COURT FINDS A 17-YEAR OLD COMPETENT TO MAKE OWN DECISION ABOUT PHASE 3 TREATMENT FOR GENDER DYSPHORIA
RYAN [2019] FAMCA 112 (16 JANUARY 2019)
This case is about 17-year old “Ryan” who was born female but identified as a male in 2015. He was diagnosed with gender dysphoria due to development of male characteristics and wished to undergo Phase 3 treatment for that condition.
ISSUES:
1. Whether Ryan’s parents must give their consent to the administration of Phase 3 treatment to him for Gender Dysphoria.
Ryan’s mother believes that he can make his own decision and that he will benefit from the surgery. On the other hand, his father believes that he is only capable of making his own decision once he turns eighteen in 2020. He fears that Ryan will regret his decision.[1]
The mother is the person who has raised Ryan. The father, having minimal involvement with Ryan’s daily routine, was probably unaware of how committed he was to change his body and his name to align with his identity.[2]
In 2018, Ryan underwent Phases 1 and 2 of treatment having been declared legally competent to consent to these procedures by the Family Court of Australia. [3]He would be in limbo for twelve months if he was not permitted to decide in circumstances where he was revolted by the physical inconsistency of his own body masculinized by Phase 2 treatment and inconsistent with the presence of female breasts. The Court has found him satisfied with the result of the treatment. [4]
2. Whether it is mandatory for the court to determine if the child is Gillick competent to give consent to his own surgery.
It depends. In the absence of controversy between parents or medical professionals about the administration of treatment to the child, it is no longer necessary to apply to the Family Court for a determination whether that child is Gillick competent to give consent. However, if there is controversy between parties, the court must apply the Gillick competence test. [5]In this case, the Family Court of Australia has found Ryan to be Gillick competent to consent to his own surgery. [6]
3. Whether a 17-year old is competent to make own decision about Phase 3 treatment for Gender Dysphoria.
YES. There is evidence from three sources on the issue of the competence of Ryan to make own decision such as:
- Expert Medical Evidence;
- A report by a Senior Family Consultant;
- The statements of Ryan himself.[7]
Dr. P has been regularly seeing and treating Ryan for more than two years. According to him, Ryan can make his own decision, and can understand the advantages and disadvantages of Phase 3 treatment. [8]He also attested to Ryan having “a full understanding of what the treatment entails, its risks and benefits and how it will affect him”. Since December 2016, Ryan has been consistent in telling Dr P. that he wishes to be “just a male, not a transgender male”. Ryan feels to be closer to who he should be once his breasts have been removed surgically. [9]Dr. P does not believe that there are any non-surgical or lesser invasive surgical options or other treatments to address Ryan’s breast related dysphoria. [10]
According to the report of the Senior Family Consultant, “Ryan is in important developmental stage of adolescence where he individuates from his parents, become more independent and seek his own way in life. His view about his gender is the most important issue he currently faces, and resolution of this issue is likely to allow him to concentrate on other important developmental tasks.” [11]
"If you are a young adult, you can make health decisions that would ordinarily require both parents consenting if you meet certain criteria to demonstrate maturity.".
[1] Ryan FAMCA112 at (31), January 16, 2019
[2] Ryan at (17)
[3] Ibid at (18)
[4] Ibid at (35)
[5] Ibid at (20)
[6] Ibid at (4)
[7] Ibid at (27)
[8] Ibid at (28)
[9] Ibid at (29)
[10] Ibid at (30.13)
[11] Ibid at (36)