Wednesday, 18 October 2023

Committees

Legal and Social Issues Committee

Reference

Moira DEEMING (Western Metropolitan) (15:04): I move notice of motion 124:

That this house:

(1) recognises that medical affirmation of gender-dysphoric children and adolescents is currently one of the most controversial areas of medicine due to the lack of clinical consensus about what is being treated, the diagnostic process, whether a diagnosis is required, the asserted benefits, risks and outcomes of the medical pathway and the alternative pathways which exist;

(2) notes that despite international medical and legislative moves to restrict the medical affirmation treatment pathway for gender-dysphoric minors, which involves the three stages of puberty blockade, cross-sex hormones and surgery, it remains the dominant pathway in Victoria;

(3) further notes that the legislation governing gender-dysphoric children and adolescents in Victoria impacts the rights of children, parents and professionals;

(4) requires the Legal and Social Issues Committee to inquire into, consider and report, within 12 months of the house agreeing to this resolution, on the appropriateness of medical affirmation treatment pathways for gender-dysphoric children and adolescents in Victoria, including but not limited to:

(a) the lack of clinical consensus about what gender dysphoria is and how it is treated, including:

(i) the diagnostic process;

(ii) whether a diagnosis is required;

(iii) the asserted benefits, risks and outcomes of the medical pathway;

(iv) the impact of social gender affirmation on rates of medical gender affirmation;

(v) the alternative pathways which exist;

(b) the impact and operation of legislation governing this issue, including:

(i) the rights of minors to access evidence-based care;

(ii) the rights of parents; and

(iii) the rights of professionals.

I am very pleased to be standing here today to call for this inquiry. I have been watching with many other people all around the world for the last 10 years the incredible rise in the rates of gender dysphoria amongst youth all around the world, and like everybody else I have been very, very concerned for their welfare. Now, after years and years of collecting evidence, there is growing international concern over the proliferation of medicalised gender-affirmation interventions on minors which have been shown to have extremely low certainty of benefits and extremely high significant potential for medical harm. In fact following systematic reviews of evidence conducted in Europe, the UK and elsewhere, many countries, health authorities and insurance companies have reversed their endorsement of the affirmation model that we use in Victoria and are treating youth presenting with gender dysphoria with supportive counselling rather than puberty blockers, hormones and surgery.

Before I finish, I would just like to talk about some frequently made accusations, rather than frequently asked questions. Other jurisdictions have called for inquiries and have had the following accusations made: firstly, that an inquiry risks creating stress that could ultimately cause vulnerable young Australians with gender dysphoria to commit suicide. Now, I do not know if these types of comments were made for the purposes of emotional blackmail or out of genuine concern, but the answer is simple. It is an undisputed fact that the medicalised gender-affirmation practices which have been mandated in Victoria have been abandoned in multiple jurisdictions all around the world, and that is because of two simple reasons: the lack of high-quality and long-term evidence that they actually deliver the promised benefits and the mounting international evidence that real harm is already being done to children that is long term, that is catastrophic and that is irreversible. We need to take every precaution to ensure that any inquiry and any public debate that surrounds it is framed in compassionate and measured language to reduce the risk of that distress to these vulnerable children. But make no mistake: an inquiry is needed because children are already being harmed.

Keira Bell, one of many girls who enjoyed life as a tomboy before puberty, says of her experience of being medically transitioned as a minor:

A lot of teenagers, especially girls, have a hard time with puberty, but I didn’t know this. I thought I was the only one who hated how my hips and breasts were growing.

…

As I look back, I see how everything led me to conclude it would be best if I stopped becoming a woman. My thinking was that, if I took hormones, I’d grow taller and wouldn’t look much different from biological men.

…

… I was adamant that I needed to transition. It was the kind of brash assertion that’s typical of teenagers. What was really going on was that I was a girl insecure in my body who had experienced parental abandonment, felt alienated from my peers, suffered from anxiety and depression, and struggled with my sexual orientation …

as a lesbian.

We are told these days that when someone presents with gender dysphoria, this reflects a person’s “real” or “true” self, that the desire to change genders is set. But this was not the case for me. As I matured, I recognized that gender dysphoria was a symptom of my overall misery, not its cause.

…

The consequences of what happened to me have been profound: possible infertility, loss of my breasts and inability to breastfeed, atrophied genitals, a permanently changed voice, facial hair. When I was seen at the Tavistock clinic, I had so many issues that it was comforting to think I really had only one that needed solving: I was a male in a female body. But it was the job of the professionals to consider all my co-morbidities, not just to affirm my naïve hope that everything could be solved with hormones and surgery.

Then there is Chloe Cole from America. She said:

At the age of 12, I began to experience what my medical team would later diagnose as gender dysphoria.

I was well into an early puberty, and I was very uncomfortable with the changes that were happening to my body. I was intimidated by male attention.

And when I told my parents that I felt like a boy, in retrospect, all I meant was that I hated puberty, that I wanted this newfound sexual tension to go away.

Her parents were asked by the doctors:

Would you rather have a dead daughter or a living transgender son?

The choice was enough for my parents to let their guard down, and in retrospect, I can’t blame them.

This is the moment that we all became victims of so-called gender-affirming care.

I was fast-tracked onto puberty blockers and then testosterone.

…

I had a double mastectomy at 15.

…

After my breasts were taken away from me, the tissue was incinerated – before I was able to legally drive.

I had a huge part of my future womanhood taken from me.

I will never be able to breastfeed.

I struggle to look at myself in the mirror at times.

I still struggle to this day with sexual dysfunction.

…

When my specialists first told my parents they could have a dead daughter or a live transgender son, I wasn’t suicidal.

I was a happy child who struggled because she was different.

However at 16, after my surgery, I did become suicidal.

I’m doing better now, but my parents almost got the dead daughter promised to them by my doctors.

My doctor had almost created the very nightmare they said they were trying to avoid.

Another frequently made accusation is that calling for this inquiry is part of some kind of Trumpian, far-right, anti-trans, hateful agenda rather than being about the wellbeing of children. Not that this type of pathetic, bigoted, self-serving, dogmatic nonsense even deserves a response, but the fact is that medical and legal professionals from all over the world and members of the LGB, and yes, even the T community from all over the world have joined their voices with MPs from the left and the right of politics all over the world to call, like me, for an inquiry just like this. That should give even the most narcissistic and arrogant opponent of my motion reason to pause and humbly ask themselves whether they should vote in favour of this motion to make entirely sure that they have not made a mistake. Because it is not political pointscoring that is at stake; it is the health and wellbeing of children and young people. I say that everyone should put aside their politics on this issue and do what is clearly and obviously the right thing to do, which is to support my motion, because if I am wrong, you can all gloat that I am wrong. But if you are wrong, none of us will be gloating and we will all be very, very sad, because children will have been, and will continue to be, harmed under our watch. I hope that that is an unacceptable scenario for every single person in this chamber.

Harriet SHING (Eastern Victoria – Minister for Housing, Minister for Water, Minister for Equality) (15:13): This is a motion which, in contradistinction to perhaps the way in which Mrs Deeming has characterised it, is about so much more than politics. This is an issue which for so many people who are the subject of it is deeply, deeply personal. This is an inquiry which goes right to the heart of trans and gender-diverse identity. In saying that and in getting to my feet today not only as Minister for Equality but also as a proud member of our LGBTIQ+ communities, I want to acknowledge that this is a debate which, despite what anyone else may say, may well cause distress or hurt or pain for a variety of different reasons. There are a number of services available to assist people with the subject matter of this debate. Tragically, these are services which have had to be developed because the world in which we live treats the idea of trans and gender-diverse people as a problem.

