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Parental consent and the treatment of transgender youth: the impact of Re Imogen

The number of transgender and gender diverse (henceforth, trans) youth seeking medical treatment has risen sharply over the past two decades in Australia and overseas.1,2 Unique legal requirements for consent to this treatment in Australia have developed through Family Court case law since 2004. Until recently, it was necessary for a young person seeking pubertal suppression or genderaffirming hormone treatment to secure Family Court approval before treatment could commence, even in circumstances where both parents and the young person’s treating doctors supported treatment and considered it to be in their best interest, and the young person was deemed Gillick competent, which is achieved when a young person has “a sufficient understanding and intelligence to enable him or her to understand fully what is proposed”.3 The requirement for court approval was removed for puberty suppression in 2013 by Re Jamie,4 but the restrictions on genderaffirming hormone treatment remained until the Full Family Court decision of Re Kelvin in 2017.5