Australia OKs Sex Change For Teen

Australia's Family Court has approved the request of a 13-year-old girl to undergo hormone treatment that will make her a boy - a controversial decision that has ignited public debate.

The ruling, announced Tuesday, is the first time an Australian child has been given legal approval to undergo sex-change hormone treatment because of psychiatric issues.

The girl, who under Family Court rules can only be known as "Alex," will also receive psychiatric care and have surgery when she turns 18 and is legally regarded as an adult.

Alex regards herself as being male after being brought up as a boy by her now-dead father and being rejected by her mother. Her home state was not revealed.

She has already begun treatment with the hormones estrogen and progestogen to prevent menstruation and feminization of her body. The court made an interim order for that treatment to commence earlier this year.

Tuesday's decision means Alex will begin treatment with the male hormone testosterone once she turns 16 that will have irreversible effects - including her voice deepening, facial and body hair, as well as muscle development.

Family Court Chief Justice Alastair Nicholson referred to Alex as "he" when making his judgment.

"I am satisfied that Alex has the capacity and, indeed, does in fact know the side effects that may arise and further, that he wishes the proposed treatment with knowledge of such risks," Nicholson said.

"The social implications of the proposed treatment are that Alex will face challenges in his chosen identity in respect of peer relationships, possible bullying and ostracism, but I'm satisfied that impressive steps have been taken to anticipate such risks."

Alex - whose condition doctors call gender identity dysphoria - beats boys at arm wrestling, and is attracted to girls, the court heard.

She has no male chromosomes and has hormone levels typical of a teenage girl as well as female reproductive organs. But she lives with an aunt who treats her like a boy.

The court's permission was necessary because sex change treatment is regarded as a special medical procedure to which neither a child, parent nor guardian can give consent.

The state welfare department, which is Alex's legal guardian, made the court application on her behalf, and will pay for the sex-change treatment until Alex becomes an adult.

Prominent Australian ethicist Nicholas Tonti-Filipini condemned the decision.

"This medical treatment, (is) completely unproven, even in adults," he told Australian Broadcasting Corp. radio. "To do it to a 13-year-old who is still in formation, whose body is still forming, whose sense of identity is still forming, it's just irresponsible."

He called for a higher court to intervene.

But Louise Newman, chairwoman of the Royal Australian and New Zealand College of Psychiatrists, Faculty of Children and Adolescent Psychiatry, disagreed, saying that in this case it would be overly stressful for the teen-ager to undergo female puberty.

A High Court spokeswoman could not say who was entitled to appeal the decision although it can be appealed before three judges of the Family Court.

By Rod McGuirk