We face a series of challenges around the way in which communities and governments and elected representatives reflect and give validation to the identities of trans and gender-diverse folk. But the starting point is not the rise in requests for gender-affirming health care or surgery or application of the Gillick principle or case law such as that in Bell, which Mrs Deeming referred to, as overturned by the Court of Appeal. It lies in the question of stigma, of discrimination, of the idea that LGBTIQ+ folk are other.

We know this only too well. We know this from the day that we first recognise that we do not quite fit in with the way the world defines sex, gender and identity. We know this in ways that are increasingly the source of distress. We know this because in all too many cases it is easy for people to say, ‘I accept and I welcome and I create space for LGBTIQ+ folk – but.’ I have spoken many times in this chamber over the years about the hurt that sits, an undercurrent, pegged to this one word ‘but’.

When we look at an inquiry and a motion in the terms that Mrs Deeming has proposed, the way in which it has been phrased – and I would urge people to go to the language of the way in which it has been phrased – it invites a conclusion that trans and gender-diverse identity is not only other but is wrong. But despite the fact that trans and gender-diverse people have existed for as long as people have existed, this is something which is being increasingly politicised. There is a significant distinction at play here – politics, lived experience; rights, lived experience; the academic understanding of what a good society should be; the reality that so many trans and gender-diverse folk face every single day in environments and systems, in frameworks, in laws, in language, in forms, in the way in which they are allowed to participate or to connect, able to access public facilities that so many of us take for granted, able to play sport, able to use change rooms, able to access education, able to access gender-affirming health care. It is the steady incursion into the basis for this desire to be connected which chips away at the capacity for trans and gender-diverse folk to participate.

At the heart of this particular motion is a further narrative that presupposes that further chipping away is not only justifiable but necessary in the name of some sense of ambiguity around treatment, around medical practice. We have divergent views around the world as they relate to gender-affirming care, as they relate to the application of the Gillick principle, as they relate to the way in which treatment is provided. The measure of ambiguity, however, is not a reason to extend to the idea of a veto, because if that were the case, if the existence of some doubt or divergence in opinion were the reason not to proceed with a decision, with a legal change, with an opportunity for people to be safe and dignified and respected and connected to communities and able to join in the lives, the routines and the wonderful rituals that so many of us take for granted, then there would be an overwhelming surge in disadvantage and discrimination – and we are better than that.

We have worked so hard since 2014 to lean into not only these challenges, not only the constant current of discrimination, that laminated disadvantage that occurs throughout the whole of a trans or gender-diverse person’s life, but to make sure that where we can we are providing counterpoints to it in the way in which documentation – a birth certificate – can reflect the identity of a person, to give a sense of reflection in bureaucracy, something so personal as that. That this can be the subject of politics ignores the reality of the value of the treasured nature of a pronoun where it is reflected in that official documentation.

In every single thing that we have done in the space of equality, whether it has been about access to adoption or whether it has been about births, deaths and marriages legislation reform; changes to the Equal Opportunity Act 2010; or removal of harmful conversion and suppression practices as allowable under the name of medical treatment or other sort of engagement with somebody in relation to their gender or their sexuality or their identity, we have worked so hard to provide a pathway for LGBTIQ+ people to be visible. That has not happened without fierce resistance. We know only too well the cost of that resistance, the cost of that ‘but’ and the idea that at every turn there must be a prosecution afresh and an advocacy afresh of our very right to hold space, our very right to talk about who we are without eyes being rolled and the idea of virtue signalling being raised as an automatic response.

We have an obligation as a Parliament to understand the impact of the work that we do, and whilst I respect Mrs Deeming’s right to bring a motion to this place, I cannot accept the way in which it has been framed. I cannot accept not just the what but the why, and I will in the course of my opportunity to talk today underscore further my support, my love for and my ongoing respect for members of our trans and gender-diverse communities. The idea of support for these communities, for our communities, is why government opposes this motion and looks forward to resolution in those terms.

Georgie CROZIER (Southern Metropolitan) (15:23): I rise to speak to motion 124, and I note the comments made by the government in relation to the concerns raised by the government, but this motion is looking at a parliamentary inquiry into a range of matters that are in the public domain and have raised significant discussion not only in Victoria but across various other jurisdictions. I want to just return to, for those members that were not in the Parliament when we debated it just a few years ago, the Change or Suppression (Conversion) Practices Prohibition Bill 2020. I spoke at length to many, many people at that time – a range of stakeholders – predominantly around the issues relating to concerns raised with me from medical practice. I want to go back to some of that, because I know that Mr Limbrick is going to put an amendment into this particular motion. I have seen the wording, and we would support that. But I do think it is important to understand that at the time when we were debating that there were a number of concerns raised by, as I said, the AMA, who had concerns around a clause that restricted:

… what psychiatrists can talk about in a session, and therefore limits appropriate normal psychiatric practice.

I am quoting from a letter that they sent me and the government.

This restriction is brought about by the use of the word ‘necessary’. There can be significant discussion around whether a treatment is necessary and by whom. Therefore, we urge that the words ‘when clinically appropriate’ be substituted in place of ‘necessary’.

Then I had further discussions with health insurers, and again they were concerned about not the intent of the bill but about how the legislation would apply. They wrote and outlined those concerns, and around the time in relation to the bill – and it goes to the point of this motion, because it is talking about a whole range of issues that are affecting gender-diverse people, transgender people, intersex, bisexual, a range of people – they said that:

Section 5 of the … Bill also makes it clear that a person is not undertaking a change or suppression practice if it is a practice or conduct for the purposes of assisting a person who is undergoing or considering undergoing a gender transition or providing them with “… acceptance, support or understanding”.

None of the legislation refers to gender dysphoria and it is not clear to us how the distinction between sexual orientation and gender dysphoria impacts on the application of the legislation, nor how providing psychiatric treatment to a person with gender dysphoria would fall foul of the legislation, particularly in light of the above.

I make these points because that is what I am interested in. Is the legislation actually working? Is the legislation that was put into this place a few years ago – the Change or Suppression (Conversion) Practices Prohibition Act 2021 – actually working to assist people that are going through treatments and a range of other things that they require? Of course we want people to be safe, we want people to be treated appropriately and we want people to be supported. All of us want that. I am particularly interested in what an inquiry would do to see if this legislation is actually working – is it doing what it is supposed to be doing? – because there is no oversight or overview that has been undertaken. That is the problem here, because we do have all of this discussion that is floating around, and it is difficult. It is difficult for people to understand: is that accurate or not accurate? What is actually going on here? We have many inquiries in this house on a range of issues. If you look at what we are doing – the committee work of this house – a house of review undertakes that work. I do not have any problem with a range of issues going to an inquiry, which this motion asks to occur. As it says on the Parliament’s own website:

Committees are formed of members from one house or both houses. Committees hold inquiries into particular issues and call for input from the wider community.

That is the work of the committee process in this Parliament, and that is what this motion is asking – get the views from the community, understand what is going on.

As I said, I am particularly interested in seeing if that legislation is actually working as it is intended. As I said, we have got a range of inquiries going on. The Economy and Infrastructure Committee is looking into industrial hemp, local government funding, cultural and creative industries and pig welfare. We have got a flood inquiry going. Education, rental and housing affordability inquiries, workplace drug testing and safety aspects in relation to medicinal cannabis and whether there is a framework that is working to keep people safe – this work is diverse. These committees do diverse work. That is a range of topics. This motion is just asking for another inquiry to be undertaken. It is not entirely controversial in relation to that work whether you agree with the wording or not.

