The Queensland government has announced the terms and leadership of an independent review to judge the efficacy of gender-affirming hormone therapy in under 18 years.
The Queensland government has announced the terms of reference and leadership of an independent review of the evidence for using puberty suppression and gender-affirming hormone therapies in the state’s public paediatric gender services.
On 28 January, Queensland health minister Tim Nicholls announced an immediate statewide pause of hormone therapy for public patients under the age of 18 years following a preliminary review conducted by the Cairns and Hinterland Health and Hospital Service in late 2024. Concerns were raised about apparently unauthorised paediatric gender services provided by the CSHS, adherence to treatment guidelines and clinical governance.
Now Mr Nicholls has named former Victorian chief psychiatrist Professor Ruth Vine as the independent lead of the review, which will assess the quality of current medical and clinical evidence, along with ethical considerations to direct government policy.
This assessment will focus on Stage 1 and 2 hormones for children with gender dysphoria, measuring the efficacy and social impacts of the treatments.
The Cass Review, commissioned by the UK’s NHS and released in 2024, led to a ban in that country on prescribing puberty blockers to those under 18 experiencing gender dysphoria (with the exception of existing patients or those in a clinical trial).
That report is believed to be a major reason for the Queensland government’s decision to pause and review the evidence.
Brisbane GP Dr Fiona Bisshop, a past president of transgender medicine peak body AusPATH, has previously told The Medical Republic that the Cass review disregarded evidence in support of gender-affirming care.
“The review ignored the fact that there is already international consensus on the use of puberty blockers and hormones for trans youth from the Endocrine Society, the American Academy of Paediatrics, WPATH and the AMA, to name a few, and the review findings ignored existing guidelines around the world,” she said.
The new independent review from the Queensland government is aimed at providing a concise review of hormonal therapy within the Australian healthcare context.
The lack of recognition for the Australian context was a major point of criticism for the Cass report’s applicability in Australia.
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This was reiterated at the time by AusPATH vice-president Dr Portia Predny, who told Equality Australia that Australia’s care landscape differs greatly from the UK’s NHS.
“The Cass review recommendations are at odds with the current evidence base, expert consensus and the majority of clinical guidelines around the world,” said Dr Predny.
The new Queensland review will give more comprehensive recognition of relevant stakeholders, who will have the opportunity to make submissions once the process is finalised.
The review has also extensively outlined the ethical requirements it will uphold to ensure a receptive and informed review.
Advice will be based on the current literature and evidence base with consideration for the short, medium and long-term impacts of the treatments.
Any reviewer involved with the project, including Professor Vine has been informed not to make any public statements unless approved by Queensland Health.
The final copy of the report will be provided to the Director-General of Queensland Health by 30 November 2025.
