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Ethics and the proposed treatment for a 13-year-old with atypical gender identity

Merle P Spriggs
Med J Aust 2004; 181 (6): . || doi: 10.5694/j.1326-5377.2004.tb06297.x
Published online: 20 September 2004

The case of a 13-year-old girl given permission by the Family Court of Australia to begin a sex-change process involves complex issues. Nevertheless, the ethical justification for the decision is not complicated. In this case, it can be argued that the net benefit eclipses concerns about competence, autonomy and the appropriateness of the intervention. The debate this case generated in the media reminds us that one of the essential tasks in ethics debates is to get our facts straight.


  • Ethics Unit, Murdoch Children’s Research Institute, Royal Children’s Hospital, Parkville, VIC.


Correspondence: 

Acknowledgements: 

I would like to thank Bob Williamson, Director of the Murdoch Children’s Research Institute, for his helpful comments on this article.

Competing interests:

None identified.

  • 1. Re Alex: hormonal treatment for gender identity dysphoria [2004] FamCA 297.
  • 2. Family Court of Australia. Court permits hormone therapy treatment for “Alex”. Media release, 13 April 2004. Available at: www.familycourt.gov.au/media/html/realex.html (accessed Jul 2004).
  • 3. Family Court of Australia. Re Alex: hormonal treatment for gender identity dysphoria [2004] FamCA 297 [summary]. Available at: www.familycourt.gov.au/judge/2004/html/realex.html (accessed Jul 2004).
  • 4. Rogers W, Draper H. Confidentiality and the ethics of medical ethics. J Med Ethics 2003; 29: 220-224.
  • 5. Cohen-Kettenis P, Pfafflin F. Transgenderism and intersexuality in childhood and adolescence: making choices. California: Sage Publications, 2003. (Developmental clinical psychology and psychiatry, Vol. 46.)
  • 6. Royal College of Psychiatrists. Gender identity disorders in children and adolescents: guidance for management. Council report CR63. London: RCP, 1998.
  • 7. Department of Health and Community Services v JWB and SMB (Marion’s case) (1992) 175 CLR 218.
  • 8. Family Court of Australia. Special medical procedures. 2004. Available at: www.familycourt.gov.au/html/medical_procedures.html (accessed Jul 2004).
  • 9. Kelly J. Court backs sex swap for girl, 13. Herald Sun (Melbourne) 2004 Apr 14; News section: 3.
  • 10. Gough D. Court allows girl’s bid to become boy. The Age (Melbourne) 2004 Apr 14; News section: 1.
  • 11. Symons E. Teenager “needs help not surgery”. The Australian 2004 Apr 15; News section: 3.
  • 12. Goddard C, Tucci J. When too much intervention may be the problem. The Age (Melbourne) 2004 May 4; Opinion: 11.
  • 13. Bolt A. A girl betrayed. Herald Sun (Melbourne) 2004 Apr 16; Opinion: 21.
  • 14. Kelly J. Sex-swap girl urged to rethink. Herald Sun (Melbourne) 2004 Apr 15; News section: 9.
  • 15. Sex change decision sparks debate. Sydney Morning Herald 2004 Apr 14. Available at: www.smh.com.au/articles/2004/04/14/1081838789145.html (accessed Jul 2004).
  • 16. Child gender change takes the law too far. The Australian 2004 Apr 15; Editorial: 12.
  • 17. The court, a child and a change of gender. The Age (Melbourne) 2004 Apr 15; Editorial: 12.
  • 18. Gregory J, Taylor C. Judge hits outdated gender laws. Courier-Mail (Brisbane) 2004 Apr 15: News section: 3.
  • 19. Zucker KJ. Gender identity disorder. In: Rutter M, Taylor E, editors. Child and adolescent psychiatry. Cambridge: Blackwell; 2002: 737-753.
  • 20. Meyer W, Bockting W, Cohen-Kettenis P, et al. The standards of care for gender identity disorders – sixth version. International Journal of Transgenderism 2001; 5(1). Available at: www.symposion.com/ijt/soc_2001/index.htm (accessed Aug 2004).
  • 21. Beauchamp T, Childress J. Principles of biomedical ethics. 5th ed. New York: Oxford University Press, 2001.
  • 22. Buchanan AE, Brock DW. Deciding for others: the ethics of surrogate decision making. Cambridge: Cambridge University Press, 1990.

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