And what kind of questions are your patients asking you at the moment. What are you hearing from.
Them, whether I'm going to have to close the clinic, if I'm going to be moving away, if I'm still going to be their doctor.
This is a doctor practicing in the United States speaking to our producer Shane Anderson. We can't tell you the doctor's name, but for three months now her work has been under attack. She provides medical care to trains and gender diverse young people, and she says since Trump's executive orders came in January, providing that care has become much harder, and she's watched as her patients have suffered as a result.
In fact, a lot of my trans kids have after tucks because the learning environment has become so hostile. In our state books supporting LGBT lifestyles with LGBT characters, I've been taken out of the libraries. Teachers are not allowed to answer questions about these things anymore. So it can be really scary to be a kid in circumstances of the US.
Right now.
For Schwartz Media, I'm Daniel James. This is seven AM today, seven AM. Senior producer Shane Anderson on the ordinary people pushing back against Trump's warren trans people and how Queensland became the testing ground for bands. Here it's Friday, April twenty five, and just a warning, this episode discusses suicide. Shane, you are able to speak with a doctor who provides healthcare to trans children and teenagers. We're going to use a pseudonym to protect her identity because her work is
under attack right now. But tell me about her and what her work involves.
Yeah.
So I got into this story because I was really interested at looking at executive orders three months on now that the dust has settled from that initial blitzkrieg of orders back in late January, so I got talking to this doctor. Let's call her Sophie for ease of convenience. Sophie told me that she lives and mostly works in
a red state in the Midwest. She's married with a kid, and she initially trained to be an obgyn, but expanded her practice when her son was little and he started wearing dresses to school, which is something that continued through until the second grade.
And I found that there are no local resources for provents, so I started learning about it. Medical transition and treatments for young kids. Realized that estrogen and testosterone are things that I prescribed every single day, and it was very possible for me to be able to make an impact on the community and provide services.
And so yeah, that's when she started getting into gender affirming care. That was seven or eight years ago, and she's been doing that ever since. But even before the executive orders came in, she says, it was difficult for her to do her job. She would have to travel over the state line to a blue state to provide care for her younger patients. But now since January, even blue states are feeling the effect of Trump's bands, and she said she's incredibly alarmed.
Understandably, man, Can you tell me a little bit more about what exactly the executive orders are and how they affect her work.
Yeah, So the main one was signed on January twenty eight, his title Protecting Children from Chemical and Surgical Mutilation. I mean, as you can hear in the title, it's a motive. It's intentionally inflammatory and a gross mischaracterization of what gender affirming care actually provides.
The order states that the US will not fund, sponsor promote, assist, or support the so called transition of a child from one sex to another, and it will rigorously enforce all laws that prohibit or limit these destructive and life altering procedures.
So it's actually been challenged already in the courts, but this order from January twenty eighth had enormous ripple effects on her ability to treat children.
So how is that planning it so far?
So the thing that Sophie explained to me is that the wording of the order leaves the door open for criminal charges for anyone providing gender affirming care promises to quote rigorously enforce all laws, even though it's not really specific what those laws are, and so it's generated this atmosphere of fear and paranoia around potentially what could come next. So the federally funded clinic that she works for has just gone into caretaker mode. They're not taking on any
new patients, Sophie said. Clinics are shutting down, pausing care.
Many people's psychiatrists, many transkind psychiatrists, dropped them as patients or stopped documenting gender tsporia completely as part of their care because they weren't afraid that they would be suoned for aiding and abetting transition care for any particular patient, and she.
Said that this extends to parents as well, being too scared to go to the pharmacy and pick up medication for their children. And at the end of the day, she said, the impact, particularly you know, on children and families that don't have the means to work around all of these restrictions, it's been really significant.
It sounds really scary for these families, for the people who are trying to work around these limitations. What does that look like. Is it's still possible to get gender affirming care.
It is still possible. I specifically asked her what she is telling young people and their patients about how her ability to give them care is being impacted.
