Since the landmark decision of Re Jamie [2013] FamCAFC 110, there have been many cases where the Family Court of Australia have made declarations that children are “Gillick” competent to consent to stage 2 hormone treatment for Gender Dysphoria which involves the administration of either testosterone or oestrogen. These are Orders that have been made based on medical evidence presented to the Family Court.

This case is different in that it involves Quinn who was born a female in 2001 and is 15 years of age but identifies as a male and wishes to have a bilateral mastectomy otherwise known as “top surgery” prior to commencing stage 2 treatment. Quinn’s parents made an application to the Family Court seeking a declaration that Quinn is competent to authorise the surgery or in the alternative that the Family Court authorise the procedure.

Surgical procedures are irreversible as set out in the World Professional Association for Transgender Health, Standards of Care (“the WPATH Guidelines”). 

There are two stages prior to the “irreversible interventions” as follows:

1. Fully reversible interventions– This involves the use of GnRH analogues to suppress oestrogen or testosterone production and consequently delay the physical changes of puberty. This treatment generally commences from the age of 12 years.
2. Partially reversible interventions– This includes hormone therapy to masculinise or feminise the body.

The WPATH Guidelines provide that a staged process is recommended to keep options open through the first two stages. It is recommended that moving from one stage to another should not occur until there has been adequate time for adolescents and their parents to fully assimilate to the effects of earlier interventions.

Quinn had not commenced stage 2 treatment at the time of the making of the application to the Family Court however his treating doctors unanimously recommended that Stage 3 treatment or “top surgery” take place immediately as it could otherwise have detrimental effects to Quinn’s mental state given he had large breasts which were causing him daily anxiety and unease. It was also found that Quinn fully understood the effects and consequences of Stage 3 treatment being sought.

The Family Court after considering the medical evidence presented to the Court ultimately declared that Quinn was competent to consent to a male chest reconstruction surgery for the purpose of treatment of Gender Dysphoria.