Queensland University of Technology, Brisbane, QLD, Australia.
Med J Aust. 2015 Feb 2;202(2):102-4. doi: 10.5694/mja14.00624.
Gender dysphoria is a condition in which a child's subjectively felt identity and gender are not congruent with her or his biological sex. Because of this, the child suffers clinically significant distress or impairment in social functioning. The Family Court of Australia has recently received an increasing number of applications seeking authorisation for the provision of hormones to treat gender dysphoria in children. Some medical procedures and interventions performed on children are of such a grave nature that court authorisation must be obtained to render them lawful. These procedures are referred to as special medical procedures. Hormonal therapy for the treatment of gender dysphoria in children is provided in two stages occurring years apart. Until recently, both stages of treatment were regarded by courts as special medical treatments, meaning court authorisation had to be provided for both stages. In a significant recent development, courts have drawn a distinction between the two stages of treatment, permitting parents to consent to the first stage. In addition, it has been held that a child who is determined by a court to be Gillick competent can consent to stage 2 treatment. The new legal developments concerning treatment for gender dysphoria are of ethical, clinical and practical importance to children and their families, and to medical practitioners treating children with gender dysphoria. Medical practitioners should benefit from an understanding of the recent developments in legal principles. This will ensure that they have up-to-date information about the circumstances under which treatment may be conducted with parental consent, and those in which they must seek court authorisation.
性别认同障碍是一种儿童主观感受到的身份和性别与其生理性别不一致的情况。因此，儿童会经历临床上显著的痛苦或社交功能受损。澳大利亚家庭法院最近收到越来越多的申请，要求授权为儿童提供治疗性别认同障碍的激素。一些在儿童身上进行的医疗程序和干预措施性质非常严重，必须获得法院授权才能使其合法。这些程序被称为特殊医疗程序。儿童性别认同障碍的激素治疗分为两个阶段，相隔数年进行。直到最近，法院都将这两个阶段的治疗视为特殊医疗治疗，这意味着必须为两个阶段提供法院授权。在最近的一个重大发展中，法院对这两个阶段的治疗进行了区分，允许父母同意第一阶段的治疗。此外，法院还裁定，被认定为吉尔克里克有能力的儿童可以同意第二阶段的治疗。与治疗性别认同障碍相关的新法律发展对儿童及其家庭以及治疗患有性别认同障碍的儿童的医疗从业者具有伦理、临床和实际重要性。医疗从业者应该从理解最近的法律原则发展中受益。这将确保他们了解在哪些情况下可以在获得父母同意的情况下进行治疗，以及在哪些情况下必须寻求法院授权。