I tell them that they should focus on being kids and let me worry about the legal stuff.
But for adults she has changed tack a little bit. For example, if someone is considering gender reaffirming surgery, she's advising some of her patients that maybe they should hold off on making a decision about these surgeries just in case they lose access to those hormones over the next couple of years. Another thing that I had heard a
lot about was report to people's stockpiling medication. So I asked about whether or not she was giving people advice around that, and she told me that actually, the stockpiling of medication is probably one of her biggest concerns for the safety of her patients.
These medications aren't safe to use without labs and without physician supervision, So trans mails can get blood clots in their legs, they can have a stroke if there aren't too much testosterone.
She said she's even seen patients this year where she's gotten the blood work back and found that their testosterone levels are putting them at risk of further serious health impacts.
Now, if you were to ask me, what's the risk of not being able to access testosterone at all, for example, versus you know, being able to access it and having this small risk of having a stroke because you're taking too much, that's a really, really sad question that I have to answer.
So Sophie's ultimately trying to keep doing her job even though it's obviously risky to do that. Trump's executive orders threaten criminal charges for doctors. So what did she say to you about how she feels about taking on that kind of legal risk.
It's a huge risk and you know, she's going into it with open eyes. Her clinics have engaged lawyers. She told me. The advice that they've gotten is that there's really no way to know what the consequences of these executive orders are until you're actually sued.
My goal is to continue to provide the care as best I can. My goal is not to violate laws. I am prepared to be sued in my home state and have contingency plans if I lose my license or if I'm incarcerated. We hope that it doesn't come to that. We're actually looking at moving to Australia things get really bad, but it's difficult because you work in the US. You end up spending a lot of money to become a doctor, and so the thought of having to start over is intimidating.
But these kinds of things make me incredibly angry, and so if I don't do something, then I don't nuts inside.
And she stressed to me that really these decisions go beyond the legal considerations for herself as well. Right like when she thinks about what might happen to her patients, especially her younger patients, if medical care isn't available, she says it's ultimately a matter of life or death. And can you just spell out and really explain for me what happens to the young people that you can't treat.
If they have.
A sense of hope in their lives that things will get better, things can get better, and a lot of them end up finding a lie these days, then sometimes they can muddle through, but many of them end up attempting suicide and their lives follow quote and they die. So we lose people all the time.
After the break the Queensland kids facing healthcare.
Bands Hi Ruby Jones here, seven am tells stories that need to be told. Our journalism is founded on trust and independence and now we're increasing our coverage Every Saturday until the election, will bring you an extra episode to break down the biggest political moments of the week. If you enjoy seven Am, the best way you can support us is by making a contribution at seven am podcast dot com dot au, forward slash support. Thanks for listening and supporting our work.
Shane Trump's executive orders are having a chilling effect on trans rights in the United States. We're also now seeing setbacks in other Western countries too. But what is the situation in Australia.
Basically the same day as Trump's directive. Back in January twenty eighth, Queensland state government put an immediate holt on all people under the age of eighteen receiving puberty blockers and hormone therapies in the public system.
So when the band came in, it was a real shock.
I spoke to doctor eloui's Brook about this. She's the CEO of OSPATH, which is a professional association for trans health.
We've been worried for some time that there was going to be an opportunity for some state governments and territories to remove general fimincare. General fimin care is quite literally the safest and best way to support young people to get the best outcomes. So when that kind of gets closed down, everyone's shocked, everyone's horrified.
We know that at the time the band was put in, there were four hundred and ninety one young people on the weightlist for the Queensland Gender Service and they really have two options now. They can go into the private system, which can be prohibitively expensive. We're talking you know, multidisciplinary care with psychiatrists and endocrinologists and medication alone, which can be worth thousands of dollars every couple months, or they can just not get care, which comes with a big
mental health risk. And so this had a pretty devastating impact, especially on families who were, you know, just weeks or months away from starting puberty blockers. And Eloise actually shared with me a testimony from one of these families.