I do take some points, and I understand that some of the issues Ms Shing raised are important issues. There are so many major medical bodies that are very supportive, supporting people who, as you described, have identity and transgender issues and should be respected. We all agree with that. I have no problem with it. It is difficult and complex at times. It is very sensitive work that needs to be done, and those medical bodies are doing some excellent work. They are doing excellent work in terms of working through this, because of some of the issues that are in the community. There are new Australian guidelines around gender-affirming care. This is all very good work. I support it, and I want to see what is happening from these experts. We need to give our general practitioners guidelines for them to be able to understand when they are dealing with these matters. It is all very sensible. But equally, I think there are some issues around some of the concerns that have been raised around parental rights. Those issues are very important. They are important for medical practitioners with the patients that they are dealing with. This is a complex issue, and we should not shy away from this house doing complex work on complex, sensitive issues. It is important work.

I say with my last few minutes that we are a house of review. We have got a range of inquiries being undertaken. This is important work. As I said, there were issues that were raised when legislation was put into this place two years ago, and an inquiry can see if the concerns that were raised then are actually being applied. I know this is slightly different, but I take it to the point of the other issue around the other matters that Mr Limbrick has put into his amendment to the motion, because that is the sort of thing I would like if this motion gets up – that it would look at: is that bill working? Those unintended consequences that were highlighted by the likes of health insurers, the AMA and others – should there be some refinement to the legislation? That is why I am supporting the intent of Mr Limbrick’s amendment – so that the inquiry can look at some of those issues as well. It is important work. There is so much good work being done around the community. As I said, this house does a lot of inquiries, and I do not see why this sensitive, complex issue should not be looked into also.

David LIMBRICK (South-Eastern Metropolitan) (15:33): I also rise to speak on this motion for an inquiry, brought forward by Mrs Deeming. Let us start with few facts. In Victoria now, due to the Change or Suppression (Conversion) Practices Prohibition Act 2021, the only real model of care that we have in Victoria is the affirmation-only model. That is the first fact. The second fact is that some people are harmed by the affirmation-only model. Some people are misdiagnosed through that process and severely harmed. In fact I acknowledge that there are two brave women today in the gallery who fit that category: Mel and Lee. The third fact: for children, when we are talking about medical treatments, which is what this inquiry is looking at – medical treatments for children – there are no good longitudinal studies that show long-term regret rates or long-term outcomes for these treatments for children. When I talk about long-term outcomes, I am talking about long-term treatments with puberty blockers, cross-sex hormones and, later on, potential surgery.

We also know that there have been inquiries in many different jurisdictions, most notably the Cass review in the UK. When the interim report on that was released, they actually suspended giving those drugs to children because they determined that the evidence base for their safety and efficacy over the short and long term was not sufficient, and they ruled them out, except for clinical research. Similarly, other jurisdictions throughout the world, such as Sweden – which were leaders in this space – have done similar things, as have Finland, Norway and various US jurisdictions.

Moira Deeming: And Denmark.

David LIMBRICK: Thank you, Mrs Deeming – Denmark as well. So it is clear that other jurisdictions do not agree with the Victorian government’s approach on whether or not there is a good evidence base for giving these types of treatments to children. I would also say that it is not just a political issue. Recently MDA insurance in Australia have said to private practice doctors that they will no longer insure them because they are concerned about lawsuits over the long term. They see what is coming down the road. It is also my understanding that later this year the final report from the Cass review in the UK will be released, and I look forward to reading that.

The fact of the matter is that over the long term we have no idea. There is no good evidence on what sort of harm these treatments might be doing to children. I question the motives of anyone that would oppose an inquiry, because if you have concerns about this you should support the inquiry. If you think that what we are doing in Victoria is world class and top notch, you have nothing to fear from an inquiry and you have nothing to fear from this being examined and scrutinised. What I am concerned about is that people that oppose this are trying to cover up what is going on. I have very serious concerns about what is going on. Why is it that every time that someone wants to talk about this the reaction from activists and from people in the government is to shut them up? They call them names. They say, ‘You’re a transphobe. You’re a Nazi.’ When people are trying to have very rational debate, instead of engaging in that debate the default response is to shut them up. This is unacceptable. These are important issues. You will not silence debate on this. Debate will happen with or without you. We are talking to people who have been harmed by this, and their voices deserve to be heard as well.

I noticed in Ms Shing’s contribution she did not mention anyone that had been harmed. She talked as if no-one has been harmed by this process.

Harriet Shing: That’s literally not what I said. Don’t verbal me. I was really careful with it.

David LIMBRICK: All right. Ms Shing is acknowledging that maybe some people –

Harriet Shing: I was really careful.

David LIMBRICK: All right. I was not trying to verbal you, Ms Shing. Nevertheless, some people have been harmed, and I am not convinced that there is good evidence over the long term on what that harm looks like. How many people are we talking about? What sorts of percentages are we talking about here? Whenever I have been shown evidence on this, there are studies that have deeply flawed science, and I am one of the few members of Parliament that has actually got a background in science. But many of these studies are deeply flawed, and most of them, if not all of the ones that I have seen, do not relate to children at all. They are talking about adults.

So I think that there are very serious concerns, and we need to look at this. Whether it is through this inquiry – if this does not pass today we are not going to give up looking at this. I think it is only going to get bigger. More and more people, in no small part due to the bravery of people like Mel, have been talking to members of the public, and I will tell you that people that do not know about what is going on are very concerned when they hear about it. They are very concerned. This is not about being anti-trans or being hateful or bigoted. We are concerned about medical harm being caused, and we want comfort that the current medical practices or the standards of care, as they call them, are not causing more harm than they are helping.

Sonja TERPSTRA (North-Eastern Metropolitan) (15:39): I also rise to make a contribution on Mrs Deeming’s motion 124. Look, I want to acknowledge Ms Shing’s contribution. It was a very thoughtful and considered contribution in this area. I also note there are people in the gallery, and I would also encourage everyone who is participating in this debate to please be mindful and respectful that we are talking about people here and that some of the discussion that we are entering into may be hurtful and upsetting to people. I want to try and conduct my contribution in as sensitive a way as I possibly can, and I just want to apologise to anyone in advance if anything that I say is hurtful. It is not my intention to be hurtful or ill considered in anything that I want to say today.

I just want to say at the outset I am not a member of the LGBTIQ+ community but I am a supporter and an ally, and I actively participate in a range of activities that this government leads, particularly around the Pride March. I am always happy to be at the Pride March supporting our LGBTIQ+ community. I want to say at the outset in regard to this motion that the nub of Mrs Deeming’s motion is the concern that she has around children who may be experiencing gender dysphoria, and I guess what Mrs Deeming is trying to advocate for is her concern about some of the treatment of children who are in this space – and it is really primarily about treatment. Talking about children under 18 is the nub of this motion. Her argument is that some of the treatment through the model of gender-affirming care can be harmful to those children.

Now, I am going to talk a bit in a moment about some of the detail, and I note Ms Shing stole a lot of my thunder there – but I thank you for that, because I think you put it more aptly than I ever could, as somebody who is a member of the LGBTIQ+ community. So I feel a little bit fraudulent as someone who is not from that community, but nevertheless I want to try and make as thoughtful a contribution as I possibly can. I just want to state that I am a parent, and as a parent, Mrs Deeming, I do not share your point of view at all in regard to this issue. What I want to do is see my children come to me as a parent and tell me that they need help in regard to any issues they are experiencing, and my unreserved offering as a parent of a child –

Moira Deeming: On a point of order, are you saying that you disagree with my point of view as a parent and implying that I would not have my child come to me or something? Could you please clarify?

Sonja TERPSTRA: If I could continue perhaps, Acting President, Mrs Deeming might understand the point that I am trying to make, and could I just state for the record that there has been a bit of a theme in here today of continued interruption of government members. I would like to be able to continue and explain myself without interruption.

The ACTING PRESIDENT (Bev McArthur): Continue, Ms Terpstra.

