Overview
The Royal Children's Hospital (RCH) Gender Service aims to improve the physical and mental health outcomes of children and adolescents who are trans or gender diverse. Being trans or gender diverse is seen as part of the natural spectrum of human diversity.
Some trans or gender diverse children and adolescents experience gender dysphoria. Gender dysphoria is a medical term that refers to the distress that a person may experience when there is an incongruence between their gender identity and their gender
assigned at birth. Trans and gender diverse children and adolescents have considerably higher rates of depression, anxiety, self-harm and attempted suicide compared to their cis-gender peers. This is due to their experiences of stigma, discrimination,
social exclusion, bullying and harassment. Increasing evidence demonstrates that with supportive, gender affirming care during childhood and adolescence, harms can be reduced and mental health and wellbeing outcomes can be significantly improved.
The
Mental Health Service State Government website provides contact details for Victoria's regionalised mental health services and
the suburbs and regions they cover.
If you or someone you know needs someone to talk to urgently:
Referrals
Children and adolescents up to 16 years
We accept new referrals from across Victoria for any child or adolescent up to the age of 16 years with questions or concerns regarding their gender identity. A referral to the Gender Service from a General Practitioner (GP) or Paediatrician is required.
Referrals can be made to the Gender Service using the interactive referral form which should then be faxed to (03) 9345 5034.
New referrals must to include:
- Relevant clinical information including whether the young person is pre-pubertal or post-pubertal. Blood tests are not required.
- Information regarding sociocultural vulnerability to assist with triage processes. This includes Aboriginal and Torres Strait Islander young people, and families with involvement of child protective services.
- Up-to-date contact information, including a phone number that can receive calls from the RCH Gender Service. Referrers are asked to specifically confirm the best contact number to be included.
At the time of referral, referrers are requested to:
- Ensure community based mental health support is in place
- Direct the young person and family to The RCH Gender Service webpage and it's linked resources
- Inform adolescents who are 16 years or under that a parent or caregiver should be aware of the appointment and attend with them
Once a referral has been received by the Gender Service it will be triaged and placed on the waitlist. Information is sent to the referring doctor at this time, which includes details of peer and parent support programs in the community - please make an appointment with your referring doctor to discuss this and obtain a copy of this information.
The young person/family will also receive an SMS from the hospital to confirm the referral has been accepted.
Unfortunately, there is still a long wait for an appointment at the RCH Gender Service. We are sorry for this and are working hard to improve access to care. When an appointment is available you will be sent out an appointment confirmation letter in the mail.
Adolescents 16 years and over
The RCH Gender Service see children and adolescents for a new assessment up to their 16th birthday. Adolescents who are 16 years or over may be eligible to access adult services:
Monash Gender Clinic
Referrals accepted from age 16 years
Phone: 03 9556 5216
Fax: 03 9556 5256
Orygen Trans and Gender Diverse Service
The Orygen Transgender & Gender Diverse (TGD) service is an initiative run by Orygen Youth Health and funded by the Victorian Government. The service is available across the five Orygen-led headspace centres at Melton, Sunshine, Craigieburn, Glenroy, Werribee,
and via telehealth.
The Orygen TGD service provides multi-disciplinary support to young people between the ages of 12 and 25 years.
Orygen TGD Information
Other community based medical services
There are also a number of community based services including Northside Clinic, Equinox Gender Diverse Health Centre, Prahran Market Clinic, TG Health Clinic, Eleanor Clinic, Ballarat Community Health , Trans and Gender Diverse Community Health Services in Preston and Turn the Corner
The RCH Gender Service - supports offered
Children under 8 years
The initial consultation for children who are younger than 8 years of age is with a mental health clinician, such as a psychologist or child psychiatrist. They may be referred in the future to a paediatrician who specialises in adolescent medicine and gender diversity if required.
Children and adolescents 8-16 years
Assessment and Support
The initial appointment (called a SsNAC appointment) is to discuss what supports the young person and family need, provide education on support options and review wellbeing. Following this initial appointment, some young people will be referred for further multi-disciplinary support at The RCH Gender Service. Unfortunately, there is often a second wait to access this ongoing support.
Multi-disciplinary support starts with appointments with a psychologist or psychiatrist, followed by appointments with a paediatrician. Often, the same psychologist and paediatrician will provide ongoing care over years. The RCH Gender Service works collaboratively with the child or adolescent and their family to develop a support plan that meets their individual needs. The RCH Gender Service will continue to see someone until they are 18 years old, or finished high school.
Every young person will have different support needs. The supports offered at RCH Gender Service include:
- Physical health and mental health supports
- Support to access inclusive school environments
- Safer binder education
- Speech pathology support
- Social work support
- Menstrual suppression
- Assessment, education and prescribing of gender affirming medicines (pubertal suppression, Oestrogen, Testosterone)
Once puberty starts, options for medical treatment include:
1. Puberty suppression
Puberty blockers – prescribed by a paediatrician or paediatric endocrinologist.
Puberty blockers suppress the development of secondary sex characteristics and are used for adolescents in the early stages of pubertal development. As they are largely reversible in their effects, should an adolescent wish to stop taking them at any time, their
biological puberty will resume.
2. Gender affirming hormone treatment
Gender affirming hormones (oestrogen or testosterone) – prescribed by a paediatrician or paediatric endocrinologist.
Gender affirming hormone treatment initiates pubertal changes consistent with the young person's affirmed gender. The timing of hormone treatment is individualised based on the young person's circumstances. Trans feminine young people can be offered oestrogen
treatment and trans masculine young people can be offered testosterone. These hormones are only partially reversible in their effects.
Guidelines
The RCH Gender Service provides care that is consistent with the Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents (Version 1.4, 2023).
Contact information
To change or cancel a booked appointment
Please contact the RCH Gender Service on (03) 9345 6175, please leave a message with your patient UR number, reason for cancellation and confirm if you would like to be rebooked or discharged from the service. For appointments that are rebooked a new appointment letter will be sent out in the mail.
Resources
Australian Standards of Care and Treatment Guidelines
Living True, Living Better - evidence-based resource pack about gender-affirming healthcare
Parent support groups
Support groups for young people
Community information and support services
Education, sport and other information links
Research and evaluation
Research into how to support trans and gender diverse children and young people has been increasing over the past 10 years however further is required. To continue to provide great care to trans children and adolescents, the RCH Gender Service is committed to ongoing research that is safe, ethical and focused on the needs and priorities of trans youth themselves and their families. For more information, please visit
Transgender Health and
Transgender Youth Health.
Professional affiliations
More about the RCH Gender Service