The night before his 11-year-old daughter was due to start taking puberty blockers, Brad* sat down with her for an important conversation.
He didn’t want to talk her out of it; he just wanted her to know what was going to happen to her developing body if she were to take the drugs, which had been prescribed to her by an Australian doctor after she began to question her gender identity.
It was a conversation that could have cost him everything.
By questioning the wishes of his ex-partner and the medical establishment, he risked being cast as the ‘villain’ in his daughter’s story. Worse, he could have lost custody for not supporting her.
For those unfamiliar with puberty blockers, they were first developed to delay early puberty in children, but nowadays are also prescribed to pre-teens with gender dysphoria so they can ‘have more time’ to better understand their identity.
The medication is controversial. It’s still available in Australia but Britain just banned them for under-18s following an independent safety review. Several U.S. states have also restricted trans healthcare for minors, including puberty blockers.
Brad’s story is a familiar one for any parent of a tomboy. His daughter was ‘girly’ until about the age of 10 when she became withdrawn and ‘conscious of her changing body’. She started wearing baggy clothes, then began saying she identified as a boy and wanted a male name and pronouns. Eventually she came out as trans.
When Brad asked without judgement why she felt this way, she said it was because she didn’t like the way women were treated and feared being sexually assaulted.
An Australian father claims his 11-year-old daughter was encouraged to take puberty blockers by a gender clinic (stock image posed by models)
Brad would do anything for his daughter, including accepting her as a son if she were genuinely trans. But his little girl’s sad admission about her fear of men convinced him she wasn’t suffering from gender dysmorphia, but was instead grappling with that awful realisation all women must face: that the world simply isn’t safe for them.
Fearful of the effects puberty blockers might have on his daughter’s development, Brad knew medical intervention would be a terrible – even irreversible – step to take.
‘My concern was this wasn’t about gender identity; it was a response to learning what it can mean to be a woman,’ he says.
But his daughter’s mother, with whom he shares joint custody, took the view they had to affirm their child’s new gender to avoid the risk of self-harm and suicide.
The family went to the gender clinic at the Adelaide Women’s and Children’s Hospital where, after two 45-minute psychiatric interviews with the three of them present, a diagnosis of gender dysphoria was given. At a second appointment – which Brad was excluded from, he says without explanation – puberty blockers were prescribed.
Brad says he submitted a written objection but the hospital’s ethics committee elected to provide the drugs without his consent.
‘I would have had to go to Family Court to stop my child being involved in what essentially is a medical trial – I was just gobsmacked,’ Brad tells me.
‘All the literature here would indicate both parents have to agree but a lawyer who works in this field said puberty blockers are considered so routine now that you would have to take it to court to stop it.
‘And if you do, the court is just going to order a second opinion and that would come from another children’s hospital, and it’s not likely to be any different from what the Adelaide one has said.
‘My legal advice was that I would be wasting my time and tens of thousands of dollars.’
So in one last attempt to get his daughter to at least consider delaying treatment, he sat down with her and together they read – ‘line by line’ – a factsheet provided by the clinic about puberty blockers and the user instructions from the drug’s manufacturer, Lucrin.
The South Australian government-produced factsheet warns taking puberty blockers such as Lucrin can have irreversible effects and the risks are still not fully understood.
‘The short- and long-term effects of blocking puberty on social and cognitive development are not known,’ it states plainly. ‘There may be risks of puberty blockers that are not yet known.’
The 11-year-old girl attended the gender clinic at Adelaide Women’s and Children Hospital (pictured) where gender dysphoria was diagnosed
However, the pamphlet says most side effects are reversible, and that puberty will start again if treatment is stopped, although there are ‘potential irreversible effects on height and unknown long-term effects on bone density’.
‘Studies have down that while on puberty blockers, bone density does not increase as it normally would during puberty,’ it states.
‘This may be partially reversible with gender affirming hormones treatment (stage 2), however long-term data is limited and the full effects are not known.’
It goes on to warn of the risk of osteoporosis later in life, and the need to ‘support bone health’ with diet, exercise and supplements while taking puberty blockers.