Sonja TERPSTRA: What I am saying is that I as a parent would like my child to feel that they could come to me if they were experiencing issues around their gender identity or whatever and that I could support them in that. As a parent, what I would do is support them and then seek appropriate medical treatment if that was necessary. I would go to the experts. I am not an expert, I am a parent. As a parent, my first approach is to support my child and then seek medical expert advice and treatment if that was deemed necessary by medical experts.

Having stated that, I want everyone in this chamber to understand that that would be the position I would come from as a parent, but that is why I have concern about the motion that you are putting forward in that it seems to frame it in a way that disconnects the idea that parents do have conversations with their children around these things and that more often than not parents do want to support their child so they do not experience issues like discrimination. I am going to read out in a moment statistics around the sorts of things that are experienced by children from the LGBTIQ+ community and particularly trans children. I have concern that we are even debating this, but I respect and understand that you want to raise this and think that the Parliament is the best place to actually inquire into these matters, whereas I do not think it is. I have done a bit of research around this matter, and there is a lot of medical research and review that is actually being conducted around the world. If I was going to have an opinion on anything, it would be guided by experts, scientists and medical professionals, not people with differing opinions.

But anyway, I just want to get on the record to say that we know that LGBTIQ+ Victorians – and not just Victorians but Australians and anyone in any part of that community – face higher levels of discrimination, stigma and exclusion than any other Victorians, which lead to poorer health outcomes. So again, the main point of this is about health outcomes.

Again, that is why I prefaced my opening remarks by saying that I am concerned that we make sure we conduct this debate in a very compassionate and caring way. Transphobia and discrimination against any member of our LGBTIQ+ community have no place in our community, nor in our healthcare system. As I said, there are a range of health concerns that people from the LGBTIQ+ community experience. Rates of self-reported depression and anxiety diagnosed in trans and gender-diverse young people in Australia is as high as 75 per cent and 72 per cent respectively. Eighty per cent of trans and gender-diverse young people report that they have self-harmed, and 48 per cent report that they have attempted suicide. More than 77 per cent of trans and gender-diverse Victorians report facing unfair treatment based on their gender identity. Almost three-quarters of trans and gender-diverse Victorians report experiencing high or very high levels of psychological distress.

We take into account those statistics, and I am going to get into the detail in a moment. I know that Ms Shing talked about this when she talked about Gillick competence. I am also going to talk about gender-affirming care in a moment and the medical guidelines that have been developed by experts in our country. My concern is that we know, based on the statistics and the research – and Mr Limbrick talked about a lack of evidence and research – that people from this community are experiencing high rates of distress. I am just looking at the clock and I have got 3 minutes left, so I will do my best to get to the point that I want to make. The point is there are models of gender-affirming care that have been developed, and I am just quickly going to go to this important point. This is again from the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents:

With increasing visibility and social acceptance of gender diversity in Australia, more children and adolescents are presenting to community and specialist healthcare services requesting support …

Being trans or gender diverse is now largely viewed as part of the natural spectrum of human diversity. It is, however, frequently accompanied by significant gender dysphoria … which is characterised by the distress that arises from incongruence between a person’s gender identity and their sex assigned at birth.

I will not go into the rest of the statistics. But then we drill down into why gender-affirming care is the appropriate model. If you talk about Gillick competence, the three aspects of Gillick competence determined by a court – again we are talking about young people under the age of 18, who seriously must be experiencing so much distress that they would put themselves through a situation where they go before the court to have the court determine whether they are competent and determine whether they should be treated under a gender-affirming care model even though their parents do not support that. There is a court process for that.

I think the problem with the motion is that it sort of suggests that there are some people that just rush out and go ‘Hey, as a 14-year-old kid I’m going to go and get this stuff,’ but there is actually a very lengthy and rigid process that people have to go through to be assessed for these sorts of things. It is not something that people enter into lightly, and the courts have been obviously looking at these things over a range of time. I just want to mention – again I am running out of time so I am trying to compress it all in – the World Health Organization, a very important body, looks at these models of gender-affirming care and makes sure that they are contemporary and up to date. I do not think a parliamentary inquiry is the appropriate place to look at these things. As a parent and as a parliamentarian I want to make sure that I am listening to the experts in regard to these things, and I am concerned that a parliamentary inquiry would cause a lot more harm and distress to members of our LGBTIQ+ community, particularly children who obviously are young and experiencing significant distress. I will not be supporting this motion, and I encourage everyone in this chamber to not support this motion as well.

The ACTING PRESIDENT (Bev McArthur): Mr Limbrick, I understand you wanted some amendments to be circulated. Would you like to circulate them now and move those amendments?

David LIMBRICK (South-Eastern Metropolitan) (15:49): Thank you, Acting Chair. I apologise. I should have circulated these before. I seek to circulate those amendments now, and I move:

1. In paragraph (4)(b)(ii), omit ‘and’.

2. In paragraph (4)(b)(iii), omit ‘professionals.’ and insert ‘professionals;’ in its place.

3. After paragraph (4)(b)(iii), insert:

‘(c) medical treatments and services available to detransitioners, and the current state of medical research in this area; and

(d) any other related matters.’.

It is a very simple amendment. It just expands the scope of the inquiry by adding ‘medical treatments and services available to detransitioners’ – a detransitioner is someone who has transitioned and then detransitions – ‘and the current state of medical research in this area’ and ‘any other related matters’.

Rachel PAYNE (South-Eastern Metropolitan) (15:51): I rise today to confirm Legalise Cannabis Victoria will not be supporting this motion. I am not trans or gender-diverse, so I do not claim to speak for the community, but with a lack of direct representation in this place, allies must use their voices. I have always had transgender people in my life, so today I would like to honour some of them.

When I was a little girl, Noel and Denise were dear friends of our family. Mum and Denise would often spend weekends together at dog shows. They shared a love of showing their prize-winning Pekingese dogs, although it was generally Denise’s dogs that were the prize winners – sorry, Jules. As a little girl, I was enamoured of Denise. She was tall, confident, vivacious and incredibly funny. She was fabulous in the eyes of me as a seven-year-old. One of my favourite childhood memories is of Denise encouraging me to pick some of the grapefruits from her backyard tree, stick them up my T-shirt and pretend to be Dolly Parton. We danced and sang in her backyard. Denise is a transgender woman, now in her 70s, and she and Noel still go to the dog shows with my mum. As I was a curious kid, my mum provided me with a perfectly acceptable explanation as to why Denise was so tall and had a husky voice. It was because she loved a Benson & Hedges and she was born in the wrong body and needed to change that.

In my first year of university in 2000, only new to Lismore, the first friend I made was Nick. We used to carpool to uni together, for which I am forever grateful, because Nick introduced me to Ani DiFranco and used to play cassette tapes on the journey. Ani DiFranco is still to this day one of the most influential artists in my life thanks to Nick, and Nick’s story from that time has also stuck with me. You see, Nick was in the process of transitioning, and back then you had to spend five years working with a psychologist to be approved to access hormone therapy – five years of therapy. Nick was always a boy, and he struggled to understand why he could not do the same activities as his younger brother; namely, Nick wanted to join the army reserve like his brother. Nick provided me an insight into what the world was like for him and just how hard it was to fight and continue to advocate just to be himself.

Today as an MP in this place I am blessed to have a very talented, intelligent, hardworking, charming and witty staff member who helped me write this and who is trans. It saddens me incredibly that despite the progress we have made we are still here having to have this fight. This motion shares the same ideologically harmful pseudoscientific foundation as the anti-trans rally on Parliament’s steps earlier this year. It seeks to dehumanise and strip rights away from one of Victoria’s most vulnerable communities, a community that has weathered so much hatred and abuse, particularly in the last 12 months.

