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When it comes to the treatment of trans youth, the beautiful stories of those whose lives are transformed by affirmative care are often lost amidst the debate. But at GenderGP we believe it is those voices that should be steering the conversation.

A recent ABC news article praised Dr Michelle Telfer for saving the lives of hundreds, even thousands of children – without ‘ever picking up a scalpel or treating a disease’.

Telfer, a former elite gymnast turned paediatrician, heads up the Gender Service at the Royal Children’s Hospital Melbourne. In the eight years since she began she has helped the clinic’s multi-disciplinary team support and treat more than 1500 gender-incongruent young people, building lasting connections with her patients along the way.

Michelle joined us on the GenderGP podcast to discuss her work, you can listen to the episode here.

One of these patients is Isabelle Langley, 18, a young woman just finishing school and about to head off to university. Langley’s success is a bittersweet moment for Dr Telfer, who has helped her flourish through her transition and now must say farewell as she heads into the adult care system. Her mother, Naomi, can’t imagine what her life would have been like without the right treatment: ‘It has made all the difference in terms of who she is today.’

 

Dr Telfer’s work with and connection to her patients remind us of the importance of centering the conversation on the voices of the young people whose lives have improved exponentially as a result of gender-affirming care.

 

It’s not an exaggeration to call this work life-saving. In Australia a 2017 survey found that half of young trans people had attempted suicide and nearly 80% had self-harmed prior to accessing treatment. Another of Dr Telfer’s young patients, Elliot Nicholas, had attempted suicide several times before coming out as trans. With loving support from his parents – both Uniting Church ministers – and proper assessment and treatment at the gender clinic his confidence has exploded, and in just two years he has gone on to become the Junior Mayor of the small city of Geelong and the vice-captain of Newcomb Secondary College. More than anything else, Nicholas attributes his good health now to the ‘support and respect and love’ that he has received during the process. And this is what is so important about Dr Telfer’s work: listening, supporting, and caring for young people who desperately need to be understood.

Unfortunately the difficulties facing trans people in Australia are representative of those presenting on a global scale. There, as in the UK and the USA, a sharp increase in referrals to gender clinics, without a corresponding increase in support for trans people, has led to many families facing long waiting times, a hostile media landscape, and a lack of resources to help support young people while they access treatment. This has pressured some young people into buying medicines on the black market, an unregulated and potentially dangerous situation.

To help support this uptick in young people looking to access gender-affirming care Dr Telfer was part of the team that developed the Australian Standards of Care – the first ever clinical guidelines for the treatment of transgender adolescents. These guidelines not only set a model for gender-affirming care both in Australia and around the world, but also help counter the narrative that transgender care for young people is harmful or experimental.

As the UK awaits the Tavistock vs. Bell appeal on the 23rd of June 2021, we can hope that some of Dr Telfer’s standards will make an impression and alleviate some of the difficulties facing trans young people since the ruling. A robust set of clinical guidelines based on an international standard could get the nation’s ailing trans healthcare away from the field of public debate and start really making a difference to vulnerable young people – to the individuals who are being forgotten. As Isabelle Langley said of her own transition: ‘It just makes very little sense to me that people would see this kind of treatment as a social experiment – it’s just medical treatment. It’s simply helping children feel more comfortable in their bodies and feel happier.’

What makes doctors like Telfer so important in the fight for adequate healthcare for transgender people isn’t their contribution to the ‘trans debate’ or even their participation in it. It’s their ongoing commitment, day after day, to keep on supporting the young people in their care and revolutionising systems of healthcare so that others around the world can follow suit.

At GenderGP we follow the guidelines set out in the Australian Standards of Care, and we encourage other healthcare providers in the UK (and anywhere else, for that matter) to follow suit. If it comes to a choice between affirming young people now or endlessly debating it then it is a choice between making a difference and doing nothing. And, as Dr Telfer says, doing nothing isn’t nothing. ‘Doing nothing is actually exposing young people to the risk of harm.’

Australian Story went behind the scenes at the Royal Children’s Hospital Melbourne’s (RCH) Gender Clinic to meet three of Dr Telfer’s patients, Isabelle, Elliot and Oliver. You can watch the documentary here.