their relationship after he informed her that he was transgender and identified as male.
Since April 2016 Eddie has worn a chest binder during the day to minimise his breasts.
In April 2016 Eddie underwent a social transition at Suburb C High School. Eddie received some support from the school community but was taunted and bullied by some students. He missed a great amount of school due to depression and anxiety. Eddie subsequently transferred to Suburb D High School on health, welfare and safety grounds.
On 6 April 2016 Eddie’s family general practitioner referred him to the Emergency Department at C Hospital after an episode of severe cutting to both forearms and breasts. Eddie was subsequently referred to a Community Adolescent & Youth Mental Health Service where he received a referral to see a psychologist, Ms H.
On 8 April 2016 Eddie attended his first appointment with a provisional psychologist from Headspace.
On 11 April 2016 Eddie began using the name Eddie and using male pronouns.
On 12 April 2016 Eddie attended his first appointment with psychologist, Ms H.
On 26 April 2016 Eddie attended upon Ms H who recommended that he return to the general practitioner at Headspace, Dr E, for more guidance in relation to gender dysphoria. At this time Eddie was experiencing more anxiety and his gender dysphoria took over his activities such that he refused to go anywhere near his school. He used words to the effect of “it’s a big black hole” to describe his gender dysphoria and experience at school.
On 31 May 2016 Dr E prescribed Eddie with the contraceptive pill to cease menstruation. However, Eddie’s menstrual cycle returned and despite trying different contraceptive pills, none were effective and he experienced menstrual cycles over the next four months. Eddie was also referred to the Gender Clinic at K Hospital for an assessment.
Eddie commenced attending Suburb D High School in July 2016. He is currently in year 9.
On 11 August 2016 the general practitioner at Headspace, Dr E, recommended that Eddie spend three weeks away from school due to his continuously low mood and self-esteem. Eddie followed this recommendation and subsequently returned to school full time.
On 29 August 2016 Eddie attended upon a paediatrician, Dr Q at the Gender Clinic at K Hospital.
On 20 October 2016 Dr E administered an injection of Progesterone on Eddie in an attempt to end his menstrual cycle. At this time Eddie’s gender dysphoria was extreme. He was not sleeping well, had low moods and very low self-esteem.
On 3 November 2016 Eddie lodged an application for a name change to Eddie …. A new birth certificate was issued under that name in 2016.
By 9 November 2016 Eddie had ceased menstruating.
On 11 November 2016 Eddie attended upon a psychiatrist, Dr G at the Gender Clinic at K Hospital who referred him to an endocrinologist, Professor F. Dr G diagnosed Eddie with gender dysphoria and the co-morbid conditions of obsessive features, anxiety and depression.
On 15 November 2016 Eddie attended the Gender Clinic at K Hospital and saw Professor F. On this day he commenced stage 1 puberty blockers.
Eddie last attended upon psychologist, Ms H on 14 December 2016. Ms H advised that there was not much more she could do for Eddie and referred him back to Headspace.
Eddie was keen to recommence school to begin year 9 at the beginning of 2017.
On 19 January 2017 Dr E administered a second injection of puberty blockers.
On 18 March 2017 Eddie attended upon psychiatrist, Dr L.
On 20 March 2017 Eddie attended upon a plastic and reconstructive surgeon, Dr J, with his mother and stepfather regarding a quote for a bilateral mastectomy and male chest reconstruction. The lawyer for Eddie’s mother has made clear today that the application before me only relates to stage 2 treatment and does not relate in any way to stage 3 treatment.
Since 30 March 2017 Eddie has received injections of puberty blockers every eight weeks.
On 5 June 2017 Eddie attended the Gender Clinic at K Hospital and saw Professor F.
On 21 June 2017 Eddie attended upon psychiatrist, Dr L.
Since 22 August 2017 Eddie has been receiving regular counselling from a clinical psychologist, Ms N, at Headspace.
