Simon Birmingham (SA, Liberal Party, Shadow Minister for Foreign Affairs) Share this | Hansard source

I want to make a few brief remarks. The fundamental issue that is at the heart of a matter like this is the wellbeing of children and young people. It must be of paramount concern. The motion before this chamber proposing an inquiry deals, in particular, with children and young people with gender dysphoria.

'Gender dysphoria' is acknowledged by the Royal Australasian College of Physicians as a term used to describe the distress experienced by a person due to incongruence between their gender identity and sex assigned at birth. The College of Physicians notes that it is generally diagnosed at clinical interview rather than self-defined. We are talking very specifically here about a category of children and young people who are diagnosed with a distress, and a distress that is further recognised by the College of Physicians as being one where:

Children and adolescents with gender dysphoria are a very vulnerable population, experiencing stigma and extremely high rates of depression, self-harm, attempted suicide and suicide.

This is why these issues should be handled with the utmost care and sensitivity.

I appreciate that some people, those who genuinely approach these issues with pure intentions, can absolutely come to different conclusions about the proposal that is before this Senate. I respect those who come to it with the purest of motivations and intentions, but I do also urge them to think very carefully about whether this proposal for a public inquiry of this nature is the right approach to handle a matter of such extreme and serious sensitivity.

I have seen motions of this nature come to the chamber before, over recent years. They have done so on numerous occasions. Again, I acknowledge that many who have voted for them have done so with the best of intentions. But I have been clearly guided by the position taken by the health minister of the previous government, Greg Hunt. Minister Hunt was very clear in his view that we needed to approach these issues with caution, with sensitivity and with concern to ensure that the actions of parliament or government did not cause further harm to a highly vulnerable population. I am clear in my view that the risks associated with the type of parliamentary inquiry proposed would outweigh any benefits of undertaking such an inquiry. I am sure—as with any field of science and medical study and research for which there is a growing body of knowledge, but from limited beginnings—that there is still much to be learned in this space and that there are still improvements to be made in the type of clinical guidance that can be provided and the type of treatments that are offered. It is essential that medical practitioners and those responsible for setting clinical guidance are absolutely consistent and persistent in the approach they take to ensuring that the type of support provided to children and young people with gender dysphoria is best practice according to the knowledge available at all times.

When former minister Hunt considered these matters and asked the Royal Australasian College of Physicians for advice, they came back very clearly identifying what they saw as being important ways forward for support. They indicated that, firstly, the Australian government should work with states and territories to improve access to and consistency of care both within and across jurisdictions. They identified deficits in relation to rural and regional access to appropriate support and care. They acknowledged there were differences in some states and territories and that ensuring that jurisdictions across Australia were pursuing best-practice outcomes was an important undertaking. Secondly, they suggested that the government consider coordinating and providing funding for research on the long-term outcomes associated with the care and treatment of gender dysphoria. This is an entirely logical recommendation and suggestion—noting, as I said, that evidence is certainly not at a point where people could say it is concluded, but, frankly, nor could you say that about most areas of medical research and treatment, where we are always striving to see and achieve advances in relation to those areas of treatment and research. The third recommendation of the RACP was to facilitate the development of evidence based information aligned to current guidelines, to be made available to all patients and to all families to ensure support for fully informed consent and engagement in relation to these matters.

These are important principles that I would urge the current government to ensure that it is working with health ministers from around the country to act upon and to deliver upon, because it's important that the Australian standards of care and treatment guidelines for trans and gender-diverse children and adolescents are at the highest practice possible; that they do provide for the best interests of those children and young people; that they do support outcomes that ensure their wellbeing for the future; and that, in doing that, they are cautious and careful to ensure that, whether it is treatment or non-treatment that occurs, whether there is action or inaction, all of those steps are undertaken in the best interests of those young Australians, of those young people, and their health—physical health and mental health and wellbeing.

I expect that there will be further changes in relation to the guidance of such treatment time and time again in years to come as, indeed, medical science, research and evidence evolve and change. But I do not believe that a committee of senators, however well intentioned some who might participate in that inquiry would be, are the best people to try to define those treatments or those approaches. I believe our medical practitioners, our researchers and our scientists are best placed to do that, under the same type of guidance, policies and settings that we apply to the treatment of many other—any other—types of issues that people face in their lives.

I particularly note, given the vulnerabilities that young people face—the vulnerabilities, in particular, that those with gender dysphoria face—the advice of the RACP:

The RACP notes that there are substantial dangers posed by some of the proposals that have been put forward during the recent public debate on this issue, such as holding a national inquiry into the issue.

The RACP went on and said very bluntly and directly:

A national inquiry would not increase the scientific evidence available regarding gender dysphoria but would further harm vulnerable patients and their families through increased media and public attention.

That should be a guiding statement for all of us. Will passing this motion increase the scientific evidence available regarding gender dysphoria? No, it will not. But could the publicity that comes with such an inquiry see some of the most vulnerable Australians face significant additional stress in their lives—stress that all too often leads to worse mental health outcomes, to suicide attempts and, ultimately, to suicide? Yes, potentially, it could. That is what should guide us in terms of the approach to this motion.

We should hold the colleges of medicine and we should hold our researchers—we should hold all—to a very high standard. There are means to ensure that they are scrutinised, that our health officials are scrutinised, through the regular processes of this chamber. There are means for committees to seek private briefings and information without necessarily needing to initiate an inquiry but to actually go and seek that information and advice for their scrutiny and knowledge and to inform their deliberations simply as a committee. But, as the RACP said in their advice to Minister Hunt at the time, considerations of care and treatment of medical conditions should be based on medical evidence and advice from medical and other health professionals, who have specific expertise in the condition in question.

Members of this chamber do not have specific expertise in the condition in question. We come to public policy issues variously well intentioned, with some sometimes seeking to achieve publicity or other outcomes too. But, on an issue like this, with the sensitivity attached to it, we should heed the warnings that are given. I encourage senators to do as I will do, which will be to vote against this motion. This is not because I do not recognise that there are concerns in parts of society—I do recognise those concerns—and not because I believe that everything is perfect in relation to the treatment of gender dysphoria at present—I'm sure it is not—but because I believe that, through enhanced knowledge and research, we will see continued improvements. But I do not believe that the type of scrutiny proposed through this committee inquiry referral would provide for improved outcomes. I am convinced that it could risk the lives of some young Australians. Therefore, I will be opposing this motion.