A tectonic shift is taking place overseas in the debate over how to treat children that question their gender identity, and there are plenty of lessons to be learned in Tasmania.
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The UK government commissioned a review into the treatment of gender-diverse children back in 2020, and its full report by UK paediatrician Dr Hilary Cass became public in early April.
Dr Cass, who wrote that her review was not about "undermining the validity of trans identities" or "challenging the right of people to express themselves", found that children were being let down by the National Health Service.
She said the NHS' gender service was using clinical practices and medical interventions on children based on "remarkably weak" evidence about their efficacy and safety.
There was a lack of reliable evidence on the long-term effects of the use of cross-sex and puberty blocking hormones, and that "people are afraid to talk openly" about these issues, according to Dr Cass.
The review has caused global shockwaves, and one graph demonstrates the urgency of the debate.
It shows the exponential rise in the number of British children referred to the NHS' Gender Identity Service.
Starting with barely 10 patients per year when it was established in 1989, referrals exploded after 2009, from 50 per year to over 1700 by 2016.
Dr Cass found that there was "no simple explanation" for the vast increase in the numbers of children seeking gender treatments.
One can only assume a similar situation here in Tasmania, where the Tasmanian Gender Service treats gender-diverse children and young people, and those experiencing gender dysphoria - the condition of feeling uncomfortable with one's biological sex.
We can only assume, because the TGS is highly secretive, and previous attempts to gain information on the numbers of children treated via Right to Information requests have failed.
It publishes no annual report, is not mentioned in the state budget papers; it has a single webpage under the Department of Health providing basic information about the services offered.
According to that website, TGS treats gender-diverse children and those experiencing gender dysphoria using "gender affirming medical interventions" such as puberty blockers and gender affirming hormones.
These are the same treatments that have now been questioned by the Cass review.
Among Dr Cass' findings were that there was a dearth of "high-quality" evidence that the use of gender medicines such as cross-sex hormones and puberty blockers - hormones that stop the progress of puberty in young people - were safe.
Her researchers found that most of the clinical guidelines used for managing gender dysphoria in children and young people were not independent or evidence-based.
They also found that of the 50 published studies on the use of puberty blockers, only one was of "high quality".
"The reality is that we have no good evidence on the long-term outcomes of interventions to manage gender-related distress," Dr Cass wrote.
She also found that medical interventions were being practiced without the solid research base that would normally be needed.
"It often takes many years before strongly positive research findings are incorporated into practice.
"Quite the reverse happened in the field of gender care for children."
The feminist group Women Speak Tasmania has called for Health Minister Guy Barnett to "defer debate" on the government's Miscellaneous (Conversion Practices) Bill.
The bill makes it illegal to conduct conversion practices on transgender and LGBTQI+ people, but contains numerous exceptions and protections for parents and religious persons, has been criticised by both sides of the debate.
Women Speak Tasmania also backed a call by Dr Philip Morris, president of the National Association of Practising Psychiatrists (NAPP) for an independent, for an investigation into treatments being used for vulnerable children struggling with gender dysphoria.
They claim that the TGS's use of the same affirmative approach criticised in the Cass Review is harmful to children, and that it does not follow other more cautious approaches recommended by NAPP.
Many transgender activists will be critical of the Cass review and organisations such as WST, but ultimately they are calling only for more evidence on gender treatments, and more transparency.
A review into these things by an independent investigator will give us both.
That can only be for the good of the children.