Not only is this motion harmful; it is based on countless lists of inaccuracies, half-truths and mischaracterisations. Take, for instance, point (1) of the motion, which claims that medical affirmation for minors experiencing gender dysphoria is:

… one of the most controversial areas of medicine due to the lack of clinical consensus about what is being treated …

Incorrect. A clearly defined definition of ‘gender dysphoria’ backed by almost a century of research is accepted by the Australian Medical Association, the American Medical Association, the World Health Organization, the British Medical Association, the Royal Australian and New Zealand College of Psychiatrists, the Royal Australian College of General Practitioners and countless other national and international organisations. This is as close as you will get to a consensus in clinical science. There are medical professionals who understand and respect the science, and then there are extreme outliers who let their personal biases cloud objective facts. Medical professionals know what they are treating and they know how to treat it.

Point (1) of this motion also asks the inquiry to explore the alternative pathways which exist. The only known alternative to gender-affirming care is conversion therapy, a faith-based practice that does not work. It is not supported by science. It is illegal in Victoria and is known to cause significant psychological and physical damage to people who experience it. I do not think anyone could argue it is safer to trust a member of the clergy with a child’s care over a medical professional. Conversion therapy is not therapy, it is abuse. A 2021 Melbourne University report stated that gender-diverse people who could not access required medical care experienced a 71 per cent higher chance of attempting suicide. That same study showed gender-diverse people who could access care experienced better mental health and overall quality of life. Medical transition is an individual process carefully considered and discussed between doctor and patient – and parent if the patient is under this age of 16. Dr Ada Cheung’s research and work with gender-diverse youth champions an individual model of care and highlights that gatekeeping support and treatment services for gender-diverse minors causes negative mental and physical health outcomes. You cannot just wander off the street into a clinic and walk out on hormone replacement therapy. The medical transition process is long, carefully tailored to each patient’s needs and fundamentally designed to allow people to live a full and happy life. The science is clear, extensive and peer reviewed. Gender diversity is not new, and it is not a phase.

Moving to point (2) of the motion and the concept of rights of the child, parents and professionals, I previously worked at the Family Court, and I saw how traumatising it was for the parents of children with gender dysphoria to attend court just to be able to access treatment. You see, at that time the hospital and the parents would have to bring the child before a judge to receive that approval, which is often a lengthy and tedious process. The parents or legal guardians were always in attendance, and any judge will tell you the rights are with the child, not the parent. As former Justice Bell would often tout, children have rights, parents have responsibilities.

Despite what many in this chamber may think, gender diversity is not some new-age leftie phenomenon. There is a rich history of gender diversity in this country and overseas. In the 2015 book Colouring the Rainbow First Nations people spoke about being LGBTIQA+. Because of their individual stories and countless others like them, we know gender diversity has been in Australia since long before British invasion. One example is the sistergirls who live in the Tiwi islands, an area where over 5 per cent of the population identifies as trans or gender-diverse. Internationally there is evidence of gender diversity in ancient cultures at least as far back as 3000 BC. It is just five millennia before the Nazi regime ransacked and destroyed the world’s first transgender medical clinic, including the incineration and subsequent erasure of thousands of clinical records, research and over 20,000 books on gender-diverse care. Despite efforts to erase gender diversity from the history books, we know it is an ancient part of a kaleidoscope of human diversity, and the science tells us it does not fade over time or from attempts to suppress it.

Being transgender or gender-diverse is not a risk to these young people. Seeking out gender-affirming care is not a risk for these young people. Where these young people are put at risk is in a society where they are subjected daily to horrid abuse, hate and systematic barriers to accessing the care they require. Motions like this one in front of us today are part of the problem. It represents an accelerated wave of social stigma towards trans and gender-diverse people, not just in Victoria but around the globe, and I encourage every member of this place to consider the real people we are discussing today. We will not be supporting this hateful and purposely misinformed motion.

Jacinta ERMACORA (Western Victoria) (16:00): I too would like to acknowledge Minister Shing’s contribution on this debate and also acknowledge Ms Payne’s contribution. I want to acknowledge before I go on, too, anybody that is here that may count themselves as diverse – whether that is gender-diverse or just broadly part of the LGBTIQ community – and those in the gallery as well. At this time, in this week, I would rather be speaking to a motion to help unite us as people rather than a motion underpinned by hurt and division, a motion that includes everyone rather than excludes, a motion that is about love rather than hate, a motion that is about joy and diversity rather than fear of someone different, a motion that addresses how in this state of Victoria equality is not negotiable. All Victorians, no matter how they identify, deserve to feel supported and equal, including with their health and wellbeing. So at this time, in this week, I wish to speak to the human experience that is not addressed in this motion – that it is okay to be different and that every human should have the right to equal services and to be simply respected for who they are in themselves.

I wish to acknowledge the bravery of the first transgender pioneers to emerge from behind closed doors, and their stories, whilst hidden in the margins of society, are a guide to survival. They encouraged others to find the courage to do the same. I speak of people who pose no threat to others. They are seeking after all to simply be themselves. We understand that these types of debates that question the validity of people’s decisions about their own bodies have real consequences on the wellbeing of trans and gender-diverse communities and in particular vulnerable young people. As others have already mentioned today, transgender young people are 15 times more likely to end their life. This is not an abstract battle of ideology; these are vulnerable young people who deserve respect and care.

I would like to personally tell the chamber of some local stories of people I know in my region; however, I do not want to risk unnecessarily identifying them and nor do I want to put any more emotional load on them than they are already experiencing in their ordinary everyday lives. Their stories are unique and also familiar. Most trans people have a story – the moment they knew, the person who showed the way. In a Guardian article from 2016, telling the stories of the experiences of people who are trans, there is a quote from someone identified as Nikki, who was 26:

On a day-to-day basis I don’t tell people I’m transgender. The thing about trans people is, we feel very normal. It’s the way we are, it’s only when people say you’re not normal that you feel that way.

And there is a further quote from Keith, who was 18:

I’m desperate for hormones and surgery. My dysphoria makes me feel like I’m embarrassed for people to look at me. In my head I’m this weird thing that is ugly. I have to wear baggy clothes to hide my hips, I have to think about how many layers I have to wear to hide my chest.

So let us not delude ourselves: this motion is rooted in discomfort with difference.

There are, however, some wonderful stories emerging across my region due to people’s bravery and also in no small part due to the support and services this government has actively provided and resourced. As Minister for Equality Harriet Shing often says, equality is not negotiable. There is $21 million to actively boost capacity for specialist gender clinics, mental health support and peer and family supports to address the increasing demand for these services; $1.5 million invested in the trans and gender-diverse community health program; $2 million in funding committed to the trans and gender-diverse peer support program; and in February 2023 we announced a grant of $2.85 million to trial LGBTIQ youth spaces in western Victoria to help address mental health and wellbeing inequalities for young people and their families.

Yumcha Hamilton was launched on IDAHOBIT in May, which is International Day against Homophobia, Biphobia, Interphobia and Transphobia. The group named Yumcha stemmed from the Warrnambool Yumcha group, which acknowledges ‘a little bit of everything’. Yumcha Hamilton is supported through a key partnership between Brophy Hamilton and Southern Grampians Shire Council. It is offering a safe space to connect and engage young people from LGBTIQ communities and their allies. This is so important in regional communities, and so far 23 young awesome people, 23 young lives, have been engaging in two groups, one for 12- to 17-year-olds and another for 18- to 25-year-olds. They have had some amazing results already. One of the initiatives to spread messages of positivity in the Southern Grampians came about by identifying that these now connected young people share a love of art. Together they created a digital design for a Pride mural. They pitched the idea on where they wanted to paint the mural to the CEO and mayor of Southern Grampians shire. This week Tony Doyle, the CEO, told me the enormous growth in confidence he saw over the six months and that it had been extraordinary to watch. He said that the mural in town has been a wonderful endorsement of their place.

