The 2020 case “has the potential to change the way doctors prescribe hormonal treatment to transgender children in Australia, with at least one state already reviewing its policy.”

Kiera Bell, now a  de-transitioned person who was prescribed puberty blockers as a 16 year-old-girl, won an agenda-setting case in the UK High Court. The ruling meant that drugs and cross-sex hormones for under-16s will be permitted only when approved by a court.

The Kiera Bell case set a precedent that under sixteens are not “Gillick competent” to undergo transgender treatment with long-term consequences, that may possibly be permanent. An assessment of Gillick competency aims to establish if a particular person is competent to give or to refuse consent in regards to a specific treatment.

Nine reports that “Since the ruling, Western Australia’s child and adolescent Gender Diversity Service, which receives an average of four to five referrals a week, has quietly started a review of its policies in a bid to reduce its liability in the event a patient, like Ms. Bell, decides to sue them in the future.

“Gender services in Victoria and the ACT are also keeping a close eye on developments in the UK and haven’t ruled out making changes to their policies.”

The Bell case marked a reversal for London’s influential Tavistock Centre which runs the Gender Identity Development Service (GIDS), a prominent service that accepts referrals from across the UK.

At that stage, it was an open question whether Kiera Bell’s case would have the effect of engendering caution in Australian clinics, or whether the American path of more readily available treatment.

Clinics in Victoria have led the way toward a more US-style system, while other states including NSW have taken a more medically cautious approach.

While the Family Court of Australia was involved in assessing the young person’s Gillick competence in earlier cases, this court involvement has been relaxed. From 2013, parents have been able to consent to the first stage of transition using puberty blockers and, in 2017, the court went further and ruled in the re Kelvin case that where the young person, parents and doctors all agreed to the second stage of drug treatment, court approval would not be required.

Stage two involves the use of hormones rather than puberty blockers and has irreversible effects.

However, Nine reports that WA’s Gender Diversity Service is now referring all cases to the Family Court for approval.