Can a child legally take puberty blockers? What if their parents disagree?
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Young people’s access to gender-affirming medical care has been making headlines this week.
Today, federal Health Minister Mark Butler announced a review into health care for trans and gender-diverse children and adolescents. The National Health and Medical Research Council will conduct the review.
Yesterday, The Australian published an open letter to Prime Minister Anthony Albanese calling for a federal inquiry, and a nationwide pause on puberty blockers and hormone therapy for minors.
This followed Queensland Health Minister Tim Nicholls earlier this week announcing an immediate pause on access to puberty blockers and hormone therapies for new patients under 18 in the state’s public health system, pending a review.
In the United States, President Donald Trump signed an executive order this week directing federal agencies to restrict access to gender-affirming care for anyone under 19.
This recent wave of political attention might imply gender-affirming care for young people is risky, controversial, perhaps even new.
But Australian courts have already extensively tested questions about its legitimacy, the conditions under which it can be provided, and the scope and limits of parental powers to authorise it.
What are puberty blockers?
Puberty blockers suppress the release of oestrogen and testosterone, which are primarily responsible for the physical changes associated with puberty. They are generally safe and used in paediatric medicine for various conditions, including precocious (early) puberty, hormone disorders and some hormone-sensitive cancers.
International and domestic standards of care state that puberty blockers are reversible, non-harmful, and can prevent young people from experiencing the distress of undergoing a puberty that does not align with their gender identity. They also give young people time to develop the maturity needed to make informed decisions about more permanent medical interventions further down the line.
Puberty blockers are one type of gender-affirming care. This care includes medical, psychological and social interventions to support transgender, gender-diverse and, in some cases, intersex people.
Young people in Australia need a medical diagnosis of gender dysphoria to receive this care. Gender dysphoria is defined as the psychological distress that can arise when a person’s gender identity does not align with their sex assigned at birth. This diagnosis is only granted after an exhaustive and often onerous medical assessment.
After a diagnosis, treatment may involve hormones such as oestrogen or testosterone and/or puberty-blocking medications.
Hormone therapies involving oestrogen and testosterone are only prescribed in Australia once a young person has been deemed capable of giving informed consent, usually around the age of 16. For puberty blockers, parents can consent at a younger age.
Can a child legally access puberty blockers?
Gender-affirming care has been the subject of extensive debate in the Family Court of Australia (now the Federal Circuit and Family Court).
Between 2004 and 2017, every minor who wanted to access gender-affirming care had to apply for a judge to approve it. However, medical professionals, human rights organisations and some judges condemned this process.
In research for my forthcoming book, I found the Family Court has heard at least 99 cases about a young person’s gender-affirming care since 2004. Across these cases, the court examined the potential risks of gender-affirming treatment and considered whether parents should have the authority to consent on their child’s behalf.
When determining whether parents can consent to a particular medical procedure for their child, the court must consider whether the treatment is “therapeutic” and whether there is a significant risk of a wrong decision being made.
However, in a landmark 2017 case, the court ruled that judicial oversight was not required because gender-affirming treatments meet the standards of normal medical care.
It reasoned that because these therapies address an internationally recognised medical condition, are supported by leading professional medical organisations, and are backed by robust clinical research, there is no justification for treating them differently from any other standard medical intervention. These principles still stand today.
What if parents disagree?
Sometimes parents disagree with decisions about gender-affirming care made by their child, or each other.
As with all forms of health care, under Australian law, parents and legal guardians are responsible for making medical decisions on behalf of their children. That responsibility usually shifts once those children reach a sufficient age and level of maturity to make their own decisions.
However, in another landmark case in 2020, the court ruled gender-affirming treatments cannot be given to minors without consent from both parents, even if the child is capable of providing their own consent. This means that if there is any disagreement among parents and the young person about either their capacity to consent or the legitimacy of the treatment, only a judge can authorise it.
In such instances, the court must assess whether the proposed treatment is in the child’s best interests and make a determination accordingly. Again, these principals apply today.
Have the courts ever denied care?
Across the at least 99 cases the court has heard about gender-affirming care since 2004, 17 have involved a parent opposing the treatment and one has involved neither parent supporting it.
Regardless of parental support, in every case, the court has been responsible for determining whether gender-affirming treatment was in the child’s best interests. These decisions were based on medical evidence, expert testimony, and the specific circumstances of the young person involved.
In all cases bar one, the court has found overwhelming evidence to support gender-affirming care, and approved it.
Supporting transgender young people
The history of Australia’s legal debates about gender-affirming care shows it has already been the subject of intense legal and medical scrutiny.
Gender-affirming care is already difficult for young people to access, with many lacking the parental support required or facing other barriers to care.
Gender-affirming care is potentially life-saving, or at the very least life-affirming. It almost invariably leads to better social and emotional outcomes. Further restricting access is not the “protection” its opponents claim.