Let us leave the science to the medical profession and researchers. Our job here in this chamber is to foster acceptance and equality for every different person in Victoria. I am proud that the Allan Labor government is leading change, at all times treating our LGBTIQ community Victorians with dignity and respect.

Bev McARTHUR (Western Victoria) (16:08): I rise to support Mrs Deeming’s motion 124. I want to first of all acknowledge Mel Jeffries, who is here today in the gallery. If you do not know Mel, Mel was born a girl but as a teenager was unhappy, depressed and, like many other teenagers, confused about her identity and sexuality. At 16 Mel said she was:

… looking for a sense of belonging …

and that she found support and comfort in online communities. She said:

And then it’s, like, if you do transition, it’s, like, oh, everyone gives you so much love.

Mel’s story illustrates another important factor – namely, response to trauma. Mel was sexually assaulted and has said:

… I feel like that was a big fuel for me wanting to transition and not be a woman anymore.

Like others, this feeling that being a woman made her vulnerable and the wish to escape the trauma experience motivated her. To quote:

The magical thinking was like, I could be someone and I wouldn’t have to be me. I wouldn’t have to deal with everything that came along in my life …

Maybe all my unhappiness is because I was born in the wrong … sex.

Mel lived as a man from the age of 18 and had testosterone treatment, which changed her, increasing her weight, muscle and facial hair and deepening her voice. But as she so movingly explained to the meeting we held here in Parliament a fortnight ago, it was not enough. It is never enough if the cure you have found is not treating the actual disease. She then sought a mastectomy:

All my hatred of being a woman was just focused on my chest …

Mel has bravely talked of her experience and the extraordinary pain, difficulty and long-term physical and mental scars that the transitioning process has left her with. Her story illustrates so many of the problematic consequences of the affirmation pathway in the treatment of gender dysphoria in children and indeed in adults. Mel has now received a different diagnosis, including autism, and is being treated for the issues which she believes were wrongly attributed to gender dysphoria by the inadequacy of the medical professionals who assessed her. But the trauma and the consequences for Mel are lifelong, and I know that she is strongly motivated to speak out by her desire to prevent others from suffering in the same way. As she said to us at the forum at Parliament, she was struck by the phrase ‘If not you, then who?’. That is what inspired her to take action, and we are greatly in her debt for doing so. I applaud what Mel has done and what she is trying to do so that this can be prevented from happening to others.

I want to be very clear: this motion is about ensuring that an inquiry will uncover the very best practice for how we treat children. This is not, as Ms Shing tried to conflate the issue, about adults who are LGBTIQ whatever. This is not about that. This is about minors – children and adolescents who have a problem, and it may well not be gender dysphoria; we have learned that.

We really have to get to the bottom of how we are treating minors with permanently disfiguring medical, pharmaceutical and even surgical applications. How can children or even young adults fully grasp the long-term implications of their choices? What is at issue here are life-changing and irreversible decisions about lifelong sexual function, experience and fertility. In fact nobody can grasp the implications, because the consequences simply are not known. There is insufficient evidence from any long-term study on the safety of the social, pharmaceutical and surgical interventions promoted. It is legally questionable, medically irresponsible and morally repugnant to reduce the influence of parents and medical professionals in this process and to accept the inadequate consent of children.

Some children may believe they would feel better in a different body as a result of other underlying issues, such as trauma or other mental health concerns. Instead of receiving treatment tailored to these distinct challenges, children are put on a path which will not adequately address their genuine needs, as Mel’s case showed. The medical community’s fundamental principle of ‘first do no harm’ is turned on its head by the affirmation model – firstly because of the lack of evidence of long-term safety or long-term effectiveness but also in the reduced scope it gives them to use their professional expertise.

In treating other conditions like anorexia or psychotic disorders, medical practitioners are trained to recognise and rectify the patient’s misconceptions of reality. They do not indulge in the individual’s potentially harmful beliefs. However, the affirmation-only model seems to diverge from this tradition. The fact that many countries around the world are now rejecting this approach is evidence of why an inquiry in this state is essential to get to the bottom of what we are doing to children. What are the long-term consequences? If you think we are managing this process magnificently in this state, then you have nothing to fear from an inquiry. Let us have all the experts on all sides of the spectrum put their positions. We will all be the better for that evidence.

In my view the risk–reward ratio for this approach has never been good. As further evidence of the lasting developmental impact of puberty blockers and cross-sex hormones emerges, it is getting ever worse. How many false positives are ethically acceptable? What are the percentages, the real numbers? Even if the affirmation-only model and the treatment it heralds has the right approach for some patients, how many damaged lives are we going to accept where it was not the right thing to do? Victorian family law barrister Belle Lane presented a detailed paper to judges of the Federal Circuit and Family Court of Australia challenging the foundational research supporting a gender-affirming model of care. Her analysis of fresh research into the effects of hormone treatments and puberty blockers on young Australians contradicts previous studies that advocated for the gender-affirming approach. Considering this evolution in scientific knowledge, Ms Lane suggests that courts must rethink how these recent scientific advancements should inform the family law system. She notes that the evidence base around what is termed ‘gender-affirming treatment’ has evolved swiftly, and our understanding of the purported benefits and associated risks of the medical pathway has deepened. Moreover, she underscores the resurgence of alternative treatment pathways.

I urge this house to support the motion that sends an inquiry to the Legal and Social Issues Committee and say again: you have nothing to fear if your position is going to be ratified. Why would you be afraid to have your position put forward? I would say as members of this Parliament our first duty should be, like the medical profession, to do no harm. I am not in this place to sanction permanent medical, pharmaceutical and surgical intervention for minors without real justification or evidence that there are long-term benefits. This has nothing to do with mature age trans or gender-diverse folk, as Ms Shing refers to them. This is about children. This is –

Harriet Shing interjected.

Bev McARTHUR: Well, that is how you referred to them, Ms Shing: ‘folk’. (Time expired)

Aiv PUGLIELLI (North-Eastern Metropolitan) (16:19): I rise to speak on this motion, and frankly what a waste of our time in this chamber it is. You would think that people in this place representing the wonderfully diverse members of the community would use their debate slot to raise issues affecting the community, but instead we get to waste our time on this, an attack on an already marginalised and persecuted group for no other reason than to entertain the fringe beliefs of a small few in this place. Let us be clear here: these are fringe beliefs. Our state, time and time again, has demonstrated that it supports the trans and gender-diverse community, and Victorian medical professionals in this field are world leaders in gender-affirming care. Yet trans and gender-diverse people still face significant barriers in accessing gender-affirming care in this state, such as access to publicly funded care.

These are barriers that actually need to be addressed, but instead some members are using their time to establish themselves as hateful transphobes. I understand all too well –

Bev McArthur: On a point of order, Acting President, I take total exception to that assertion, and I would like the member to withdraw it.

The ACTING PRESIDENT (John Berger): I ask that you withdraw that comment.

Aiv PUGLIELLI: Just to respond, I have not named a member.

The ACTING PRESIDENT (John Berger): Mr Puglielli, I ask that you withdraw that comment.

Aiv PUGLIELLI: I withdraw the word ‘transphobe’. I understand all too well what it is like to grow up queer, growing up as an outsider, where people genuinely believe I have no right to exist and that being gay is something that can be fixed, that parents, teachers and doctors who support gay kids are wrong. And things have not changed; it is just that now trans kids are being subject to this treatment instead. Haven’t trans and gender-diverse people been through enough? It is not enough for some in this place that trans and gender-diverse people are receiving an unprecedented amount of hate. They want to remove their health care too.