Proposed treatment and its effects
Professor F is a Paediatric Endocrinologist employed as Senior Staff Specialist at K Hospital and is the Head of the Department of Endocrinology and Diabetes. His specialist practice frequently involves him seeing young people with gender dysphoria. In a report dated 4 August 2017 he opines that while Eddie has tolerated puberty suppression well and has been successful in reducing female hormone effects.
Professor F explains that stage 2 therapy for gender dysphoria is:
…the administration of testosterone (male type or androgen hormones) to achieve male type secondary sexual characteristics. This will include the development of male sexual hair distribution, male body habitus and muscular development, enlargement of the clitoris and enlargement of the larynx and deepening of the voice. It will also cause suppression of ovarian function and potential loss of female fertility. Many of these changes are irreversible or only partly irreversible.
Professor F is in the process of referring Eddie to an adult endocrinologist who would be prepared to prescribe and supervise that therapy. He has advised Eddie that there are no long-term data on the social, psychological or medical outcomes for people who have transitioned gender at a young age and therefore a decision needs to be made based according to an individual’s own judgment as to what is best in their own circumstances, guided by mental health professionals.
Dr L is a consultant psychiatrist with a further qualification in child and adolescent psychiatry and a subspecialty interest in gender dysphoria. He is employed as a Senior Child and Adolescent Psychiatrist in the S Service and also works as a youth psychiatrist at Headspace and a Consultant Psychiatrist at the P Service. In a report dated 24 July 2017 Dr L explains the likely short and long term physical, social and psychological effects of the procedure on Eddie if the procedure is carried out are:
The proposed treatment will induce development of male secondary sexual characteristics (such as voice deepening, muscle development and growth of facial and body hair over a period of several months) and reduce some female secondary sexual characteristics, primarily in terms of body shape. There may be some enlargement of the clitoris, but otherwise no change is anticipated in the structure of his primary internal or external sexual organs …
Physical risks include: premature fusion of epiphyses, limiting final height; acne; male pattern baldness; elevated HDL cholesterol; renal dysfunction; hepatic dysfunction; weight gain.
Social risks include: rejection by some family members, friends and casual acquaintances; discrimination in public and in the workplace; transphobic harassment, abuse and assault in the worst case scenario.
Psychological risks include: the stress of passing as a person of male gender while still transitioning; adjustments to his sense of identity as his body changes; exacerbation of mood dysregulation due to the hormonal therapy causing increased aggressive emotions.
Dr L says that stage 2 treatment “will enhance Eddie’s self-esteem and reduce the incongruence between his assigned gender and his experienced and expressed gender” which is “very likely to improve his mood state, through reduction of the gender dysphoria and the self-loathing of his body as the masculinisation proceeds” which “will also allow him to be perceived and treated as a male by others, reducing social dysphoria and the significant anxiety around not “passing” as a mid-adolescent person of his experienced (male) gender.”
In his report Dr L describes the likely short and long term physical, social and psychological effects of the procedure on the child if the procedure is not carried out as follows:
Eddie will need to continue in his present physiological state until he reaches legal majority, and is then able to independently consent to the procedure. This objectively means a delay in treatment of nearly two years. The likely psychological effect of not carrying out this procedure in the short term is prolongation of Eddie’s dysphoric state with attendant risks of relapse into depression and deliberate self harm, especially as the social and academic stresses inherent in proceeding with secondary school increase. Emotionally, Eddie will feel invalidated by society and a core aspect of his essential personhood will be effectively negated. Socially, it will pose obstacles to Eddie’s ability to be perceived (“pass”) as a male amongst his age peers, as he will be advancing in age yet appear non-pubertal as a male. He will likely find it difficult to form friendships and relationships due to restricted physical activity, inner conflicts, body dysmorphia and attendant self-loathing. He would then be very likely to underachieve academically, isolate himself socially and become highly prone to self-destructive behaviours.
