The Dangers of the Politicization of Medicine

Some months ago, I was deeply concerned and confused when I attended a seminar put on by the Victorian Equal Opportunity and Human Rights Commission about Victoria’s new laws about gender suppression and anti-gay conversion practices. My thoughts on the legislation are ambivalent as I support a ban on gay conversion therapies, but what amounts as “suppression” of a gender identity can be notoriously broad and can include the very mention of the words “celibacy” and “holiness.”

The convenor offered an explanation of the legislation and explained how it applied to clergy when talking about sexuality with particular emphasis on the things that could render them liable to complaint and prosecution under the legislation. It was sobering and gave us advanced notice of what types of religious speech and behaviour were illegal in Victoria.

I did have one question as to how clergy and clinicians could provide either pastoral care or medical care to adolescents with gender dysphoria without transgressing the new legislation. So I asked the convenor,  “Can a clinical practitioner – like a GP, psychiatrist, psychologist, or pediatrician – treat an adolescent with gender dysphoria in such a way they would desist in their dysphoric symptoms?”

I asked the question because, according to DSM-5, 80% of adolescents with gender dysphoria desist in their symptoms, most become gay or bisexual. I was then flabbergasted when the convenor said, “No,” such a treatment would violate the legislation, with the result that a medical practitioner could be subject of a complaint and prosecution for treating an adolescent in such a way.

Now this is precisely why the Australian Medical Association initially opposed the Victorian gender identity and suppression legislation back in 2021 because medical professionals would not be able to challenge a patient’s self-diagnosis. I was of the understanding that revisions to the gender suppression legislation in Victoria meant that medical professionals had dispensation to pursue best medical practices in treatment of a patient even if it was not strictly gender identity affirmative. However, the convenor of the seminar I attended did not share that view of the legislation. Medical professionals, as well as clergy, had to affirm a person’s gender identity and could not treat it as a pathology that needed to be cured, healed, or repaired.

I think this particular case, the medical treatment of adolescents with gender dysphoria, is going to come to a flash point of conflict between trans-activists, government, and medical practitioners because the National Association of Practicing Psychiatrists have recently advised against giving puberty blockers or cross-sex hormones to adolescents outside of clinical trials due to the adverse side effects of such pharmaceutical treatments. If a psychiatrist refuses to give cross-sex hormones to an adolescent who identifies as “transgender,” that could be interpreted as suppression of said person’s gender identity and make the practicing psychiatrist liable to complaint or prosecution.

The politicization of medicine thus poses a social risk when a government intends to compel or coerce clinicians to engage in treatments that cause harm, do not accord with best clinical practice, or even violate the consciences of medical professionals.

I have to say that I am similarly concerned with recent legislation in Queensland to change the Health Practitioner Regulation National Law Act 2009 so that the Australian Health Practitioner Regulation Agency can investigate complaints against medical professionals who do not comply with government directives. The legislation included a subtle but sinister change. Instead of the current requirement to make “health and safety of the public” the paramount concern, the change directs the agency to maintain “public confidence in the safety of services provided by registered health practitioners and students.”

Medical professionals will have to provide advice promoting confidence in public policies and certain practices, even if it is not in the individual patient’s best interests or does them potential harm. So, rather than seek public health and safety, a government agency can require medical professionals to treat the public with care that affirms government policy irrespective of the risks to the public.

The change is not semantic or administrative as it affects practicing medical professionals. The concerning thing here is that a medical professional could be investigated for even warning about the side effects of puberty blockers or the risk of myocarditis from COVID vaccines. Or, to give a concrete recent example, Dr Jillian Spencer, a Queensland psychiatrist has been treating students with gender dysphoria cases without an affirmation approach. An approach which is, to be clear, not rogue, but consistent with increasingly international medical practice on gender treatment for adolescents in the UK, Finland, Sweden, and the Netherlands.

Her approach has led to discipline by the Queensland Children’s Hospital as Dr. Spencer was stood down. Dr. Spencer is supported by the LGB Alliance, the Human Rights Law Alliance, the Australian Doctors Federation. In fact, according to the ADF:

The ADF advocates for and supports medical practitioners who may be targeted for upholding important professional principles, especially in ensuring the need for procedural fairness and natural justice when there is dispute about their practice.

Gender dysphoria in children and its skilled and considered medical management are the subject of ongoing debate, both in Australia and internationally.  There is a particular obligation to first do no harm when making medical decisions during a particularly volatile period of a person’s development, especially should the outcome potentially not accord with later mature reflection.

It is essential for good medicine and societal well-being that there is open and unbigoted debate about the merits or otherwise of relevant treatment protocols, and that medical decision-making be guided by evidence rather than bias or ideology.

 We must not only hope, but advocate for laws which protect for the ability of medical practitioners to pursue a “no harm” principle and treat patients with the best medical practices without being coerced or punished by a government who promotes ideology over public health and safety.