Current legal and clinical framework for treatment of trans and gender diverse youth in Australia

Legal and clinical complexities surrounding consent to medical treatment for trans and gender diverse (TGD) youth in Australia continue to develop. New Australian Standards of Care and Treatment Guidelines have also introduced substantial clinical developments. Significant changes to legal principles from court decisions require doctors and health authorities, youth and parents, and legal advisors, to make and administer treatment decisions in compliance with the new legal requirements. Recent developments in the law relating to consent for medical treatment of TGD youth are clarified, with focus on the 2017 case Re: Kelvin and its implications for clinical practice. This article presents a new medico-legal analysis of clinical practice for treating TGD youth, mapping Australian clinical guidelines and legal principles against three stages of clinical treatment. Clinical scenarios are used to demonstrate situations where the legal framework no longer presents a barrier to clinical practice, as well as those where ambiguity remains. The aim of this paper is to ensure that clinicians working with TGD youth understand what the law currently requires in term of consent, with reference to the stages of treatment, and where the law fails to provide clear guidance for patients, parents and health professionals. Residual uncertainty in the applicable legal principles requires legislative or judicial resolution and policy clarity.