Telfer Michelle, Kelly Fiona, Feldman Debi, Stone Georgie, Robertson Rebekah, Poulakis Zeffie
Department of Adolescent Medicine, Royal Children's Hospital, Melbourne, Victoria, Australia.
School of Law, La Trobe University, Melbourne, Victoria, Australia.
J Paediatr Child Health. 2018 Oct;54(10):1096-1099. doi: 10.1111/jpc.14124.
Transgender children and adolescents face hardships in all domains of their lives, with many experiencing family rejection, social exclusion, discrimination, bullying and assaults. The mental health implications of these experiences include high rates of depression, anxiety, self-harm and attempted suicide. Gender-affirming social support and medical treatment has been shown to ameliorate the poor mental health outcomes of transgender youth, with those who are supported in their social and medical transition reporting rates of depression and self-worth equivalent to general population levels. Advocacy efforts that improve access to support and medical treatment are therefore likely to produce significant positive health and well-being outcomes for this vulnerable population. The transgender community in Australia identified the legal restrictions placed on children and adolescents accessing medical treatment as a significant barrier to positive psychological well-being. Australian law, unique internationally, required the parents of transgender adolescents to apply for court authorisation prior to the commencement of their child's gender-affirming medical treatment. Concerned by the harm created by this process, a coalition of experts, including transgender children, adolescents and their parents, as well as academic and clinical experts in the fields of law and medicine, was created to advocate for reform. Over a period of approximately 4 years, a collaborative process was undertaken, which ultimately led to law reform and improved access to medical treatment for the transgender community.
跨性别儿童和青少年在生活的各个领域都面临困境，许多人经历过家庭排斥、社会排斥、歧视、欺凌和攻击。这些经历对心理健康的影响包括高比例的抑郁、焦虑、自我伤害和自杀未遂。事实表明，性别肯定性的社会支持和医疗治疗能够改善跨性别青少年不佳的心理健康状况，那些在社会和医疗过渡过程中得到支持的人，其抑郁率和自我价值感与普通人群水平相当。因此，旨在增加获得支持和医疗治疗机会的宣传努力，很可能为这一弱势群体带来显著的积极健康和幸福成果。澳大利亚的跨性别群体认为，对儿童和青少年获得医疗治疗的法律限制是实现积极心理健康的重大障碍。澳大利亚的法律在国际上独一无二，要求跨性别青少年的父母在其子女开始接受性别肯定性医疗治疗之前申请法院授权。由于担心这一过程造成的伤害，包括跨性别儿童、青少年及其父母以及法律和医学领域的学术和临床专家在内的一个专家联盟成立，以倡导改革。在大约4年的时间里，开展了一个合作过程，最终促成了法律改革，并改善了跨性别群体获得医疗治疗的机会。