If this article has raised issues for you, or if you’re concerned about someone you know, call Lifeline on 13 11 14. For LGBTQIA+ peer support and resources, you can also contact Switchboard, QLife (call 1800 184 527), Queerspace, Transcend Australia (support for trans, gender-diverse, and non-binary young people and their families) or Minus18 (resources and community support for LGBTQIA+ young people).
Matthew Mitchell, Lecturer in Criminology, Deakin University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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What Happens To Your Body When You Stop Drinking Alcohol
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Immediately after we stop drinking is rarely when we feel our best. But how long is it before we can expect to see benefits, instead of just suffering?
Timeline
After stopping drinking alcohol for…
- Seconds: the liver starts making progress filtering out toxins and sugars; ethanol starts to leave the system
- 1 hour: fatigue sets in as the body uses a lot of energy to metabolize and eliminate alcohol. However, sleep quality (if one goes to sleep now) is low because alcohol disrupts the brain patterns required for restful sleep
- 6–12 hours: the immune system starts recovering from the suppression caused by alcohol
- 24 hours: immune system is back to normal; withdrawal symptoms may occur in the case of heavy drinkers
- 3–5 days: resting blood pressure begins to drop, as stress levels decrease (alcohol may seem anxiolytic, but it is actually anxiogenic; it just masks its own effect in this regard). Also, because of insulin responses improving, appetite reduces. The liver, once it has finished dealing your last drinking session (if you used to drink all the time, it probably had a backlog to clear), can now begin to make repairs on itself.
- 1 week: skin will start looking better, as antidiuretic hormone levels neutralize, leading to a healthier maintenance of hydration
- 2 weeks: cognitive abilities improve as the brain begins to make progress in repairing itself. At the same time, kidneys start to heal.
- 3–4 weeks: the liver begins to regenerate in earnest. You may wonder what took it so long given the liver’s famous regenerative abilities, but in this case, the liver was also the organ that took the most damage from drinking, so its regeneration gets off to a slow start (in contrast, if the liver had “merely” suffered physical trauma, such as being shot, stabbed,
or eaten by eagles,it’d start regenerating vigorously as soon as the immediate wound-response had been tended to). Once it is able to pick up the pace though, overall health improves, as the liver can focus on breaking down other toxins. - 1–2 months: the heart is able to repair itself, and start to become stronger again (dependent on other lifestyle factors, of course).
- 3 months and more: bodily repairs continue (for example, the damage to the liver is often so severe that it can take quite a bit longer to recover completely, and repairs in the brain are always slow, for reasons beyond the scope of this article). Looking at the big picture, at this point we also see other benefits, such as reduced cancer risks.
In short… It’s never too soon to stop, but it’s also never too late, unless you are going to die in the next few days. So long as you’ll be in the land of the living for a few days yet, there’s time to enjoy the benefits of stopping.
Most importantly: the timeline for the most important repairs is not as long as many people might think, and that itself can be very motivating.
For more detail on much of the above, enjoy:
Click Here If The Embedded Video Doesn’t Load Automatically!
Want to learn more?
You might also like to read:
- Can We Drink To Good Health?
- How To Reduce Or Quit Alcohol
- Addiction Myths That Are Hard To Quit
- How To Unfatty A Fatty Liver
Take care!
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How to Find Happiness In Yourself – by Michelle Mann
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A lot of books about happiness tell you what to pursue, generally. What things to focus on, and that’s good, but incomplete. This book does cover those things too (complete with academic sources to back up what really works), but also goes further:
Michelle Mann gives 25 key habits that will cumulatively build happiness, which is what it’s really about. After all:
- If you watch your favourite movie, you’ll be happy for 90 minutes (or 9 hours if it’s The Lord of the Rings).
- If you build daily habits that add happiness to you, your surroundings, and those around you, you’ll be happy for life.
They do also cover happiness while going through difficult times, such as divorce, job loss, illness, or bereavement.
Sometimes, knowing what we “should” do in theory is the easy part. Where Mann excels here is in providing explanations of each habit. This means that rather than it being some platitude, the principles underlying it are truly understood… and thus motivate us to actually apply the advice and build the habits into our life.
While the explanations are therefore the greatest value of the book, we do recommend copying out the 25 habits (which are effectively subchapter headings) and putting them somewhere to read often.
Bottom line: we recommend getting yourself (and/or your loved ones!) a copy of this book. You (and/or they) will be happy you did!
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The Cancer Journey – by Dr. Chadi Nabhan
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After a brief introduction of what cancer actually is and what causes it, the layout of the rest of the book is in chronological order of patient experience, that is to say, what to expect during the journey from screening and diagnosis, to one’s first oncology visit (the author being an oncologist himself), how cancer staging works, getting second opinions, and a chapter-by-chapter review of many different treatment options, ranging from surgery and chemotherapy, to radiation and hormonal therapies, and even more modern targeted therapies, immunotherapy, cellular therapies, and yes, complementary and alternative therapies, amongst others we haven’t listed for the sake of brevity.
