Re: Larissa

[2015] FamCA 1144

FAMILY COURT OF AUSTRALIA

RE: LARISSA [2015] FamCA 1144

CHILDREN – MEDICAL PROCEDURES – Where the applicant mother seeks a declaration that the child is competent to authorise her own stage two treatment for Gender Dysphoria – where orders have previously been made that the mother have sole parental responsibility in relation to the child’s treatment for Gender Dysphoria – where the father has not participated in the current proceedings – where the child’s treating medical experts and mother support the child commencing stage two treatment – assessment of whether 16 year old child is Gillick competent to consent to medical treatment – finding that the child is competent to consent and authorised to make her own decision about stage two treatment.

PRACTICE AND PROCEDURE – Where the applicant seeks to dispense with the requirement under Rule 4.10 to serve a Medical Procedure Application upon persons including the prescribed child welfare authority – where there is no controversy as to the competency of the child – order that r 4.10 be dispensed with pursuant to r 1.12.

Family Law Act 1975 (Cth)

Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112
Re: Jamie [2013] FamCAFC 110; (2013) 50 Fam LR 369
Re: K (1994) FLC 92-461
Secretary, Department of Health and Community Services v JWB and SMB (1992) 175 CLR 218

APPLICANT: The Mother

RESPONDENT: The Father

FILE NUMBER: Suppressed by Court order

DATE DELIVERED: 18 December 2015

JUDGMENT OF: Johns J

HEARING DATE: 1 December 2015

REPRESENTATION

By Court Order the names of solicitors have been suppressed

Orders

1. That pursuant to rule 1.12 of the Family Law Rules 2004 (Cth) (the Rules) the requirement pursuant to rule 4.10 of the Rules that the Initiating Application filed 5 August 2015 be served on the prescribed child welfare authority be dispensed with.

2. That the name of the child Larissa (Born …) born … 1999, Larissa’s family members and their occupations, the hospital, Larissa’s medical practitioners, Larissa’s school, this Court, file number, the State of Australia in which the proceedings were initiated, the name of the mother’s lawyer and any other fact or matter that may identify Larissa shall not be published in any way and only anonymised Reasons for Judgment and orders (with coversheets excluding the Registry, file number and lawyers’ names and details as well as the parties’ real names) shall be released by the Court to non-parties without further contrary order of a judge, it being noted that each party shall be handed one full copy of these orders with the relevant details included for provision to the treating medical practitioners and to enable their execution, and one coversheet of Reasons for Judgment that includes the file number and the lawyers’ names.

3. That no person shall be permitted to search the Court file in this matter without first obtaining the leave of a judge.

4. Upon the Court being satisfied that the child Larissa (also known as …) born … 1999 is competent to consent to the medical treatment described in the Initiating Application filed 5 August 2015 the Court authorises Larissa to make her own decision in relation to that treatment.

5. That the applicant mother be at liberty to provide a copy of the un-anonymised orders and the un-anonymised Reasons for Judgment to all persons involved with Larissa’s treatment. 

6. That the applicant mother cause a sealed copy of these orders and Reasons for Judgment to be personally served upon the father.

7. That the applicant’s Initiating Application filed 5 August 2015 be otherwise dismissed.

AND THE COURT NOTES

The treatment described in the applicant’s Initiating Application filed 5 August 2015 is the following treatment for gender dysphoria:-

Gender Identity Dysphoria, stage two (cross-sex) hormone treatment of the child.

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

FAMILY COURT OF AUSTRALIA

The Mother

Applicant

And

The Father

Respondent

REASONS FOR JUDGMENT

INTRODUCTION

1. Larissa is aged 16 years.  Although biologically male, since 2012 Larissa has lived as a female in all aspects of her life.  In 2007 Larissa commenced attending the X Hospital Gender Clinic for treatment.  Larissa was formally diagnosed with Gender Dysphoria when aged 11 years. 