The child's capacity to make an informed decision
Eddie’s mother says that Eddie has not changed his mind regarding his gender identification following his social transition. She states:
Eddie has talked with the family about the proposed treatment. He understands that stage 2 treatment will not resolve his mental health issues. Eddie is looking forward to treatment; testosterone and top surgery, and the positive effect this will have on his self esteem.
As I have already said the application that is being made to this court on this occasion does not have any relevance to the question of top surgery.
Eddie’s mother describes him as a “mature, rational and considerate young person”. She says that Eddie talks with his family and puts a lot of thought into his decision making. She says that he “has a cautious attitude and makes decisions accordingly, especially when decisions will affect his future. Once Eddie makes up his mind, he is very determined and firm.” Consequently, his mother trusts that Eddie has the capacity to make his own decisions.
In his report dated 4 August 2017 Professor F states that in a recent meeting with Eddie and his mother he formed the view that Eddie:
…has continued to firmly express the view that he wishes to continue living in a male role and pursue stage 2 therapy with androgen therapy. I am of the opinion that the gender dysphoria remains firmly entrenched and that Eddie has sufficient knowledge and understanding of the effects of stage 2 therapy to proceed with that. He understands that many aspects of androgen therapy are irreversible or partially reversible. I have given him the opportunity to raise any questions or express any doubts about his intended course and I have answered his questions to the best of my ability and our current state of knowledge. He also understands that he could stop pubertal suppression at any time and not proceed with androgen therapy and return to a female gender role; he has firmly expressed that he does not wish to do that.
While Professor F has formed the opinion that from an endocrinology perspective, Eddie is sufficiently informed and capable of making the decision about proceeding with stage 2 treatment he states that mental health professionals are better placed to advise whether Eddie is currently psychologically and intellectually capable of making an informed decision. He also says that these are the appropriate professionals to advise as to the degree of certainty of the diagnosis of gender dysphoria, whether the state of gender dysphoria persists and the adaptation of the real life experience of living in the male role in recent years.
As indicated, on 11 November 2016 Dr G, psychiatrist, diagnosed Eddie as suffering from gender dysphoria. Dr L in his report dated 24 July 2017 confirms that diagnosis and provides considerable detail as to why he did so. The report also discusses Dr L’s interview with Eddie on 21 June 2017 and his assessment of Eddie’s competence to consent to the Gillick Standard. He sets out his observations in his report dated 24 July 2017 as follows:
able to comprehend and retain both existing and new information regarding the new treatment – Eddie demonstrated a broad knowledge about the treatment and was able to understand and integrate additional information that I introduced from time to time as the interview progressed.
able to provide a full explanation, in terms appropriate to [his] level of maturity and education, of the nature of Phase 2 treatment – Eddie explained that the treatment was the male hormone, testosterone. It can be given as a gel, a tablet or an injection. One injection form lasts two or three weeks, the other lasts for three months. He knew that the treatment would be of many years’ duration, essentially lifelong. He would also require regular medical checks and blood tests for hormone levels and side effects.
able to describe the advantages of Phase 2 treatment – Eddie described the main advantage of Phase 2 treatment as being his increased confidence and likely reduction of his depression. The treatment would bring about desired physical changes including a more masculine body shape, increased muscle mass, deepened voice and more body hair. He would then feel enabled to be more socially active as he would not have to worry about being misgendered – people would see him and treat him as a boy.
able to describe the disadvantages of Phase 2 treatment – Eddie was aware that there are possible side effects of the treatment, including acne, balding, weight gain, limitation of height through fusion of growth plates, high blood pressure, high cholesterol, increased chance of cardiovascular problems and diabetes, liver toxicity and possible increased risk of ovarian and breast cancers. He realised that he would probably need to have needles and regular medical checks.
able to weight the advantages and disadvantages in the balance, and arrive at an informed decision about whether and when he should proceed with Phase 2 treatment – Eddie considered the advantages and disadvantages of Phase 2 treatment and said that, for him, the advantages offered much more hope and outweighed the disadvantages. He said that he wanted to start testosterone as soon as he could.
able to understand that Phase 2 treatment will not necessarily address all of the psychological and social difficulties that he had before the commencement of treatment – Eddie acknowledged that the treatment would not be likely to fix all of his pre-existing psychological and social problems, but he felt certain that it will help, as he will be closer to being the person that he wishes to be. He thought it likely that he will be more socially confident and able to express himself more easily.
