More than 200 people gathered to listen to doctors, lawyers, academics, parents and detransitioners discuss the growing concerns surrounding the medicalisation of gender-distressed children at the Coalition Advancing Scientific Care (CASC) gender summit in Adelaide.

The message was clear: children deserve proper care, parents deserve to be heard, and medical practitioners must be allowed to question treatments that can have lifelong consequences.

Former University of Queensland Dean of Law, Professor Patrick Parkinson, warned that Australian gender clinicians could face substantial damages claims if patients later discover they were harmed by treatment.

He highlighted concerns about children receiving treatment without the agreement of both parents, inadequate assessments, missing consent documentation and failure to investigate other conditions that might explain a child’s distress.

Australian law has required court authorisation for certain medical treatments for gender-distressed minors when parents disagree. Professor Parkinson warned that clinicians who disregard these requirements could face serious legal consequences.

“There are practitioners, very prominent practitioners, very well known practitioners in this area who are currently disobeying that law,” Prof Parkinson said.

He also questioned whether young people are being properly informed about the long-term consequences of hormone treatment and surgery, including issues with fertility, sexual function and the physical realities of living as a transgender adult.

Irish psychotherapist Stella O’Malley, founder of Genspect, challenged the assumption that medical transition is the appropriate response to gender distress.

She argued that decades of research have failed to demonstrate consistent improvements in long-term outcomes and warned against treating patient satisfaction as the only measure of success.

“Healthcare is about long-term outcomes that have been studied in evidence that we can rely on,” she said, arguing that medicine should not simply give vulnerable patients what they want if the evidence for benefit is weak and the evidence of harm is strong.

Dr O’Malley highlighted several studies, but gave particular weight to long-term Swedish research, saying it found trans-identified people remained “19.1 times more likely to die by suicide compared to the general population”, alongside elevated psychiatric hospitalisation and suicide attempts.

She also pointed to a Finnish study of under-23s published earlier this year, saying psychiatric comorbidity rose sharply after treatment and that this “clearly” showed “it didn’t work”.

Dr O’Malley argued the adult data should have prompted a rethink rather than an expansion into pediatric treatment.

Professor Sallie Baxendale and psychologist Rachel Hannam questioned child-led treatment pathways and spoke about the need to investigate underlying issues instead of affirming a child’s gender distress.

Dr Hannam finished with a declaration: “Patience, curiosity, and distress tolerance are not failures of care; they are care,” she said.

“Reality matters … You have to hold steady and make inquiry great again.”

One of the summit’s most significant moments was the presentation of the second annual CASC award to Queensland child psychiatrist Dr Jillian Spencer.

Dr Spencer was stood down from her position at Queensland Children’s Hospital after raising concerns about the treatment of gender-distressed children. She subsequently reached a legal settlement, received a public apology and was cleared of wrongdoing.

Her experience illustrates the consequences faced by medical professionals who question established gender policies.

The CASC conference reiterated that we must not allow ideology to take precedence over evidence.

Children experiencing gender distress deserve compassionate psychological support, thorough assessments and time to mature. Parents must not be sidelined, and detransitioners must not be abandoned when they need help.

Medical practitioners must be free to ask difficult questions without fearing for their careers.

No child should be rushed into irreversible treatment because adults are too afraid to question the prevailing ideology.

Courageous conversations are only the beginning. What matters now is whether Australia’s medical authorities and politicians have the courage to act.