2. On 9 December 2013 orders were made by the Court providing that Larissa’s mother have sole parental responsibility in respect of all matters and decisions pertaining to Larissa’s treatment for stage one hormone suppression.  Larissa commenced that treatment in December 2013.

3. Larissa now wishes to commence stage two treatment for gender dysphoria.  To that end, an application has been filed by Larissa’s mother seeking a declaration that Larissa be declared Gillick competent to consent to that treatment.  Alternatively, Larissa’s mother seeks an order that she have sole parental responsibility for all matters and decisions pertaining to the proposed stage two treatment. 

4. These are my reasons for judgment with respect to that application.

Background

1. Larissa was born in 1999.  She has a twin brother, M.

2. Larissa’s parents separated when Larissa was approximately four months old.

3. In 2008 the mother and the father consented to orders made in the Federal Magistrates' Court of Australia (as it then was) which provided that the children live with the mother and spend such time with the father as agreed between the parties in accordance with the children’s wishes.

4. When aged approximately three years, Larissa began exhibiting female mannerisms.  For example, she expressed a strong interest in toys marketed to girls, such as a Barbie car.  Larissa asked to be called a range of different female names.  At age 11, Larissa selected her name and settled upon it. 

5. From age six Larissa began wearing female clothing.  Initially she would dress as a female around the house and later progressed to wearing female clothing outside.  She expressed a desire to grow her hair long, enjoyed playing with make-up and dolls.

6. Larissa’s father did not support her identification as a female.  At the conclusion of time with her father, Larissa would be upset reporting that the father continued to call her by her name at birth and would challenge her desire to wear girl’s clothing and to act like a girl. 

7. Upon her commencement at secondary school in 2012 Larissa commenced living full-time as a female.  She is enrolled at her high school as a girl. 

8. Larissa commenced treatment with the X Hospital Gender Clinic in 2007.  She has been under the care of Associate Professor G, a consultant child and adolescent psychiatrist, since that time.  Larissa was formally diagnosed with Gender Dysphoria at age 11 years.  She commenced stage one puberty hormone suppression treatment in December 2013.  Larissa attends appointments with the X Hospital at three to four monthly intervals to receive hormone suppression injections.  At those appointments, Larissa also meets with Associate Professor G for on-going monitoring.

9. Larissa now wishes to commence stage two treatment for gender dysphoria.  That treatment will involve the administration of oestrogen via injection to encourage the development of female characteristics in Larissa.  Larissa’s mother, brother and maternal grandparents are supportive of her commencing that treatment. 

10. Larissa is described by her mother as a happy and healthy young woman who continues to develop and mature.  She enjoys attending school and her interests include shopping, cooking and socialising with her friends.  Larissa’s mother deposes that Larissa has stated on a number of occasions a keen desire to commence the stage two treatment, which Larissa views as a necessary stepping stone in her development. 

11. Historically Larissa’s father has not supported her desire to live as a female and undertake treatment for gender dysphoria.  Since orders were made by this Court in December 2013 permitting the commencement of the stage one hormone treatment Larissa has had no contact with the father. 

12. Notwithstanding the apparent opposition of the father to Larissa commencing treatment for her gender dysphoria he has not sought to participate in these proceedings.  The affidavit of Ms T filed 9 October 2015 confirms that the father was personally served with the mother’s Initiating Application and affidavit in support on 4 September 2015.

13. The affidavit of Ms P filed 1 December 2015 confirms that the father was served with the affidavits of Associate Professor G and Dr J under cover of letter dated 29 October 2015. That letter confirmed that the mother’s application was listed for a Directions Hearing in the Family Court of Australia on 4 November 2015 and that it would be necessary for the father to appear at Court that day in the event that he wished to be heard in respect of the application for Larissa to commence stage two hormone treatment.  The Australia Post website confirmed that that correspondence was delivered to the father on 13 November 2015 at 12.35 pm (annexure KAE-4). 