It is my opinion that Eddie was free to the greatest extent possible from temporary factors that could impair his judgement in providing consent to the procedure. Eddie was alert and orientated. He was interviewed alone to avoid potential influence by others. He did not demonstrate any evidence of sensory misperception or impaired cognitive processes. He was not in physical pain or in emotional distress.
Eddie's welfare
Eddie’s mother supports his decision to transition. She states, “I want Eddie to live happily without hiding himself. Eddie has all my support and love for his transition.” His mother says that after Eddie removes his chest binder at night, “he walks hunched over with his shoulders forward so his breasts are never visible.” She goes on to say:
At the moment Eddie is able to present as a boy however he is concerned with his voice. Eddie’s feminine voice is having a negative impact on his self-esteem.
Eddie wants to complete the physical transition, including top surgery. He feels he cannot move forward until all aspects of the transition are complete. The disparity between his gender identification and his biological sex has made him extremely anxious, which is consuming his every fibre every second of every day.
Since commencing puberty blockers in November 2016 Eddie’s mother says that she has observed Eddie to be in an improved state of mind. She says that he is aware of his anxiety and is working hard to overcome those feelings.
Since transferring to Suburb D High School, Eddie has been accepted and his friends have been supportive of his transition. He has formed a close group of school friends at Suburb D High School including two transgender boys who support each other during their transition.
Eddie’s parents and other family members are aware of his transition and have been very supportive.
Dr L says that Eddie is now well integrated into Suburb D High School and no longer avoids attendance at school. He says that Eddie continues to experience severe body dysphoria and cannot look at his breasts. Eddie strongly desires to be rid of his breasts, his rounded hips and thighs, and his vagina due to these being incongruent with his experienced and expressed gender as a male. He has expressed a strong ongoing desire to have a deeper voice, a flat chest, a male body shape with broader shoulders and more muscular development and facial hair. In his report dated 24 July 2017 Dr L opines that Eddie “is extremely keen to further normalise his physical development as an adolescent male by commencing testosterone treatment and has already actively investigated chest masculinisation surgery.”
While Eddie’s anxiety and depression have improved, he remains on a high dose of antidepressant medical and attends upon mental health professionals on a regular basis.
Conclusion
Having regard to all of the matters referred to, particularly the evidence of Dr L and Eddie’s mother, I am satisfied that Eddie is Gillick competent, given that he has sufficient understanding and intelligence to enable him to understand fully what is proposed by stage or phase 2 treatment. It follows that I shall make a finding that Eddie is Gillick competent to consent to stage 2 treatment for gender dysphoria.
Confidentiality
It is appropriate to make orders for confidentiality and restrictions on persons who shall be permitted to search the court file, as sought.
Adjournment
Having made the finding that Eddie is Gillick competent to consent to stage 2 treatment for gender dysphoria there is no legal impediment that would stop that treatment commencing immediately. Given however the Full Court is reserved in Re: Kelvin and the outcome of the Full Court’s deliberations in that case will almost certainly impact upon whether or not it would be appropriate to dismiss the application that has been brought or make some other order or declaration, I intend to adjourn these proceedings to await the outcome of the decision in Re: Kelvin.
I certify that the preceding seventy-four (74) paragraphs are a true copy of the reasons for judgment of the Honourable Justice Watts delivered on 9 October 2017.
Associate:
Date: 9 October 2017