Judgement Day
A judicial spotlight falls on Australian gender clinics
In a landmark decision on April 4, 2025, Justice Andrew Strum of the Australian Family Court delivered a groundbreaking ruling against the Royal Children's Hospital’s (RCH) gender clinic and criticised its "affirmation " model (which includes social transition, puberty blockade, cross-sex hormones and sex reassignment surgeries).
Judge Strum’s ruling was highly critical of Dr. Michelle Telfer under whose leadership the RCH gender clinic has seen an explosion in the numbers of children attending – up from 18 children in 2012 to 1,290 by 2023 - an over 7,000% increase.
In Strum’s 130-page ruling, he said Dr. Telfer; “…cheapened the suffering of victims of Nazism when she suggested a landmark review (the UK’s Cass Review) which recommended limitations on medication for gender-dysphoric children formed part of a wave of transgender oppression.”
Background to the Case
Michelle Telfer was Director of RCH gender clinic from 2012 to 2022 and has been arguably the most influential figure in Australian gender medicine – she has:
Authored the 2018 Australian Standards of Care (SOC) and Treatment Guidelines for Transgender and Gender Diverse Children and Adolescents (TGGDC).
Played a pivotal role in the 2017 Re Kelvin court case where she advocated for the removal of Family Court approval when prescribing puberty blockers.
Promoted the affirmation medical model as “evidence-based,” and “best practice” and providing evidence to the Family Court judges that puberty blockers are fully reversible.
Justice Andrew Strum described Telfer’s role as an ‘expert’ in the Re Devin case as akin to being the "proverbial judge, jury and executioner” while Telfer herself conceded under cross-examination that her opinion was essentially self-endorsement.
The God Complex
In the ABC’s Australian Story episode, Treating Trans Kids, Michelle Telfer tells her own origin story as a ‘pioneer’ of gender medicine. Telfer remembers when she met her first ‘trans child’ a 10-year-old girl who told her that every birthday she wished that she could “have the body of a boy.” Telfer said she wanted to be ‘part of making that wish into reality’ and it was an ‘amazing thing’ to get involved in.
In an interview for the Emerging Minds podcast in Nov 2021, Telfer makes the familiar argument that ‘trans’ children are ‘born in the wrong body’:
And for them, it’s not a decision, not a choice. What they’re doing is expressing who they are and what they need to have happen to give them a fulfilling, happy life…. and parents not supporting the young person to have interventions, what we often see are very fractured relationships within the family. And I think that’s probably the greatest shame of all that families break down because they don’t recognise how important that might be for that young person to fulfil what they need.
Telfer ascribes the high levels of mental illness in the trans community to “…negative experiences…the stigma…the discrimination…the social isolation… particularly family rejection that many trans people experience on a daily basis.”
Telfer promotes puberty blockers as fully reversible.
“Imagine you’re a young child assigned female at birth based on your physical characteristics, but you have a male gender identity. If you start to go through puberty and develop breasts, that’s a very distressing situation to be in. We can intervene to prevent this by using puberty blockers that are entirely reversible, you can stay on them for three or four years and if you stop…the natural hormones will just recommence, and your body will change accordingly.”
Telfer is speaking directly to parents when she says children who transition do “astonishingly well’ and get ‘top marks in the VCE and scholarships to university”. While those whose parents refuse medicalisation experience, “very high rates of depression, anxiety, self-harm, and some attempt suicide, because for those young people, there really isn’t a safe space for them”.
The Chickens Come Home to Roost
The Cass Review, commissioned by NHS England in 2020 and led by Dr. Hilary Cass, investigated gender services for children and young people and focused on the evidence base for gender medicine. The University of York conducted seven systematic reviews and analysed 237 papers involving 113,269 children across 18 countries and found the evidence base for medicalisation weak with significant gaps in long-term outcome data.
The Cass Review resulted in the UK government banning the use of puberty blockers and the NHS taking a much more cautious approach for prescribing cross-sex hormones. Many European countries including Denmark, Holland, Sweden, Finland and the US have conducted reviews and recommend a ‘watchful waiting’ model that focuses on psychological and social support and a full assessment of a child’s comorbidities including autism, trauma family issues, mental health issues and sexual use. Australia is one of the few countries that continues to defend and promote the ‘affirmation model.’
Australian Gender Medicine under the spotlight
The Cass Review evaluated the Standards of Care and guidelines across 10 countries and scored the Australian Standards a mere 18 out of 100 for methodological rigour. The Review also highlighted significant deficiencies in the development of the Standards and reported that claims about improved mental health outcomes for medicalisation were not substantiated by the evidence.
Michelle Telfer, along with Professor Ada Cheung, Dr Portia Predny and Dr Fiona Bisshop criticised the Cass Review and said it was ‘not relevant’ while maintaining that hormones are ‘safe’, ‘effective’ and ‘reversible’ (despite providing any evidence to the contrary).