14. The father did not appear before the Court on 4 November 2015.  Accordingly, that day Registrar Field made orders adjourning the proceedings for determination before me on 1 December 2015.  Further orders were made as follows:-

    2.All parties appear and/or be represented on the adjourned hearing date.

    3.The Applicant forthwith serve a sealed copy of this order on the Respondent and any further affidavits she wishes to rely upon by sending same to the Respondent at his last known address being, … by ordinary pre-paid post.

    4.The Applicant inform the Respondent of the hearing on the 1 December 2015 at 10:00 am by sms to his last known mobile phone number.

    5.The Applicant file an Affidavit of Service confirming compliance with paragraphs 3 and 4 of these orders.

    6.The Respondent file and serve any Response to the said Initiating Application by the 25 November 2015.

    7.In the event the Respondent fails to comply with paragraph 2 and 6 of these orders, the Applicant has leave to apply to proceed with her application on an undefended basis.

15. The affidavit of Ms P confirms that in accordance with the orders of Registrar Field a further letter was sent by pre-paid post to the father serving a copy of the orders of 4 November 2015.  Further, Ms P caused an SMS text message to be sent to the father at his last known mobile telephone number on 27 November 2015.  The content of that message was:-

    Re: Larissa … [sic] – Hearing of this matter will proceed on 1 December 2015 at 10.00am in the … Family Court Registry.  All parties are to appear.  [N Firm].

16. Ms P deposes that there was no response to her SMS text message. 

17. The father has filed no material in these proceedings.  At the commencement of the hearing at 10.00 am the father was called.  He did not respond to that call.  The matter was stood down until 2.15pm to enable Ms P to swear her affidavits of service.  The father was called again at 2.20 pm prior to the commencement of the hearing.  Again, there was no response to that call. 

18. Accordingly, the hearing proceeded in the father’s absence.

Material relied upon

1. The applicant relies upon the following material:-

   ·Initiating Application filed 4 August 2015;

   ·Affidavit of the mother filed 5 August 2015;

   ·Affidavit of Associate Professor G filed 2 November 2015;

   ·Affidavit of Dr J filed 2 November 2015;

   ·Affidavits of Ms P filed 1 December 2015 (2); and

   ·Affidavit of service of Ms T filed 9 October 2015.

Legal principles

1. Section 60B(1) of the Family Law Act1975 (Cth) (“the Act”) sets out the objects of Part VII of the Act. One of the objects is to ensure that parents fulfil their duties and meet their responsibilities concerning the care, welfare and development of their children.

2. In deciding a particular parenting order, the best interests of the child are the paramount consideration (s 60CA). The primary and additional considerations for the Court in determining what is in the child’s best interests are set out in ss 60CC(2) and (3) of the Act.

3. Generally it is within the scope of a parent’s responsibility to consent to medical treatment for and on behalf of their child.  However, there are certain procedures that fall beyond that responsibility and require determination by the Court, as part of the Court’s parens patriae or welfare jurisdiction (Secretary, Department of Health and Community Services v JWB and SMB (1992) 175 CLR 218 (“Marion’s case”)).

4. Section 67ZC of the Act provides that the Court has jurisdiction to make orders relating to the welfare of children. The children’s best interests remain the paramount consideration in making such orders.

5. The procedure to be followed with respect to applications requiring Court authorisation of medical procedures is set out at Division 4.2.3 of the Family Law Rules 2004 (Cth) (“the Rules”).

6. Rule 4.09(1) provides that evidence must be given that satisfies the Court that the proposed medical procedure is in the best interests of the child.

7. The Full Court in Re: Jamie [2013] FamCAFC 110; (2013) 50 Fam LR 369 (“Re Jamie”) confirms that if a proposed treatment falls within the ambit of Marion’s case, and if the child is not Gillick competent, the proposed treatment must be first authorised by the Court. 

8. In the decision of Re Jamie, the Full Court considered what is known as stage two treatment of gender dysphoria.  The issues considered therein included whether the stage two treatment is a medical procedure for which consent lies outside the bounds of parental responsibility and thus requires the imprimatur of the Court. 

