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Blake's Journey to Affirmation: Court Recognises Gillick Competence and Orders Gender-Affirming Care

INTRODUCTORY PARAGRAPH

In Re: Blake [2025] FedCFamC1F 364, the Federal Circuit and Family Court of Australia delivered a landmark decision affirming the autonomy and dignity of a transgender child seeking stage 2 gender-affirming treatment. The Court ruled that Blake, a 17-year-old diagnosed with gender dysphoria, was Gillick competent to consent to hormone therapy and ordered a legal change of name aligning with his affirmed gender. The case underscores the Court’s willingness to prioritise the psychological wellbeing and expressed wishes of a mature minor, especially where one parent fails to engage with or support the process.

🧾 FACTS & ISSUES

Facts:

  • Blake, born in 2007 and assigned female at birth, has identified as male for several years.
  • Diagnosed with gender dysphoria, Blake underwent consistent psychological and psychiatric care since 2018.
  • The treating psychiatrist, Dr B, confirmed Blake was "persistent, insistent, and consistent" in his male identity and supported stage 2 treatment.
  • The child’s father had little involvement in his life and actively opposed gender-affirming care, despite minimal contact.
  • Blake experienced distress and self-harm risks due to gender dysphoria, worsened by paternal rejection.
  • The mother and Independent Children’s Lawyer (ICL) supported the treatment and name change application.

Issues:

  1. Is Blake Gillick competent to consent to stage 2 gender-affirming hormone treatment?
  2. Should the Court authorise the administration of testosterone in the absence of paternal consent?
  3. Is it in the best interests of the child to change his legal name to reflect his gender identity?

⚖️ APPLICATION OF LAW TO FACTS

The Court applied the Gillick competence test derived from Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112, confirmed in Australia in Secretary, Department of Health and Community Services v JWB and SMB (Marion’s Case) (1992) 175 CLR 189. The test requires that a minor must fully understand the nature and consequences of the proposed medical treatment.

Dr B provided comprehensive and unchallenged expert testimony confirming Blake:

  • Understood the reversible and irreversible effects of testosterone,
  • Had explored non-medical interventions (social transition, chest binding),
  • Displayed maturity and insight necessary to give informed consent.

Blake’s persistent identification as male, understanding of treatment, and clear articulation of his needs established that he met the threshold for Gillick competence.

Further, citing Re: Imogen (No 6) (2020) 61 Fam LR 344 at [45], the Court acknowledged the necessity of considering a child’s views—especially one nearing adulthood—and prioritised Blake’s mental and emotional wellbeing.

🧠 ANALYSIS OF THE JUDGMENT & JUDICIAL REASONING

Justice Hartnett’s decision was grounded in:

  • The uncontested expert evidence by Dr B that the treatment was medically necessary and Blake was capable of informed consent,
  • The statutory obligation under the Family Law Act 1975 (Cth) to act in the best interests of the child,
  • Recognition of the risk of significant psychological harm if treatment were denied.

The Judge noted the father’s non-involvement, both historically and in the proceedings, contrasting sharply with the mother’s support. The judgment stated:

"The child’s safety will best be promoted by orders authorising administration of masculinising testosterone...".

The decision reflects a shift toward recognising the capacity and rights of mature minors in matters of medical autonomy, especially where denial of treatment could result in serious harm.

📚 PRECEDENTS CITED

  • Gillick v West Norfolk and Wisbech Area Health Authority [1986] AC 112
  • Secretary, Department of Health and Community Services v JWB and SMB (“Marion’s Case”) (1992) 175 CLR 189
  • Re: Imogen (No 6) (2020) 61 Fam LR 344 at [45]

🧠 TAKE-HOME LESSON

This case reaffirms that mature minors have a legal right to make informed medical decisions regarding gender-affirming treatment, especially when supported by consistent expert care. The Court will prioritise a child’s mental health, expressed wishes, and best interests, even in the absence of consensus from both parents. It emphasises the legal system’s evolving support for transgender youth and their autonomy in healthcare decisions.

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