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Puberty blockers are medications that temporarily pause the development of physical characteristics from gonadotropin-releasing hormones (GnRH) in the body. Blockers might be taken while making a decision about beginning or waiting to be allowed to begin hormonal affirmation, or before accessing some kinds of gender affirming surgeries.
“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.” – Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents (2018)
For young trans people wanting access hormonal affirmation, puberty blockers are sometimes the first step. This page aims to give you an overview of what puberty blockers are, their effects and how they may be accessed in your State or Territory.
Further information and resources to assist clinicians to learn more about puberty blockers can be found here.
Explore more about puberty blockers in your state or territory through the tabs above.
Acknowledgements: This page was created with input from trans writers across each state and territory, and developed in collaboration with Northern Territory AIDS and Hepatitis Council (NTAHC), SHINE SA, Transgender Victoria (TGV), A Gender Agenda, TransFolk of WA, Queensland Council for LGBTI Health (QC), and Working It Out Tasmania (WIC). All content was reviewed by the Inner City Legal Centre.
Puberty blockers are taken by trans people whose bodies have just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in New South Wales
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 2020 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance for trans people is also available at Inner City Legal Centre who offer a NSW-wide free legal service for trans and gender diverse people.
AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in NSW
Accessing puberty blockers in NSW often involves a referral from a GP or another doctor to a specialist clinic. For eligible adolescents, this is usually coordinated through a multi-disciplinary team, when available.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
In NSW, the two specialist services that work with trans and gender diverse youth, and their families, are True Colours (Sydney) and Maple Leaf House (Newcastle). Waitlists for each of these clinics can be quite long, with some people waiting up to 12 months before being seen.
For a list of doctors who support and understand trans people and our needs, check out ACON’s Gender Affirming Doctor List.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in Victoria
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling ( Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance for trans people may be available from Legal Aid Victoria and Fitzroy Legal Service Fitzroy Legal Service (who run Q+Law).
AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in VIC
Accessing puberty blockers in Australia often involves a referral from a GP or another doctor to a specialist clinic. For eligible adolescents, this is usually coordinated through a multi-disciplinary team, when available.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in Western Australia
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 2020 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available from Legal Aid WA. AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in WA
Currently puberty blockers are only available in WA through the Gender Diversity Service (GDS) at Perth Children’s Hospital, with waiting times to access care through the GDS often being long. It’s recommended that a patient makes a long appointment with their GP to discuss options for care and support.
Puberty suppression may continue for a few years, at which time a decision is made to either discontinue all hormone therapy or transition to a feminising/masculinising hormone regimen. Pubertal suppression does not inevitably lead to social transition or to further medical gender affirmation.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here) Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in the Northern Territory
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 20207 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available from Darwin Community Legal Service or Legal Aid NT.
AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in the NT
In the NT, accessing Puberty Blockers (also known as “Stage 1 Treatment”) is relatively simple. Anecdotally, the NT has some of the shortest wait times in the country to get assessed for this treatment, with a referral from a LGBTQI+ Doctor to the Public Paediatric Endocrinologist often only taking a few months.
There is a Gender Clinic at Royal Darwin Hospital, and young people should seek a referral from their GP or from a specialist LGBTQI+ Health Service to be assessed by the paediatric endocrinologist for Puberty Blockers, either in person or remote. Bulk Billed (free) appointments to request a referral are available through the Northside Health LGBTQIA+ Clinic monthly. NTAHC has free LGBTI+ counselling available that young people can access as part of their affirmative care. Other mental health services to support them during the assessment or administering of Puberty Blockers include Headspace, or privately billed mental health services.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
Under a Health Service Directive (HSD) issued by the Director-General Queensland Health on 28 January 2025, no new public patients under 18 years can be prescribed Stage 1 (puberty blockers) or Stage 2 (gender-affirming hormones) treatment for gender dysphoria.
You can read more about this change and efforts to support trans youth in Queensland through AusPATH’s Project 491 initiative.
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in Queensland
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 2020 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available through Legal Aid QLD.
AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in QLD
The Queensland Government has recently restricted access to puberty blockers and hormone therapy for patients under 18 years of age. Under this decision, no new public patients under 18 years can be prescribed Stage 1 (puberty blockers) or Stage 2 (gender-affirming hormones) treatment for gender dysphoria. This decision goes against the Australian Standards of Care for trans and gender diverse children and adolescents and evidence demonstrating the safety and essentiality for these medications.