He doesn’t leave it there though; he also talks managing side effects, monitoring for recurrence, and even caring for the caregiver(s), along with eventual survivorship and that emotional journey, or if it comes down to it, palliative and hospice care.
Finishing on a hopeful note, he also brings attention to novel approaches that are being trialled presently, and the prospects for the near future of cancer care.
The style is very human and readable, notwithstanding that the author has hundreds of peer-reviewed publications to his name, the content here is presented in a much more approachable, less clinical way, while still conveying all the information that needs to be conveyed.
Bottom line: if you or a loved one is facing cancer, this book will be an invaluable resource.
Click here to check out The Cancer Journey, and understand each part of it!
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Eat Well With Arthritis – by Emily Johnson, with Dr. Deepak Ravindran
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Author Emily Johnson was diagnosed with arthritis in her early 20s, but it had been affecting her life since the age of 4. Suffice it to say, managing the condition has been integral to her life.
She’s written this book with not only her own accumulated knowledge, but also the input of professional experts; the book contains insights from chronic pain specialist Dr. Deepak Ravindran, and gets an additional medical thumbs-up in a foreword by rheumatologist Dr. Lauren Freid.
The recipes themselves are clear and easy, and the ingredients are not obscure. There’s information on what makes each dish anti-inflammatory, per ingredient, so if you have cause to make any substitutions, that’s useful to know.
Speaking of ingredients, the recipes are mostly plant-based (though there are some chicken/fish ones) and free from common allergens—but not all of them are, so each of those is marked appropriately.
Beyond the recipes, there are also sections on managing arthritis more generally, and information on things to get for your kitchen that can make your life with arthritis a lot easier!
Bottom line: if you have arthritis, cook for somebody with arthritis, or would just like a low-inflammation diet, then this is an excellent book for you.
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Kiwi Fruit vs Pineapple – Which is Healthier?
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Our Verdict
When comparing kiwi fruit to pineapple, we picked the kiwi.
Why?
In terms of macros, they’re mostly quite comparable, being fruits made of mostly water, and a similar carb count (slightly different proportions of sugar types, but nothing that throws out the end result, and the GI is low for both). Technically kiwi has twice the protein, but they are fruits and “twice the protein” means “0.5g difference per 100g”. Aside from that, and more meaningfully, kiwi also has twice the fiber.
When it comes to vitamins, kiwi has more of vitamins A, B9, C, E, K, and choline, while pineapple has more of vitamins B1, B2, B3, B5, and B6. This would be a marginal (6:5) win for kiwi, but kiwi’s margins of difference are greater per vitamin, including 72x more vitamin E (with a cupful giving 29% of the RDA, vs a cupful of pineapple giving 0.4% of the RDA) and 57x more vitamin K (with a cupful giving a day’s RDA, vs a cupful of pineapple giving a little under 2% of the RDA). So, this is a fair win for kiwi.
In the category of minerals, things are clear: kiwi has more calcium, copper, iron, magnesium, manganese, phosphorus, potassium, selenium, and zinc, while pineapple has more manganese. An overwhelming win for kiwi.
Looking at their respective anti-inflammatory powers, pineapple has its special bromelain enzymes, which is a point in its favour, but when it comes to actual polyphenols, the two fruits are quite balanced, with kiwi’s flavonoids vs pineapple’s lignans.
Adding up the sections, it’s a clear win for kiwi—but pineapple is a very respectable fruit too (especially because of its bromelain content), so do enjoy both!
Want to learn more?
You might like to read:
Bromelain vs Inflammation & Much More
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A short history of sunscreen, from basting like a chook to preventing skin cancer
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Australians have used commercial creams, lotions or gels to manage our skin’s sun exposure for nearly a century.
But why we do it, the preparations themselves, and whether they work, has changed over time.
In this short history of sunscreen in Australia, we look at how we’ve slathered, slopped and spritzed our skin for sometimes surprising reasons.
At first, suncreams helped you ‘tan with ease’
This early sunscreen claimed you could ‘tan with ease’.
Trove/NLASunscreens have been available in Australia since the 30s. Chemist Milton Blake made one of the first.
He used a kerosene heater to cook batches of “sunburn vanishing cream”, scented with French perfume.
His backyard business became H.A. Milton (Hamilton) Laboratories, which still makes sunscreens today.
Hamilton’s first cream claimed you could “
Sunbathe in Comfort and TAN with ease”. According to modern standards, it would have had an SPF (or sun protection factor) of 2.The mirage of ‘safe tanning’
A tan was considered a “modern complexion” and for most of the 20th century, you might put something on your skin to help gain one. That’s when “safe tanning” (without burning) was thought possible.