9. In determining that issue, the Full Court considered the question of the child’s capacity to consent to stage two treatment; that is, the question of whether a Gillick competent child could consent to the procedure.

10. The term “Gillick competence” comes from the decision of Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, where it was said by Lord Scarman at pages 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.  Until the child achieves the capacity to consent, the parental right to make the decision continues save only in exceptional circumstances.

11. In Marion’s case, the High Court confirmed that the view of the House of Lords in Gillick represents the common law in Australia.

12. The Full Court in Re Jamie determined that a Gillick competent child could consent to such stage two treatment.  In considering that question Bryant CJ stated:-

    134.     In my view, it would be contrary to the Convention on the Rights of the Child, and to the autonomous decision-making to which a Gillick competent child is entitled, to hold that there is a particular class of treatment, namely stage two treatment for childhood gender identity disorder, that disentitles autonomous decision-making by the child, whereas no other medical procedure does.  The High Court in Marion’s case, adopting the formulation in Gillick, held at 237 that a child is capable of giving informed consent when he or she “achieves a sufficient understanding and intelligence to enable him or her to understand fully what is proposed”.

    135.     I see no basis for reading this down because the treatment is for childhood gender identity disorder.  Indeed, one might think that, of all the medical treatments that might arise, treatment for something as personal and essential as the perception of one’s gender and sexuality would be the very exemplar of when the rights of the Gillick-competent child should be given full effect.

    (Original emphasis).

13. The next issue considered by the Full Court in Re Jamie was who should determine the question of Gillick competence.  It was held by the Full Court that, due to the nature of the stage two treatment, it is a matter for the Court to determine whether a child is Gillick competent.  Following the reasoning of the High Court in Marion’s case, the Full Court held that this is so for two reasons: firstly due to the risk of making the wrong decision as to the child’s capacity to give consent and secondly, because the consequences of a wrong decision are particularly grave.

14. With respect to stage two treatment, the Full Court held that once the question of Gillick competence was established, the Court would have no further role. 

15. As to how such proceedings are to be conducted, at paragraph 139 of the judgment, 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.  She stated there that:-

    The material in support of such an application, whilst needing to address the proposed treatment and its effects, and the child’s capacity to make an informed decision, would not need to be as extensive as an application for the court to authorise treatment and I can see no reason why any other party need be involved, absent some controversy.  It would be an issue of fact to be determined by the court on the material presented. 

16. Rule 4.10 of the Rules requires that applications for medical procedures in relation to a child must be served on the prescribed child welfare authority. The prescribed child welfare authority in this instance is the Department of Health and Human Services (“the Department”).

17. In circumstances where the father has elected not to participate in the proceedings, I am satisfied that there is no genuine controversy in the matter.  The mother is supportive of Larissa’s desire to commence stage two treatment.  The father has elected not to be heard with respect to the issue.   The assessment of Larissa’s treating medical practitioners, to which I will refer to in more detail later in this judgment, is that she is Gillick competent.

18. The main purpose of the Rules is to ensure that each case is resolved in a just and timely manner at a cost to the parties and the Court that is reasonable in the circumstances of the case. In the absence of controversy as to Larissa’s wishes or the view of her mother and treating doctors, I am satisfied pursuant to r 1.12 of the Rules that it is appropriate to dispense with compliance with r 4.10. There is no benefit to Larissa or her mother in delaying the finalisation of the application by requiring service of the application on the Department.

19. I am also satisfied that the appointment of an Independent Children’s Lawyer is unnecessary.  The guidelines provided by the Full Court as to the circumstances in which such appointment should be made are set out in the decision of Re: K (1994) FLC 92-461. Applications in the Court’s child welfare jurisdiction regarding medical treatment of children where the child’s interests are not adequately represented is one of the categories so identified in that judgment as warranting the appointment of an Independent Children’s Lawyer. However, I am satisfied in this instance that Larissa’s interests are well represented by her mother. Larissa’s mother has been solely responsible for her care since she commenced treatment for gender dysphoria in December 2013. Larissa’s mother has confirmed her assessment that Larissa understands the proposed treatment and is therefore Gillick competent.