Our heart broke for our little person who is due to start blockers in the first week of March.
This is a family who'd already sat on the waitlists and at the very last moment had had support disappear in front of their eyes. And Eloise described their distress at not being able to afford private health care and some of the options the mother was even considering.
All I could do was cry and have panic attacks about what this could mean for them. I thought at one stage that if I wasn't alive, my husband could use my super to pay for it.
But the thing that really separates the situation in Australia from the situation and the States is how the federal
government is responding. Mark Butler, the Health Minister, he immediately called on Queensland to pause the ban and he commissioned the National Health and Medical Research Center to do a formal, independent, scientifically backed review of the use of puberty blockers for children, and everyone I spoke to had a lot of hope that this review would follow what the science says that these medications are safe and vital for good mental health outcomes for young people. But this review is going to
take a long time. I think twenty twenty six is when we'll expect to hear back from that.
And in the meantime, how are people in Queensland trying to push back.
Well, there is one legal challenge that's just taken its first steps. There is a mother who's put in an application to the Supreme Court trying to get more information from the Queensland Health Director General about the decision making that went into this snap ban. Another initiative underway is called Project four nine one, which was launched by doctor Elouise Brook from Ospath and they came up with this project which raises funds to bequeath to those families to
get private treatment. To this date, they've raised over one hundred grand and they've only just launched a couple of weeks ago. On the thirty first of March Transgender Day of Visibility and so far they've helped support two families.
I mean, that is amazing, but it's also not something that will be able to help the hundreds of families that may actually need support as well. So what does it say to you, Shane, that we're in a situation where a state government is making a decision like this and what is the likely impact for the future gender affirming care in Australia.
I think it shows that people are learning from what's happening in the States and speaking to everyone in the
process of making the story. I got the sense that the lesson is that it's kind of everyone's responsibility not to let the transgender diverse community become this political football in Australia and not to let, you know, this ideologically driven set of politics of the day kind of stand in the way of quite a significant body of medical research showing the safety of pubity blockers and hormone therapy.
So and the backlash to what's happening in Queensland, especially at the federal government level, you know, does make some people cautiously optimistic that maybe there isn't that appetite for that kind of politics. More broadly in Australia, the same way, and to the same extent that it's happening in the US and the UK and the community support the groups
like Project four nine to one have seen. I think our testament to that as well, and so while there was a lot of cautious optimism, there is also a warning to not get complacent.
So really want people to keep focusing on how we support our young people. I am looking forward to that point when Project four nine one no longer is necessary, but I'm not sure when that might be.
Shane, thank you so much for your time.
Thanks for having me on, Daniel.
If this episode has raised issues for you, or if you're concerned about someone you know, you can call Lifeline on thirteen eleven fourteen. You can also call q Life on one eight hundred one, eight four five two seven. Support is also available at Switchboard, Queer Space, Transcend Australia, Transgender Victoria and Minus eighteen. Also in the news, most doctors say they won't move to full bonk billing, despite
promises by both major parties. ABCWS surveyed more than eight hundred gps and combine their findings with data from the Royal College of General Practitioners. Ninety percent of doctors told the ABC they wouldn't move to full bulk billing, with many saying the eight point five billion dollar scheme pledged by Labor and match dollar for dollar by the Coalition shows a lack of understanding for how general practice works.
They warned the policy could incentivize shorter consults and compromise care, and the Prime Minister says there's no place for violence. After a series of incidents at pre polling booths this week, Yesterday, a teenager in Anthony Alberizi's electric was charged over an alleged assault of a man at a polling booth. The man was wearing a Maga hat. Prominence to Alberzi stressed the need for respect of polling booths and wished the
man a swift recovery. I'm Daniel James. This is seven am and we'll be back tomorrow with the full rap of all the biggest political moments of the week. See it then
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