Under 18s

Trans young people - those who are under the age of 18 - may have different or additional rights and restrictions to trans adults. This includes not having the same freedom to make decisions under the law.

There are always ways to affirm your gender and stay safe. Your identity is real and valid, and you are loved. Information for people under 18 about changing your name or gender marker are available on those pages.

The NSW Department of Education states that “a student who has identified as transgender enjoys the same legal rights or protections afforded to all students under the duty of care, education and work health and safety laws. Additional protections apply to such students under discrimination law.”

For more information about your rights at school, including how this relates to private and religious schools, visit our page on schools.

No matter who you are or what your gender is, every person has the right to physical activity. As Sport Australia writes:

“All Australians should have the opportunity to be involved in sport and physical activity, regardless of their gender, sexual orientation, ability, cultural background or ethnicity.”

Sport Australia - Trans and Gender Diverse Inclusion1

Playing for the club or team of your gender or choice depends on several criteria around legal gender markers and how inclusive the club or team are. It’s worth having a parent, guardian, or trusted adult get in touch with a team to ask about their policies and how they support trans and gender diverse young people already, including if there are any trans people already part of the organisation or group.

Some clubs may seek a permanent exemption from anti-discrimination legislation to not allow trans people whose gender is not legally recognised to compete. It is important to note that this exemption does not apply to children who are younger than 12.

There are three legally defined developmental stages for a young person’s ability to consent to medical care.

• Young children, who are unable to consent

• Young people who are under 16, but Gillick Competent

• Young people who are between 16 and 18, who are able to consent as an adult

Gillick Competence

Gillick Competence is a legal state where a person under 16 years old is considered to have “the degree of maturity and intelligence needed” to consent to a treatment2. It changes depending on the nature of the medical decision, e.g. A different level of competence would be needed for having a small cut dressed compared to being prescribed a contraceptive medication.

Being assessed as Gillick Competent can take some time, and it’s a process doctors need to take very seriously. Parents generally hold responsibility for their children until the age of 18, however children gain the ability to independently consent gradually depending on Gillick Competence. This is individualised and determined on a case-by-case basis i.e there is no hard and fast rule on what reaching competence looks like. It’s not quite as simple as one day someone being not Gillick Competent, and the next day they are.

It is recommended that you contact the Inner City Legal Centre (ICLC) for further legal advice. They offer a NSW-wide free legal service for trans and gender diverse people. ICLC has also developed a fantastic fact sheet on medical treatment for trans children here.

“Where a child is considered Gillick Competent then the consent is as effective as that of an adult and cannot be overruled by a parent.”

Griffith R, Human Vaccines & Immunotherapeutics Journal2

In NSW, the Minors (Property and Contracts) Act 1970 provides some guidance regarding the medical treatment of young people. Section 49 of this Act states that a medical practitioner who provides treatment with the consent of a child 14 years or over will have a defence to any action for assault or battery. This Act does not assist in a situation where there is a conflict between a child (aged 14+) and their parents or guardians. A parent can still potentially override a child’s consent to treatment.

Medical privacy

It makes sense that you may want to see your doctor about medical affirmation without your carers, or guardians knowing. It’s also reasonable to expect and hope for some level of medical confidentiality, this is not guaranteed in all cases though.

In many cases, doctors can sensitively meet their obligations in relation to disclosing information (for example in cases of risk or immediate harm), while also working with you to minimise the risk of those around you finding out that you are trans before you are ready to share.

If you are concerned about your confidentiality, discuss this with your doctor before you disclose to them so you can make an informed decision.

For more information, Slater Gordon Lawyers have a great post about understanding medical confidentiality.

“Ideally, the decision regarding timing of hormone commencement should be individualised to provide best care for the adolescent …The decision should be shared between the clinicians, the adolescent and their family with the values and belief systems of all contributors being respectfully considered.”

Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents

In Australia, any person over the age of 18 years is deemed competent to make decisions about their own medical treatment, but it’s slightly different for people under 18.

A Family Court of Australia ruling (Re Kelvin, 2017) overturned an existing law that required all young people and their parents/carers to go to Court to commence gender affirming hormones prior to age 18. This ruling was further clarified in the judgement of Re Imogen 20204 to mean that gender affirming treatment can be commenced in Australia with people under 18 only when there is no dispute between parents (or those with parental responsibility), the medical practitioner and the young person themselves with regard to:

• The Gillick competence of an adolescent; or

• A diagnosis of gender dysphoria; or

• Proposed treatment for gender dysphoria

Any dispute requires a mandatory application to the Family Court of Australia as per the judgement of Re Imogen 2020.

Medical practitioners seeing patients under the age of 18 are unable to initiate puberty blockers or gender affirming hormonal treatment without first ascertaining whether or not a child’s parents or legal guardians consent to the proposed treatment. If there is a dispute about consent or treatment, a doctor should not administer puberty blockers (“Stage 1”), hormones (“Stage 2”) or surgical intervention (“Stage 3”) without court authorisation.

For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court must be involved. Unfortunately, in many cases where parents, carers or guardians do not consent, this may result in a trans person simply waiting until they are 18 to access puberty blockers and hormones, or seeking to access them outside of medical care and oversight.

Puberty  suppression  may  continue  for  a  few  years,  at  which  time  a  decision  is  made  to  either discontinue  all  hormone  therapy  or  transition  to  a  feminizing/masculinizing  hormone  regimen. Pubertal suppression does not inevitably lead to social transition or to [medical affirmation].

WPATH

AusPATH, the RACP, the RACGP, and the Australian Endocrine Society all endorse access to puberty suppression/blockers for trans young people and adolescents.

“Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be ameliorated and mental health and wellbeing outcomes can be significantly improved.”

Australian Standards of Care and Treatment Guidelines for trans and gender diverse children and adolescents

For more information about starting hormones, visit this page.

For trans people under 18 whose parents, carers or guardians will not consent to starting hormones, the Family Court must be involved. For assistance, you can contact the Inner City Legal Centre who offer a state-wide free legal service for trans and gender diverse people.

Generally, gender affirming surgeries are not available to people under the age of 18.