This 1967 Coppertone advertisement urged you to ‘tan, not burn’.
SenseiAlan/Flickr, CC BY-SASunburn was known to be caused by the UVB component of ultraviolet (UV) light. UVA, however, was thought not to be involved in burning; it was just thought to darken the skin pigment melanin. So, medical authorities advised that by using a sunscreen that filtered out UVB, you could “safely tan” without burning.
But that was wrong.
From the 70s, medical research suggested UVA penetrated damagingly deep into the skin, causing ageing effects such as sunspots and wrinkles. And both UVA and UVB could cause skin cancer.
Sunscreens from the 80s sought to be “broad spectrum” – they filtered both UVB and UVA.
Researchers consequently recommended sunscreens for all skin tones, including for preventing sun damage in people with dark skin.
Delaying burning … or encouraging it?
Up to the 80s, sun preparations ranged from something that claimed to delay burning, to preparations that actively encouraged it to get that desirable tan – think, baby oil or coconut oil. Sun-worshippers even raided the kitchen cabinet, slicking olive oil on their skin.
One manufacturer’s “sun lotion” might effectively filter UVB; another’s merely basted you like a roast chicken.
Since labelling laws before the 80s didn’t require manufacturers to list the ingredients, it was often hard for consumers to tell which was which.
At last, SPF arrives to guide consumers
In the 70s, two Queensland researchers, Gordon Groves and Don Robertson, developed tests for sunscreens – sometimes experimenting on students or colleagues. They printed their ranking in the newspaper, which the public could use to choose a product.
An Australian sunscreen manufacturer then asked the federal health department to regulate the industry. The company wanted standard definitions to market their products, backed up by consistent lab testing methods.
In 1986, after years of consultation with manufacturers, researchers and consumers, Australian Standard AS2604 gave a specified a testing method, based on the Queensland researchers’ work. We also had a way of expressing how well sunscreens worked – the sun protection factor or SPF.
This is the ratio of how long it takes a fair-skinned person to burn using the product compared with how long it takes to burn without it. So a cream that protects the skin sufficiently so it takes 40 minutes to burn instead of 20 minutes has an SPF of 2.
Manufacturers liked SPF because businesses that invested in clever chemistry could distinguish themselves in marketing. Consumers liked SPF because it was easy to understand – the higher the number, the better the protection.
Australians, encouraged from 1981 by the Slip! Slop! Slap! nationwide skin cancer campaign, could now “slop” on a sunscreen knowing the degree of protection it offered.
How about skin cancer?
It wasn’t until 1999 that research proved that using sunscreen prevents skin cancer. Again, we have Queensland to thank, specifically the residents of Nambour. They took part in a trial for nearly five years, carried out by a research team led by Adele Green of the Queensland Institute of Medical Research. Using sunscreen daily over that time reduced rates of squamous cell carcinoma (a common form of skin cancer) by about 60%.
Follow-up studies in 2011 and 2013 showed regular sunscreen use almost halved the rate of melanoma and slowed skin ageing. But there was no impact on rates of basal cell carcinoma, another common skin cancer.
By then, researchers had shown sunscreen stopped sunburn, and stopping sunburn would prevent at least some types of skin cancer.
What’s in sunscreen today?
An effective sunscreen uses one or more active ingredients in a cream, lotion or gel. The active ingredient either works:
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“chemically” by absorbing UV and converting it to heat. Examples include PABA (para-aminobenzoic acid) and benzyl salicylate, or
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“physically” by blocking the UV, such as zinc oxide or titanium dioxide.
Physical blockers at first had limited cosmetic appeal because they were opaque pastes. (Think cricketers with zinc smeared on their noses.)
With microfine particle technology from the 90s, sunscreen manufacturers could then use a combination of chemical absorbers and physical blockers to achieve high degrees of sun protection in a cosmetically acceptable formulation.
Where now?
Australians have embraced sunscreen, but they still don’t apply enough or reapply often enough.
Although some people are concerned sunscreen will block the skin’s ability to make vitamin D this is unlikely. That’s because even SPF50 sunscreen doesn’t filter out all UVB.
There’s also concern about the active ingredients in sunscreen getting into the environment and whether their absorption by our bodies is a problem.
Sunscreens have evolved from something that at best offered mild protection to effective, easy-to-use products that stave off the harmful effects of UV. They’ve evolved from something only people with fair skin used to a product for anyone.
Remember, slopping on sunscreen is just one part of sun protection. Don’t forget to also slip (protective clothing), slap (hat), seek (shade) and slide (sunglasses).
Laura Dawes, Research Fellow in Medico-Legal History, Australian National University
This article is republished from The Conversation under a Creative Commons license. Read the original article.
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