The factsheet also warns puberty blockers will slow growth and as a result ‘your final height may be different to what it would’ve been if you hadn’t had treatment’.
Reversible side effects mentioned include nausea, vomiting, dizziness, hot flushes, tiredness, mood changes, reduced libido and a halting of menstruation, and the clinic recommends considering storing eggs or ovarian tissue before starting puberty blockers due to the potential effects the drugs have on fertility.
Brad says he was also shocked to discover that gender dysphoria, a condition where someone believes they are trapped in a body that does not match their gender, is not cited by Lucrin’s maker as a condition that can be treated with the drug.
According to the Consumer Medicine Information provided by Lucrin, the drug is used to treat prostate cancer in men and unusually early puberty in children, and bone loss is mentioned as a serious side effect for those being treated for precocious puberty.
A South Australian government-produced factsheet warns taking puberty blockers such as Lucrin can have irreversible effects and the risks are still not fully understood
The factsheet also warns puberty blockers will slow growth and as a result ‘your final height may be different to what it would’ve been if you hadn’t had treatment’
‘There has never been a controlled study into the use of puberty blockers for the treatment of gender dysphoria, and the drug company does not list gender dysphoria as one of the conditions the drug is intended to treat,’ Brad says.
‘It’s use for this purpose is off-label and therefore experimental.’
Brad also explained to his daughter that she risked losing sexual function and never being able to have an orgasm, which he recalls was a ‘very awkward’ conversation.
Although the discussion was difficult, his daughter eventually decided not to go ahead with the treatment. He says her deciding against puberty blockers ‘was like dodging a bullet’ and, much to his relief, she became instantly happier afterwards.
‘Within days, her sleep and anxiety levels improved, and the cutting and talk of suicide stopped,’ he tells me.
‘Late last year, she went back to identifying as a girl again and has gone back to her birth name.’
Brad says the two consultations at the clinic were not in-depth enough to properly investigate the root causes of his daughter’s anguish.
‘I didn’t believe in my heart of hearts that her feeling wasn’t going to change when she hit puberty, if she was allowed to hit puberty, because I think when you hit puberty you discover a lot about yourself,’ he says.
‘In the gender clinic’s mind, we were in a race against the clock, and approaching 12 years of age, puberty was around the corner for her.
‘That my daughter had flipped from identifying as a boy to being gender fluid to non-binary and was on the third name change was of no concern.
‘There was no effort to explore family dynamics, developmental history and pre-existing mental health conditions and all that other stuff – the clock was ticking.’
Brad feels vindicated by his daughter’s progress after deciding against puberty blockers. He says it’s proof the medical establishment’s ‘gender-affirming’ approach to treatment could be a terrible mistake.
‘[My daughter] recently said to me, “When I started puberty, you said I might start to feel different. You were right”.’
Brad is now calling for a parliamentary inquiry, and says Australia is at least three years behind Britain, where puberty blockers have been indefinitely banned by the NHS, and Sweden, which has begun restricting gender reassignment for children.
‘As much as any medical body is going to say “we are going to do our own research” if they are not looking to the UK and the Scandinavian countries, which are ahead of the us is terms of winding this back, it is quite irresponsible I think,’ he says.
‘I guess it is natural there is anxiety around puberty and we are saying “we have a pill for that” – but 11-year-old girls can’t be making those decisions.’
A spokesperson for the South Australian Women’s and Children’s Health Network, which runs the clinic, said that without details the father was unwilling to provide it could not comment on the case.
In general, the spokesperson said the services for gender-diverse youth in South Australia are delivered by clinicians in accordance with International and National Clinical Practice guidelines.
‘Care is provided by experienced clinicians in a multidisciplinary setting with appropriate safeguards in place,’ the spokesperson said.
‘Guardians are also consulted throughout the process. Informed consent is obtained prior to any medical treatment.
‘All youth undergo initial assessment and care as indicated from the mental health team prior to medical assessment or care.’
* Not his real name