The Unmasking of Telfer
The Re Devin case in the Family Court, presided over by Judge Strum involved a custody dispute between the parents of a 12-year-old boy, referred to as Devin. Michelle Telfer advocated for the mother who wanted to commence puberty blockers for her son, while the father argued his son was gender-exploratory, not gender dysphoric and was concerned that medicalization was potentially harmful.
In his 130-page judgement Justice Strum sharply criticized Telfer for providing “misleading” testimony and found her evidence biased, overly ideological and dismissive of the UK’s Cass Review. Telfer’s responses were: “…misleading or omitted findings and material that detracted from (her) opinion contrary to the obligations as an expert witness. Some of the many examples proffered are concerning.”
The court awarded custody to the father with Judge Stum stating the father could support his son through open conversations and professional psychological support rather than “one-directional gender affirming treatment.”
The Judge originally prevented the media from identifying both Telfer and the Royal Children’s Hospital, instead referring to them as “Professor L” and “the hospital” respectively.
But following the initial judgement, The Australian newspaper petitioned the Judge to lift the suppression order on the grounds of the significant public interest and Telfer’s pivotal role in gender medicine. Strum agreed and The Australian ran this front-page story:
Australian Media in the Dock
The ABC consistently portrays Telfer as a compassionate advocate for ‘trans youth’ and has commissioned various profiles of her work at the clinic:
Australian Story: A Balancing Act (May 24, 2021) The episode profiled Telfer as a world leader in gender medicine guiding hundreds of children and youth through transition.
The Year that Made Me: Dr. Michelle Telfer (March 13, 2022): This ABC radio segment profiled Telfer’s work positively as a dedicated professional navigating ‘cultural’ controversies and her reaction to ‘hostile’ media coverage.
The Conversation Hour: Yolanda and Kai’s Story (April 1, 2016): Telfer co-hosted this ABC radio segment where she shared her insights about transgender family experiences.
The Australian Newspaper has maintained a more critical eye and published 45 articles and opinion pieces between August 2019 and June 2020.
Telfer criticized The Australian’s coverage saying it contained “false, inaccurate, unfair, and unbalanced information,” that portrayed her as harming children and causing her ‘significant distress’ for which she had to seek the support of a psychiatrist.
Telfer brought a 42-page complaint regarding The Australian’s coverage to The Australian Press Council (APC) in 2020. The APC ruled the newspaper had breached its Standards of Practice. The newspaper defended its reporting and argued it was in the public interest to scrutinize gender medicine, a topic with legal, ethical and health consequences for vulnerable children and youth.
The journalist Bernard Lane, who wrote many of the articles said the APC ruling favoured Telfer’s “hurt feelings” over legitimate journalistic inquiry and stifled a debate on a contentious issue.
Following the recent Strum ruling, the RCH reiterated its support for Telfer citing her advocacy for legal reforms and stating that her work aligns with the Australian SOC and TGTGDC which she co-authored.
In other words, Telfer is above reproach because she’s following the SOC she wrote and puberty blockers are safe because she says they are - despite the Cass Review, the U.S. Department of Health and Human Services (DHHS) review, the many European reviews and Judge Strum’s ruling.
Forward to the Future
When the movie is made of the short history of Australian gender medicine, Michelle Telfer will be the central figure - an ex-Olympic gymnast who traded the parallel bars to become Australia's pioneering gender doctor. Far from a celebration, it will be a cautionary tale about humanity's failure to learn from medical scandals of the past - lobotomies, electric shock treatment, the false memory syndrome and thalidomide, to name just a few.
The heroes of this film will be the parents like Devin's father, who refused to be silenced despite enormous pressure and fought through the courts to protect their children from experimental treatments. They will be the international researchers like Dr. Hilary Cass who conducted rigorous systematic reviews and had the courage to follow the evidence wherever it led. They will be the European clinicians who recognized the weak evidence base and shifted toward more cautious, evidence-based approaches. They will be the journalists like Bernard Lane who persisted in asking difficult questions despite institutional backlash and groundless accusations of causing harm. And they will be Justice Andrew Strum and other judges who demanded actual evidence rather than ideological assertions in their courtrooms.
Telfer will not be among the heroes.
Telfer, the Melbourne Mengele, is lucky I have no say in her judgement, as I'd readily jail her for life. But really, it's the societal enabling that's mostly to blame. Psychopaths like Telfer can think what they like. It's when the people around such maniacs don't say NO that real harm is done. We all have to start doing that, a LOT more. A firm, serious unwavering NO to this utter insanity.
The sooner creatures like Telfer are locked up and the key thrown away, the better. Unfortunately, that won't happen. Looking at the examples referred to in the piece, all the perpetrators of electric shock therapy, lobotomy, false memory and all the rest, just walked away scot-free. In fact Mr Lobotomy earned himself the Nobel Prize. Medicine has had and has blind spots and gender medicine is another example.