MINISTER FOR HEALTH AND AGED CARE, MARK BUTLER: Thanks for coming along this afternoon.
Our Government is determined to deliver a strong health system for all Australians, and we're especially determined to ensure that young people, children and teenagers, receive the best possible care. That is particularly important for highly vulnerable young people, including trans and gender diverse children and adolescents. Currently, those children are treated by state governments in accordance with a set of clinical guidelines that was first published in 2018. And while that might not seem too long ago, it's important to point out that that much of the evidence around the treatment of gender-diverse and trans young people has emerged over recent years. It's also important to point out that those guidelines have not been approved by the NHMRC.
Now groups representing clinicians and families and young people themselves, in this area of practice, have indicated to the government last year that they think that those guidelines should be updated. I'm referring in particular to AusPATH, representing clinicians, and Transcend, a group representing families. There's been a lot of movement in this area overseas in recent times: in the UK, notably, but in other jurisdictions in Europe as well.
The advice that I've received from the National Health and Medical Research Council, the NHMRC, describes this area as “contested and evolving”.
I've given deep consideration to this area over the course of summer, given movements overseas. Also, I read the Sax Institute Review that was commissioned by the New South Wales Government last year. And two weeks ago, I sought some formal advice from the National Health and Medical Research Council, as well as the Therapeutic Goods Administration on the current provision of care in Australia for trans and gender diverse children and adolescents. After considering that advice, I've decided to ask the NHMRC to undertake a comprehensive review of the current guidelines - the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents in Australia - and I've asked them to develop new guidelines.
The provision of public gender services to young people in Australia is exclusively led by states and territories who are responsible for the relevant services and who employ the relevant clinicians. But the NHMRC is the nation's leading expert body in health and medical research and has a statutory responsibility and charter, set out in the NHMRC Act, for developing and supporting high quality guidelines for clinical practice. It is the right body to do this work.
It's imperative also that there is community confidence that Australian children, adolescents and their families are receiving the most appropriate and the best available care. The guidelines will be developed in accordance with the NHMRC Standards for Guidelines and the international GRADE approach. The NHMRC will develop the guidelines with an expert committee that includes lived experience, and will be informed by public consultation as well as international work and developments. Interim advice on the use, particularly, of puberty blockers, will be completed in the middle of 2026 and more information about this process will be published on the NHMRC’s website shortly.
It's important that this process and the outcome is driven by evidence and is conducted by our most eminent medical researchers and clinicians, engaging, obviously, with Australians with lived experience and their families. These guidelines will ensure that Australia has the most appropriate national guidelines for clinical practice, and that families have the utmost confidence in the health care that their precious young Australians receive.
I also want to indicate that I've spoken, among others, to the Queensland Health Minister, Tim Nicholls, in light of the announcements that the Queensland Government made over recent days. Given the pre-eminence of the NHMRC and the statutory charter that it has to commission and issue clinical guidelines, I've indicated to Minister Nicholls that I don't think it would be appropriate for Queensland to continue with their stated intention to undertake an evidence review in this area of care. These issues should be nationally consistent, and in my view, should be driven by the preeminent authority, which is the NHMRC.
Queensland Government has indicated its intention to undertake a second inquiry, particularly in relation to its state health service in Cairns and the hinterland. And that obviously, is another matter. That is a matter for the Queensland Government. I also reiterated to Minister Nicholls the crucial importance of ensuring that young trans and gender diverse Queenslanders have access to the best possible comprehensive and appropriate care, particularly given the decision of the Queensland Government to pause an element of the existing model of care in that state. I'm happy to take questions.
JOURNALIST: Minister Butler, is this review in response at all to the Queensland Government's pause, are you hoping that the outcome of this review will, you know, potentially prevent a government, a state government, state or territory government, to almost act on its own volition like that?
BUTLER: It is certainly best practice to ensure that that state governments and private services are operating in accordance with national and consistent clinical guidelines that are issued, or at least approved, by the nation's preeminent authority in this area, the NHMRC. But in response directly to your question, I can say I've been thinking and reading deeply about these issues over the course of the entire summer, and I asked the NHMRC and the TGA for advice about particular options in this area some weeks ago, before the announcement of the Queensland Government's decision.
JOURNALIST: How does that make you feel that the Queensland Government has paused some treatments for people under 18?