The medical care that trans kids are receiving from the dedicated, caring professionals in Victoria is exemplary, and I trust those professionals far more than members in this place who have a very public disdain for trans and gender-diverse people and a very transparent political goal. They do not care about kids. They care more about a headline in the paper. Again, these are fringe beliefs. There are incredible experts working in Victoria to ensure that our trans and gender-diverse community members of all ages receive the best possible care, and we have a responsibility to support them. Research shows that access to gender-affirming care is associated with lower rates of depression and suicidality among trans and gender-diverse people. Gender-affirming care saves lives. That is a fact. The people in the best position to determine what care they need are the people themselves and trained medical professionals, as is already the case in Victoria.

I was speaking earlier with a non-binary member of my staff about this motion. During their time here in this place, they have experienced distress. They have broken down crying in the hallways of this building because of the hate they have witnessed in this place towards their community. But they wanted the people in this place to know that trans people are resilient. They are a wonderful, inclusive community who are not going anywhere. We need to be looking at what more we can be doing to support trans and gender-diverse youth, to make gender-affirming care more accessible, to stop the hatred they are currently facing. Despite the hatred from people in this place, I am glad that I get to stand up today and say that I and the Greens unequivocally support trans and gender-diverse people, and I say to them: you are not alone. We will fight for you. We will fight for your medical care, your safety and your right to exist. I promise you that. We will not be supporting this motion.

Sheena WATT (Northern Metropolitan) (16:23): It is truly a delight to get up and reaffirm that in this state equality is not negotiable. All Victorians – let me say this three times – all Victorians, no matter how they identify, deserve to feel safe, supported and equal, including in their health and wellbeing. Now, I rise, and let me tell you, I feel quite a passion about this. It is just a shame I have only got 7 minutes, because I could take 74, actually. I rise to oppose this divisive motion. We know absolutely without a second of hesitation that LGBTIQ+ Victorians face higher levels of discrimination, stigma and exclusion than other Victorians, which leads to poorer health outcomes. Transphobia and discrimination against any member of the LGBTIQA+ community are completely and categorically unacceptable in our community each and every day. You see, in our community, whether that be out on the streets, in our health systems or even in this place, the Allan Labor government is committed to improving the health and wellbeing of trans and gender-diverse Victorians. We know without hesitation that trans and gender-diverse people can face significant challenges through the journey to affirming their gender identity, especially when this is met with stigma and misunderstanding.

We know that access to timely multidisciplinary trans and gender-diverse healthcare teams makes a crucial difference. That is why the Victorian government is absolutely committed to ensuring trans and gender-diverse Victorians receive the health care and the support that they need, and there is so much that we are doing to make that possible. Despite the life-changing and life-saving progress that has been made, there is always more to be done, particularly for the trans community living in regional Victoria. Let me just say we will continue to show leadership and stand with the LGBTI community, particularly trans Victorians. We are committed to making sure that you have access to the services you need and that when you walk in there you feel welcomed and you feel safe in this state, something others in this place would see reversed. Well, not me, and not those of us on this side. There is no place for hate in our state.

While I am here and on my feet I am going to take a moment to acknowledge the work of the Minister for Equality in this place, Harriet Shing. You are absolutely tireless, relentless and unwaveringly dedicated to ensuring that this place, this state, is leading the nation. You are a champion. I heard your remarks earlier and I have heard them over the years, and I am just so proud to get to share this with you. You are a champion, but you do not do this alone. As good as you are, you do not do this alone. So many walk with you in this work, and so many of the folks that walk with you are members of the caucus, members of the government, members of the healthcare community, members of our NGOs and our rep bodies – they are all over the place. The truth is that the work just has not stopped and it will not stop whilst we await the celebration and the support necessary to ensure that the LGBTI community’s rights are protected.

I could talk so much about the Northern Metropolitan Region, home to so many members of the LGBTIQA+ community – members that are proud, members that have hopes and aspirations – and of course all the organisations that wrap around and support them, including Thorne Harbour Health. A big shout-out to you. For over 40 years you been a bastion of health and wellbeing, a leader in our community, and I am just so proud that you find home in the northern suburbs. Celebrating your 40th anniversary – what a special occasion that was. Simon and the team, this is a tough time for each and every one of you, and I want to especially acknowledge that these debates make it harder for you to do what you do. So thank you to your team for standing up, and know that when you do that you stand up supported by each and every member of the Allan Labor government. Supporting these communities is not just vital, is not just important; it goes to the very heart of who we are as a state.

There are statistics for days about why we need to fix this, but let me tell you this government, the most progressive in this state’s history, is entirely committed, absolutely committed, to ensuring the Victorian gender-diverse community know that we see you and we are here for you. The Allan Labor government is committed to helping in every way it can. We have allocated millions of dollars and all the rest, but let me just say I am a little bit emotional because I just got off the phone with the commissioner for LGBTIQA+ communities, who let me know about how tough it is out there. The calls are off the charts to the leadership right now. The hurt and the harm are real and are very much felt. To the commissioner, the team and all the organisations that wrap around our community, thank you. Know that it is just one day and one motion, and it will not stop our resolve to stand up, walk together and walk firmly with the community.

You will see me and so many of us at all the things that we do, and on the very rare occasions that I find myself in the Southern Metro Region, one of those places that I visit most frequently is the Victorian Pride Centre. I have got to say there is a centre full of hope and love and a really proud achievement of our government. There is so much that we could do, but it does not go unnoticed that when these questions and debates come up they can cause harm – so, so, so much hurt. But we have a plan for that and a plan that is one that I have read thoroughly many, many times.

The Victorian government has a 10-year plan for LGBTI equality. It is called Pride in our Future, and it outlines a series of efforts to break down barriers for Victorians to live freely and safely and receive the crucial healthcare services that they require and absolutely deserve. If you want to know what the plan is for this state, have a read of the strategy. It is good reading, I have got to say. It happened following immense community consultations with the community, not just from the current commissioner but the former commissioner, and I pay my respects to commissioner Ro Allen for her incredible, remarkable leadership over the last little while. The work outlined in that strategy, the model of care that the commission and the strategy outline, I just think is second to none and something we should be enormously proud of.

We will never stop working – never, never stop working – to ensure that LGBTIQA+ Victorians feel safe and know that we walk with them each and every day. The strategy is something that I know comes from the voice of members of the LGBTI community. Those consultations, my gosh, were extensive. They went to the very corners of our state – the big smoke, the little towns, the places that some of us have not gone to – because everywhere in this state are members of the LGBTI community. Wherever they are, they deserve to feel supported by this government. Know that you are. You absolutely are. This government will always stand with our rainbow mob family and make clear that equality is absolutely not negotiable.

Sarah MANSFIELD (Western Victoria) incorporated the following:

My contribution today on Mrs Deeming’s motion is made as a health professional and ally of trans and gender-diverse people.

At the outset, can I pay tribute to the strength and resilience of trans and gender-diverse Victorians, and I am sorry that your lives are once again being subjected to unnecessary and public scrutiny. Can I also recognise the families, organisations, health professionals, and other community members for whom these public discussions are distressing as well.

The Greens are deeply concerned by the amplification of misinformation about health care provided to trans and gender-diverse young people, which only perpetuates this harm by fostering stigma and discrimination in the broader community.

The role of gender-affirming health care is to support trans people so that they may be given the right to live a full life – something we all deserve. The right to access gender-affirming care is supported by all major medical bodies in Australia and the World Health Organization.

Evidence shows that access to supportive gender-affirming care during childhood and adolescence significantly improves health outcomes and reduces harms.