20. The hearing was conducted on the papers.  None of the witnesses were required for cross-examination. 

21. The applicable standard of proof is the balance of probabilities in accordance with s 140 of the Evidence Act1995 (Cth).

Is Larissa Gillick competent?

1. The evidence of both Associate Professor G and Dr J overwhelmingly supports a finding that Larissa is Gillick competent. 

2. Associate Professor G is a consultant child and adolescent psychiatrist.  He has been treating Larissa at the X Hospital Gender Clinic since 2007.  Since that time he has seen Larissa and her mother at approximately three- to four-monthly intervals.  Associate Professor G confirmed that since commencing treatment for Larissa she has consistently identified as female. 

3. In 2013 Larissa was referred to Dr H, consultant child and adolescent psychiatrist for a second mental health opinion regarding diagnosis and treatment.  Dr H concurred with Associate Professor G in concluding that Larissa meets the criteria for a diagnosis of gender dysphoria, transsexual type male to female.  She concurred with Associate Professor G’s view that Larissa would benefit from hormone treatment for gender dysphoria. 

4. Associate Professor G has liaised with Larissa’s paediatric endocrinologist Dr J regarding Larissa’s treatment.  Associate Professor G’s mental-state assessment of Larissa at page 4 of his report dated 26 October 2015 (annexure A to his affidavit filed 2 November 2015) describes her in the following terms:-

   … She is co-operative, lucid, well oriented and able to be thoughtful and self-reflective.  There is no evidence of any abnormal perceptual experiences or abnormal beliefs.  Larissa is sleeping well has a good appetite and has grown appropriately.  Larissa says she is feeling well and describes no significant depressive disorder.  At times she is stressed by schoolwork, although she performs extremely well in her tests and assessments.  From time to time when I have met with Larissa she could be tearful when she reflected on her distress about the male components of her body, but was able to talk positively about the prospects of commencing oestrogen therapy and feminising her body.  She says she also looks forward to the possibility of having surgery to feminise her body further, although she says she would not consider this until she was over 18 years.

5. It is Associate Professor G’s assessment that Larissa meets the criteria for diagnosis of gender dysphoria and further that she has consistently identified as a girl and lived as a girl at least since late-primary school.  In his assessment, it is crucial for Larissa’s social and emotional health and development that she be able to commence oestrogen therapy in the near future. 

6. The proposed stage two treatment is a cross-sex hormone treatment with oestrogen in order to minimise further masculinisation of Larissa’s body and to facilitate the feminisation of her body.  That treatment will lead to the feminisation of Larissa’s body including the development of breasts, reduction of facial and body hair, re-distribution of body fat so that buttocks, hips and thighs have a more feminine shape.  The therapy will also suppress the emergence of secondary male sexual characteristics such as enlarged penile and testicular development, male facial and body hair distribution, increased height and masculine build.

7. From a psychological perspective, the proposed treatment will enable Larissa to continue to live happily as female.  She is likely to gain greater social confidence by the development of a more obviously feminine body.  The risk of her developing major depressive and anxiety symptoms will be minimised in the event that she commences the treatment.  Associate Professor G was asked whether Larissa was capable of making an informed decision with respect to the proposed stage two treatment.  He responded affirmatively to that question at page 10 of his report stating:-

   I believe that Larissa is able to make an informed decision about the procedure.  Larissa has said on many occasions unambiguously that he [sic] wants to commence treatment with oestrogen therapy.  She clearly agrees to the procedure, namely commencing oestrogen therapy.  I believe that Larissa is capable of making an informed decision to commence treatment with oestrogen therapy.  Larissa has read the information sheet provided by the [X Hospital] Gender Service and I believe she understands the benefits of feminisation of her body, and the potential risks that might arise from long-term use of oestrogen.  Larissa has also looked extensively on the Web regarding the experience of the other young people with gender dysphoria who transition and commence hormone treatment.  She has done this in a thoughtful and curious way and has been very ready to talk about her understanding of the experience of others, as it might inform her own decisions. 