BUTLER: All of the scripts for puberty blockers are issued by state governments and state government clinicians, so that is ultimately a matter for them to determine, according to the best available advice that they have. They should be taking those decisions with the best interests of young people as the paramount consideration. And as I said, I reiterated to Minister Nicholls that, particularly in light of the decision that his government has taken around this, it is particularly important to ensure that vulnerable young Queenslanders have access to the best available comprehensive care and support.
JOURNALIST: Minister Butler, you sought advice from the NHMRC and the TGA on the current care for trans and gender diverse young people and Australians. What was that advice?
BUTLER: As I said in particular in my introductory remarks, the NHMRC confirmed a view I think most people who've paid attention to this area would agree with. And that is that that clinical care in this area is evolving very quickly. Much of the evidence that's been published about this has only been published in recent years. And it's contested. That is what the NHMRC said to me, in writing their advice, was this is a “contested and evolving” space. Also, it is important that clinicians working in this area have indicated to government that they think these guidelines should be updated, particularly clinicians represented by AusPATH. The NHMRC provided me advice that it would be open to exercising its statutory charter to undertake a review and issue new guidelines for the treatment of children and young people in Australia who are trans or gender diverse.
JOURNALIST: It's fair to say that in other jurisdictions, like the United States, for example, with President Donald Trump ordering an end to gender affirming care, or federal funding for gender affirming care for children. Do you feel like this is an important show demonstration that Australia, I guess, is like, committed, I suppose, to gender affirming care?
BUTLER: Our Government is determined to provide all Australians with the best possible health care, but we are especially determined to provide precious children and adolescents with the best possible care. That should always be a paramount focus of any government, and certainly is of the Albanese Government. We're also determined to make sure that as Australians, we tap into the expertise, the experience, the intellect of the NHMRC to ensure that we have the best possible clinical guidelines to guide that care, to guide clinicians and to give families the confidence that their children and adolescents are receiving the best possible care.
JOURNALIST: There's quite a lot of misconceptions around young people regretting their gender affirming surgeries and things like that. Is, I guess, public perception - do you view that as a bit of a barrier or an issue to addressing this health topic more broadly?
BUTLER: There's a lot of public commentary about this area of care. Not all of it is particularly constructive, and some of it, frankly, is quite damaging to the mental health of young people and families who are so desperately trying to care for them, as well as their clinicians. Which is why I'm so determined to make sure that, going forward, we do this in an evidence based way, that we conduct this process through well-established systems that have served Australia well for decades, under the auspices of the NHMRC, that we tap into the best minds that we have in Australia, that we engage with people with lived experience and their families as well. Now some people will continue to try to play politics with this issue. I'm not interested in doing that. My job is to do everything I can to ensure that the best possible clinical care is provided to these highly vulnerable young Australians, to give them the best start to what we hope will be a long, healthy and happy life.
JOURNALIST: Minister Butler, I'd like to change the topic to Botox. Are you concerned about fake Botox that's led to botulism in four patients in Australia?
BUTLER: Look, we're deeply concerned about the potential in this market of cosmetic surgery and injectibles, for some Australians are vulnerable to poor quality products and to practitioners who might not be properly qualified to deliver them. Over the course of my time as Health Minister, particularly in the area of cosmetic surgery, I've been determined to call out cosmetic cowboys, determined to strengthen the regulation in this area, to ensure that people who are taking the decision to avail themselves of these technologies are getting the best possible care through good products and through properly qualified practitioners. And whether it's Botox or whether it's cosmetic surgery, my approach will remain the same.
JOURNALIST: Just around Botox, health regulators in two states have issued public safety alerts warning about unregulated Botox injections being provided in residential homes. Is there enough being done by authorities to stop these kinds of dodgy products from being imported?
BUTLER: State authorities and the federal authority of the TGA are highly alert to the potential for Australians to be quite significantly compromised and injured through poor quality cosmetic products, from surgery through to injectables like Botox. There is a real risk that Australians do themselves harm by receiving products or receiving procedures from practitioners who don't have the right qualifications. That's why I was so strong in calling out the cosmetic cowboys who are undertaking cosmetic surgery well beyond their proper registration, and I'll do so as well through these injectables. I know state and territory health ministers share my concern that people are vulnerable to being misinformed by people who hold themselves out as having the right qualifications when they don't, or hold their products out as being safe when they are not. And I know regulators at state territory and federal level will continue to do everything we can to keep Australians safe.
JOURNALIST: Are you able to shed light on how that's been handled at the border?
BUTLER: No, I'd have to take that on notice, but I know that all of our authorities are alive to the unregulated market that operates in these areas and making sure that Australians are kept safe. Thanks very much.
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