Private providers can still prescribe puberty blockers and hormone therapy for patients under 18 years of age. GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Open Doors Youth Service (ODYS) is a youth service exclusively supporting LGBTIQASB+ young people aged 12–24, including those seeking or accessing gender-affirming healthcare. In response to the recent changes they wrote:
“ODYS is Queensland’s only youth service exclusively supporting LGBTIQASB+ young people aged 12–24, including those seeking or accessing gender-affirming healthcare. For 25 years, we have walked alongside young people and their families, providing frontline mental health, psychosocial, and peer-based supports. Our submission draws on this deep practice expertise, supported by direct lived experience and the voices of young people in our care.
We write this submission in the midst of a devastating and unnecessary crisis. Since the pause on gender-affirming care was introduced in January 2025, ODYS has witnessed a staggering 250% increase in referrals for under-18s, and a 64% increase in presentations of very high psychological distress at intake. These figures are not theoretical — they represent real young people in acute distress, being harmed by the sudden denial of life-affirming, evidence-based care.”
You can read the full submission here.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in South Australia
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 2020 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available from Legal Services Commission of South Australia.
AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in SA
Accessing puberty blockers in Australia often involves a referral from a GP or another doctor to a specialist clinic. For eligible adolescents, this is usually coordinated through a multi-disciplinary team, when available.
Currently puberty blockers are only available in SA through the Women & Children’s Hospital Gender Diversity Clinic. This means that it’s very important to organise a referral to the WCH as soon as possible, and that young people and their families may need to access support to maintain their wellbeing whilst on the waitlist. For more on where young people and their families can seek counselling and peer support, check out Shine SA.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in Tasmania
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 20207 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available from Legal Aid TAS. AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in TAS
Currently puberty blockers are only available in Tasmania through the Tas Gender Service (TGS). The TGS is for children and young people 16 years and under, and, is a statewide team based in Hobart that connects with health professionals in the North and North-West of the state. The team includes:
- Child and Adolescent Psychiatrist
- Paediatrician
- Psychologist
- Clinical Nurse Specialist
Young people are also required to see a fertility specialist for fertility counselling. Your family may also work with local professionals, with appointments being held in Hobart and via Telehealth.
GnRH analogues are not listed on the PBS for puberty suppression related to gender affirmation, and as a result the costs can be prohibitively expensive for many young people and their families.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
Puberty blockers are taken by trans people whose bodies are just started or are about to undergo puberty. For those who are pre-pubertal (i.e. children), gender affirmation is only ever social (studies here and here). Masculinising and feminising hormones are commenced after puberty would have, or did, occur.
“They work by blocking the hormones — testosterone and estrogen — that lead to puberty-related changes in your body. This stops things like periods and breast growth, or voice-deepening and facial hair growth.” – Planned Parenthood What are Puberty Blockers?
What types of puberty blockers are there?
The puberty blocker that is right for you will depend on a combination of your age, puberty-stage, preferences, access, existing contraindications, and other factors. Talk to your doctor about what treatment is going to be right for you (or your child).
GnRH analogues
Gonadotropin-releasing hormones (GnRH) or gonadotropin-releasing hormone analogues (GnRHa) are drugs suppress the secretion of gonadotropin-releasing hormones and are commonly used to prevent a spontaneous puberty in young trans people.
These include:
- Goserelin (Zoladex) – implant with a cycle of 10-12 weeks
- Leuprorelin (Lucrin) – injection every 3-4 months
- Triptorelin (Diphereline) – injection every 5-6 months
“In general, the goal of GnRHa administration in TGD adolescents is to prevent further development of the endogenous secondary sex characteristics corresponding to the sex designated at birth. Since this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – Standards of Care 8 (2022)
What are the effects of puberty blockers?
Studies on puberty blockers have shown that they are an effective and safe part of the hormonal therapy toolkit for young trans people. Puberty blockers are not only prescribed for trans young people but are also freely given to cis children and adolescents for a range of reasons.
WPATH, AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.
In 2024 the Sax Institute released an evidence summary into the effectiveness of interventions for children and young people with gender dysphoria.
“Broadly, the newly identified evidence reinforced the previous finding regarding benefits and effectiveness. That is [puberty blockers] were reported to be safe, effective and reversible.” – The Sax Institute (2024)
GnHRa’s may reduce bone density, however results showing this are mixed. It is recommended to for bone density be continually monitored for trans youth in collaboration with their endocrinologist or paediatrician.