Supportive healthcare professionals can help to diminish the impact of constant and pervasive discrimination, which has a tremendously negative impact on health and wellbeing, particularly mental health. The clinicians who provide gender-affirming care that I have encountered are amongst the most sensitive, dedicated, and well-qualified people I know. What is striking is their commitment to person-centredness – they recognise that to provide the care that people need in a safe and effective way, you have to listen to and work collaboratively with them. This is true of all health care; however, it is especially the case for gender-affirming care due to the broad spectrum of needs and experiences of trans and gender-diverse people.

There are many different measures that can form part of gender-affirming care for children and adolescents, most quite simple and reversible. The singular and often ill-informed focus that some have on specific clinical interventions perpetuates unhelpful myths about gender-affirming care and fails to recognise the holistic and individualised nature of care.

This diversity of needs and care is reflected in the extensive body of national and international guidelines that inform clinical care provided to trans and gender-diverse children. These guidelines include the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents from the Royal Children’s Hospital and the World Professional Association for Transgender Health’s Standards of Care for the Health of Transgender and Gender Diverse People.

These guidelines are the result of decades of research, collaboration, and expertise. The fundamental principles underpinning them have support of peak medical bodies in Australia, including the Royal Australasian College of Physicians. There are established scientific processes that are followed for their development, and they are continually revised and updated as we learn more.

An example of the evolution of medical guidance can be seen in the recent update of the World Health Organization’s international classification of diseases, or ICD-11. It is worth noting that the term ‘gender dysphoria’ is no longer used, and importantly, it is also no longer listed in the mental and behavioural disorders chapter of ICD-11. This is because it has been rightly recognised that trans and gender identities are not a result of mental ill health, and this outdated terminology and conception of gender identities perpetuates stigma. The main driver now for including gender incongruence in the ICD-11 at all is to ensure all health systems include access to gender-affirming care.

However, one of the major issues that young trans Victorians face – particularly adolescents – is in fact tremendous difficulty accessing gender-affirming care. There are insufficient services, exacerbated by all the usual barriers to care, such as rurality. GPs are restricted in the types of care they can provide, and consent provisions make it more challenging for adolescents to access than other types of health care. The result is many young people face years of waiting to access care that they need, which in turn results in significant harm and distress.

Moreover, it’s important to acknowledge that a quarter of trans and gender-diverse people have experienced discrimination in accessing health care, including at times refusal of care – the medical profession sadly sometimes perpetuates harms, which is a reflection of the stigma that is still deeply embedded throughout society.

We still have a long way to go, and as demonstrated by the motion and contributions today, progress cannot be assumed or the gains made taken for granted.

A GP who provides gender-affirming care summarised it well when she told me that if we genuinely care about the safety and quality of life of trans and gender-diverse young people, we need to do more to ensure that society embraces them for who they are. An inquiry would not only fail to achieve this or add anything to the body of scientific evidence available to guide care, it would cause further harm by providing a platform for misinformation and stigma.

The Greens are committed to ensuring all young people can access the health care they need and have a fundamental right to, regardless of who they are or where they live.

Moira DEEMING (Western Metropolitan) (16:32): I thank everybody for their contributions today. I could not help but notice that most of the people on the other side of the chamber spent more time talking about themselves and their own identities and their own government and who their friends are and how it was such a waste of their time to have to spend time on a subject like this. Well, I have to remind you all that it is not about you; it is about children and what they deserve. What they deserve is evidence-based care, and that is not what they are getting in Victoria.

You talk about participation. Is it going to help children to participate when they have got fistulas? Is it going to help them participate, like the little girl in Sweden who went on puberty blockers, if their spine erodes to the point where they cannot walk anymore? She is in a wheelchair. Are you going to help them with their dignity when they have secondary gender dysphoria because after they desist they now feel like they no longer fit in to either category and, because the damage in this case is permanent, they do not know what to do with the rest of their lives? Is it progressive to let minors have full hysterectomies and go into catastrophic early dementia by the time they are 30 and end up in care homes? I do not think so. I do not actually think that that sounds anything like love.

I could not believe the amount of non-arguments that I just heard and the abuse and the personal attacks, which have absolutely nothing to do with what is best for children. It does not matter about their sexuality. The amount of you that brought up sexuality – it is nothing to do with their sexuality. It is nothing to do with really anything except evidence-based care. I did not deny the existence of gender dysphoria. I did not say it was not hard. I think it is a terrible thing for a child to have, and I want them to get the very best care in the whole world. Countries that you have all praised for their progressive approach on this very issue have now changed their minds due to massive research projects you are now ignoring as if they do not exist. There are people in this gallery that belong to the LGBTQI community, and they do not agree with you – and they were harmed.

You can attack me all you want. You can call me terrible names, and it will not do anything to help those children get evidence-based care, which is all this motion is about. I raise parents’ rights because parents are the very best and first protectors of their children. They know their children more than anyone else. I could not believe it as a teacher when I found out I had permission to lie to parents if their kids decided to socially transition at school. Teachers should not have that power. They do not know enough about the personal life. I do believe in experts having a say. That is why I want this inquiry. That is why teachers, who are not experts, should never be involved in such a massive clinical decision.

Clinicians themselves do not even have the freedom now to give proper care for their patients and individualised care. That is just a lie. We have set in stone through legislation in Victoria one treatment pathway and one treatment pathway only, and it just so happens to be the treatment pathway that is doing catastrophic, irreversible harm to children. Why would you let your hate for me, which by the way is totally unfounded, get in the way of an honest look at what is best for children in this situation? The fact that you spend half of your time attacking me and labelling your opponents with nasty names instead of dealing with the actual issue at hand is honestly disappointing. I am sure you are all very nice people to the people that you like, but children come first in this motion.

Honestly, I did not think that this motion would get up. I just wanted to have on record the exact names of all the people who voted against this commonsense motion. There was nothing in there that could remotely be accused of being hateful or transphobic or homophobic or any kind of phobic. Either your conclusions, your views, would have been proven correct or mine would have – or maybe neither of ours, maybe some other version. But for the safety and welfare of children we absolutely should have done it. You certainly do not mind spending money on whatever you want or on debt, so it is not like you are going to run out money or resources, and this is one thing that is absolutely worth every dollar.

I am sick and tired and traumatised myself from meeting all these detransitioners, like the ones up here ‍– these brave women and these brave men who come back 10, 15, 20 years later or maybe not even that long sometimes. All over the world it is happening, and they are saying, ‘Why did you let me do this? Why did anybody let me do this? Why did they allow this to happen? You don’t let us get tattoos. You don’t let us go out beyond a certain hour. You don’t let us watch certain TV shows. You control us in a lot of other ways, but why would you let us make this decision, which is catastrophic, irreversible and permanent?’

Council divided on amendments:

Ayes (16): Matthew Bach, Melina Bath, Georgie Crozier, David Davis, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Adem Somyurek, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Lee Tarlamis, Sonja Terpstra, Gayle Tierney, Sheena Watt

Amendments negatived.

Council divided on motion:

Ayes (16): Matthew Bach, Melina Bath, Georgie Crozier, David Davis, Moira Deeming, Renee Heath, Ann-Marie Hermans, David Limbrick, Wendy Lovell, Trung Luu, Bev McArthur, Joe McCracken, Nicholas McGowan, Evan Mulholland, Adem Somyurek, Rikkie-Lee Tyrrell

Noes (21): Ryan Batchelor, John Berger, Lizzie Blandthorn, Katherine Copsey, Enver Erdogan, Jacinta Ermacora, David Ettershank, Michael Galea, Shaun Leane, Sarah Mansfield, Tom McIntosh, Rachel Payne, Aiv Puglielli, Georgie Purcell, Samantha Ratnam, Harriet Shing, Ingrid Stitt, Lee Tarlamis, Sonja Terpstra, Gayle Tierney, Sheena Watt

Motion negatived.