- Investigations to be instigated into paediatric gender health services delivered at the Cairns Sexual Health Service.
- A preliminary review by the Cairns and Hinterland Hospital and Health Service (CHHHS) exposed issues relating to clinical governance and compliance with endorsed clinical guidelines.
- A Part 6 (clinical review) and a Part 9 (health service investigation) to be instigated.
The Minister for Health and Ambulance Services Tim Nicholls today announced that at his direction, Queensland Health Director-General David Rosengren is to commission a Part 6 clinical review and a Part 9 health service investigation into paediatric gender health services provided by the Cairns Sexual Health Service.
It follows a preliminary review conducted by the Cairns and Hinterland Health and Hospital Service (CHHHS) in late 2024, after concerns were raised about apparently unauthorised paediatric gender services provided by the Cairns Sexual Health Service (CSHS), adherence to treatment guidelines and clinical governance.
Stage 1 hormone therapy ("puberty blockers") and Stage 2 hormone therapy ("gender affirming hormones") were being delivered in a way that may not have aligned with the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents or complied with standards for clinical documentation.
On 21 May 2024, a Public Interest Disclosure (PID) was received regarding prescribing of a puberty blocker to a 12-year-old and concerns with clinical decision making. Concerns included the lack of multi-disciplinary consultation, in accordance with best practice, which must be held for all young people 14 years and under who seek to commence treatment with puberty blockers.
"The Cairns Sexual Health Service delivered an apparently unauthorised paediatric gender service without an agreed model of care. The service was delivered to 42 paediatric gender services clients, 17 of whom were prescribed Stage 1 or Stage 2 hormone therapy," Minister Nicholls said.
"A recent internal review undertaken of the CSHS identified deficiencies relating to credentialling and scope of practice and medicolegal concerns relating to patient and parental consent.
"Clinical variation and delay was identified, including delayed blood tests or bone mineral density tests in some patients.
"The client records did not meet minimum standards for documentation around multidisciplinary team discussions or consensus. Reference to fertility discussions and referral to private fertility specialists was inconsistent.
"In short, assessment, diagnosis and treatment may not have aligned with Australian treatment guidelines," Minister Nicholls said.
On 7 November 2024, any further intake of clients under 18 years of age into the service was suspended and referrals were waitlisted.
On 20 January 2025, government received advice regarding the next steps to be taken in relation to disclosure to patients and families regarding consent matters and clinical concerns.
PART 6 AND PART 9 INVESTIGATIONS IN CAIRNS
The investigation into the clinical governance and services within the Cairns Sexual Health Service will include a clinical review (Part 6) and a health service investigation (Part 9) under the Hospital and Health Boards Act 2011.
"The Part 6 clinical review will focus on the health services delivered to patients through the service.
"It's critical that children and adolescents with gender dysphoria receive appropriate diagnosis, care and treatment.
" The Part 9 health service investigation will examine the governance framework and pathways of clinical care processes for paediatric gender services.
"The findings of the investigation and clinical review will be used in the assessment of paediatric gender services across Queensland, not just for the Cairns and Hinterland HHS," Minister Nicholls said.
The Part 6 clinical review is due to be completed by 30 April 2025 with the Part 9 health service investigation report due 30 June 2025. These reports will be released in line with the Crisafulli Government's commitment to transparency.