GnHRa’s can affect your final height and could make you slightly taller if administered without gender affirming hormones and before the first growth spurt of puberty. This is because bones do not stop growing until exposed to estrogen or testosterone.
In general, GnHR’s are well-tolerated by the body. In 2024 Transcend Australia and AusPATH also released ‘Living True, Living Better’ evidence briefs & factsheets. These resources provide comprehensive, evidence-based information to guide decision-making for families, caregivers, and health providers. You can read the evidence brief for puberty blockers here.
Legal status of prescribing of puberty blockers to trans adolescents in the Australian Capital Territory
In Australia, trans young people may commence puberty blockers with permission from all carers or guardians, and their doctor. However, there are exceptions to this.
A Family Court ruling (Re Jamie, 2013) overturned existing law that required an adolescent and their family to go to the Family Court of Australia to gain authority to commence puberty blockers prior to 18, provided parents consented.
This ruling was further clarified in the judgement of Re Imogen 2020 to mean that treatment can be commenced in Australia with people under 18 when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:
- The Gillick competence of an adolescent; or
- A diagnosis of gender dysphoria; or
- Proposed treatment for gender dysphoria
Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.
Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.
For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court may be involved. However, a recent case (Re CD, 2024) clarified that in some circumstances an individual parent can provide valid consent to stage 1.
Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.
Further assistance may be available from Legal Aid ACT. AusPATH endorses local and international Standards of Care that offer guidance on puberty suppression for trans young people and adolescents.
Accessing puberty blockers in the ACT
Accessing puberty blockers in Australia often involves a referral from a GP or another doctor to a specialist clinic. For eligible adolescents, this is usually coordinated through a multi-disciplinary team, when available.
Services
ACT Paediatric Gender Service
In the ACT, the Paediatric Gender Service is the primary pathway for young people under 16 years of age wishing to access puberty blockers or other medical gender-affirming care. The Paediatric Gender Service is within ACT Health Services at the Canberra Hospital. A formal referral from a general practitioner is required to access this service.
Initially the young person will see a social worker for an intake appointment. They will then have an appointment with a paediatric endocrinologist for commencement. Ongoing maintenance may be handled within the service, or by a GP attached to the service, or the young person’s regular GP. Young people aged 16 and 17 years (and adults 18 years and over) will access gender affirming care through the Canberra Sexual Health Service.
Gender Pathways
For young people and their families seeking more information, or support, Gender Pathways is a peer navigation service supporting trans people of all genders with resources and referrals. Peer navigators can offer information about social, legal, and medical affirmation in the ACT. Gender Pathways is also accessible to clinicians seeking more information for their patients.
Please note Gender Pathways cannot provide a direct referral to the ACT Paediatric Gender Service. They can provide information about affirming GPs in the ACT, however any GP can provide a referral to the service.
Canberra Trans Care Network
For clinicians seeking more information or ongoing support, the Canberra Transgender Care Network is a group of healthcare professionals that have a commitment to the quality care of trans people of all genders. Their aim is to improve care in the Canberra region through improved referral networks, learning from each other and our mutual patients, and advocating for better local services for this population.
To join the group or for more information: ca**********************@***il.com.
Criteria
The Australian Standards of Care for trans and gender diverse children and adolescents outlines the criteria for adolescents to commence puberty suppression.
Puberty blockers can be offered to trans and gender diverse young people who have started puberty. A mental health professional needs to confirm gender dysphoria, and a doctor must check their physical development and talk about future fertility options. The healthcare team must agree it’s the right step, and both the young person and their legal guardians must give consent.
Further detailed information about the criteria for puberty blockers can be found here.
References & Links
- Coleman, E., et al. (2022). Standards of care for the health of transgender and gender diverse people, Version 8.
- Telfer, M.M., Tollit, M. A., Pace, C. C., & Pang, K. C (2018) Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. The Royal Children’s Hospital Melbourne
- Planned Parenthood (n.d.) What are Puberty Blockers?
- The Sax Institute (2024) Evidence for effective interventions for children and young people with gender dysphoria—update
- Equality Australia (2024) Re: C.D. Factsheet
- Davey R, Hillis C, Carnie L. (2017). Family Court of Australia clears the way for young trans people to access hormone treatment without court authorisation. Human Rights Law Centre.
- Family Court of Australia. (2020). Re: Imogen (No. 6) [2020] FamCA 761. AustLII.