   She is also aware that oestrogen has the theoretical possibility of minimising some of the male-based health risks associated with male levels of testosterone, but does not give this overdue importance.  Larissa was able to ask appropriate questions relating to the impact of oestrogen on her body, it was clear that she is extremely uncomfortable with the possible masculine aspects of her body, such as facial hair, deep voice and larger muscles.

   Larissa was aware that oestrogen therapy may minimise the possibility of using her sperm in the future should she wish to try to have a child with her own genetic material.  Consequently she provided a sperm specimen for cryopreservation.  She is aware that there is no guarantee that this procedure will be necessarily successful.

8. The views of Associate Professor G as to Larissa’s Gillick competence are echoed by her treating paediatric endocrinologist, Dr J.  Dr J is a paediatric endocrinologist at the X Hospital.  Larissa has been attending Dr J’s clinic since January 2015 and was previously seen by another endocrinologist at that clinic between 2011 and 2014.  Dr J had met with Larissa on four occasions prior to the preparation of her report dated 28 October 2015 being annexure A to her affidavit.  Dr J’s report confirms that she has discussed extensively with Larissa her proposed treatment plan for stage two hormone therapy.  That treatment will include the provision of a female sex hormone either via an oral tablet or a transdermal patch. 

9. As to the risks of the proposed stage two treatment, Dr J identifies the increased risks of the following:-

   ·Heart disease;

   ·Pulmonary embolism;

   ·Stroke;

   ·Type 2 diabetes;

   ·Liver disease;

   ·Chronic problems with veins in the legs;

   ·High cholesterol and high blood pressure;

   ·Gall stones;

   ·Headaches or migraines;

   ·Prolactinoma.

10. In addition to the above risks, oestrogen is likely to have testicular effects that result in decreased sperm production and function.  Dr J confirmed that Larissa and the mother have been provided with an information statement regarding the potential risks of the proposed treatment and have had a number of months to absorb that information.  Further, Dr J confirmed that Larissa and the mother have had the opportunity to discuss with her the treatment at clinic appointments and on telephone and tele-health reviews.  Dr J confirmed that Larissa has provided a sperm sample which is stored at the Andrology Service at the Y Hospital. 

11. Dr J assessed Larissa’s capacity of making an informed decision about the proposed treatment in the following terms:-

    My assessment is that Larissa is Gillick competent to make the decisions regarding continuation of stage two (oestrogen) treatment.  This has been demonstrated during our conversations where Larissa has engaged in sophisticated discussion around the issues of her gender identification, fertility preservation and the long term consequences of treatment both in terms of physical and psychological health and wellbeing.  She has stated clearly and unambiguously that she wants to commence oestrogen therapy.  She has read the [X Hospital] information statement on this treatment and has also sought out information from other sources such as the internet.  Her GP has also given her some material which she has read and they too had independent discussions in this regard. 

    Larissa is aware that one of the options for transitioning is to do so socially without having hormonal treatment.  Larissa expresses that she does not see this as an option for her, as the current incongruence between her gender identity and her physical appearance causes significant distress.  She describes that ‘this (oestrogen therapy) is what I have been working towards’ and that she strongly desires the feminising effects of oestrogen on her body.  Larissa presents as an intelligent young lady who has given a lot of thought to this treatment in recent years.  She has been able to demonstrate a thorough understanding of the effects and potential risks of oestrogen.  Although Larissa understands the concept of treatment regret she identifies so strongly and persistently with the female gender that she does not envisage a scenario where this may arise for her.  We have discussed that presumably many (or all) of those who experience regret feel similarly at the time of commencing cross-sex hormone therapy and Larissa understands this.  She is aware that she can decide to discontinue oestrogen therapy at any stage in the future should this be her choice; however some irreversible oestrogen effects may occur in the meantime, particularly in relation to fertility.  Larissa understands this fully. 

12. The reports of both Associate Professor G and Dr J provide detailed histories of their treatment of Larissa, the discussions they have had with her regarding the proposed treatment, including the potential risks of the proposed treatment upon her.  Both medical practitioners are clear and unequivocal in their assessment that Larissa is an intelligent and mature young woman who has engaged in detailed and sophisticated discussion with them as to the impact of the proposed treatment upon her.  Both medical practitioners have assessed Larissa as having a thorough and detailed understanding of the consequences of the stage two treatment, both negative and positive and have confirmed that she is capable of giving informed consent to that treatment.  I accept the evidence of both Associate Professor G and Dr J.

13. Having regard to the unchallenged evidence of Associate Professor G and Dr J I am satisfied that Larissa is Gillick competent.  The assessment of those treating medical practitioners as to Larissa’s competence is shared by the mother. 

14. Having regard to that evidence, I am satisfied on the balance of probabilities that Larissa is competent to fully understand the nature and consequences of the proposed treatment and to make her own decision in relation to that treatment.  

15. The application of the mother also seeks orders that Larissa be known by the name Larissa … and that the mother be the sole signatory to authorise any application to register a change of name.  Orders were made by Senior Registrar Fitzgibbon on 9 December 2013 confirming that until further order that Larissa be known by that name and authorising the mother to be the sole signatory required in order to give effect to Larissa’s use of that name.  No submissions were made as to the need for a further order with respect to that issue.  In the circumstances I do not propose to make any further order regarding the authorisation of the mother as the sole signatory to affect the registration of Larissa’s name.  There is already an order in force empowering the mother to so authorise Larissa’s use of her name. 

16. The orders I make are as follows:-

    (1)That pursuant to rule 1.12 of the Family Law Rules 2004 (Cth) (the Rules) the requirement pursuant to rule 4.10 of the Rules that the Initiating Application filed 5 August 2015 be served on the prescribed child welfare authority be dispensed with.

    (2)That the name of the child LARISSA … (Born …) born … 1999, Larissa’s family members and their occupations, the hospital, Larissa’s medical practitioners, Larissa’s school, this Court, file number, the State of Australia in which the proceedings were initiated, the name of the mother’s lawyer and any other fact or matter that may identify Larissa shall not be published in any way and only anonymised Reasons for Judgment and orders (with coversheets excluding the Registry, file number and lawyers’ names and details as well as the parties’ real names) shall be released by the Court to non-parties without further contrary order of a judge, it being noted that each party shall be handed one full copy of these orders with the relevant details included for provision to the treating medical practitioners and to enable their execution, and one coversheet of Reasons for Judgment that includes the file number and the lawyers’ names.

    (3)That no person shall be permitted to search the Court file in this matter without first obtaining the leave of a judge.

    (4)Upon the Court being satisfied that the child Larissa … (also known as …) born … 1999 is competent to consent to the medical treatment described in the Initiating Application filed 5 August 2015 the Court authorises Larissa to make her own decision in relation to that treatment.

    (5)That the applicant mother be at liberty to provide a copy of the un-anonymised orders and the un-anonymised Reasons for Judgment to all persons involved with Larissa’s treatment. 

    (6)That the applicant mother cause a sealed copy of these orders and Reasons for Judgment to be personally served upon the father.

    (7)That the applicant’s Initiating Application filed 5 August 2015 be otherwise dismissed.

AND THE COURT NOTES

The treatment described in the applicant’s Initiating Application filed 5 August 2015 is the following treatment for gender dysphoria:-

Gender Identity Dysphoria, stage two (cross-sex) hormone treatment of the child.

I certify that the preceding sixty (60) paragraphs are a true copy of the reasons for judgment of the Honourable Justice Johns delivered on 18 December 2015

Associate: 

Date: 15 December 2015