• Federal Court
  • LGBTQI+ person
  • Young person
  • VIC
  • NSW
  • QLD
  • ACT
  • TAS
  • NT
  • SA
  • WA
  • Federal

What is this resource?

This resource covers some of the common questions children and parents have about stage 1 and 2 hormone treatment. 

If you are reading this and want assistance, Justice Connect can put you in touch with lawyers who will help you through the legal process on a pro bono basis (for free!). Call Justice Connect on 1800 STAGE2 (1800 782 432) or apply online here.

Why would a child need access to stage 2 treatment?

A child is anyone who does not yet have legal adulthood. This is everyone under the age of 16 in South Australia, and everyone under the age of 18 in all other Australian states and territories. This includes most adolescents and teenagers. A child may need access to stage 1 or 2 hormone treatment if their biological sex does not align with their gender identity. In other words, the sex they are assigned at birth is different from the gender with which they identify

How can medical intervention help individuals align with their gender identity?

Trans and gender diverse children can receive stage 1 and stage 2 treatment to help them align their gender:

Stage 1 consists of the administration of puberty suppressant hormones, “puberty blockers”. This treatment suppresses the onset of puberty and physical characteristics which may be incompatible with their gender identity. Stage 1 allows children to explore their gender identity before beginning Stage 2. Stage 1 is reversible.

Stage 2 involves the administration of either estrogen or testosterone. Stage 2 results in the development of physical characteristics which are compatible with the child’s gender identity (such as facial hair and muscle growth for those taking testosterone and breast development and reduced visibility of body hair for those taking estrogen). Certain effects of stage 2 are irreversible without surgical intervention.

In addition to stage 1 and stage 2 hormone treatment, sex affirmation surgery is also available (usually once the child reaches 18 years of age) (Stage 3). 

What does “affirming your gender identity” mean?

Irrespective of whether a trans or gender diverse person receives hormone treatment, they may at some point begin to affirm their gender publicly. This may be known as “transitioning”.  “Affirming one’s gender identity” usually involves using a preferred pronoun and a new name that aligns with the individual’s gender identityIt may also include wearing clothes, hairstyles and accessories that are consistent with their gender identity. 

Why is it important for a young person to get access to stage 2 treatment quickly?

According to the Royal Children’s Hospital, “The health risks associated with inadequate care and support of transgender adolescents are well known”. The Trans Pathways survey found that 42% of trans children in Australia had reached out to a service provider who did not understand or respect their gender identity, and 60% felt isolated from medical and mental health services. The Health and Well-Being of Transgender Australians survey found that better training in trans health issues for doctors was the community’s top priority for government funding. The current lack of appropriate health care for trans children is a significant contributor to the extreme prevalence of mental health issues in the trans community. Further information on the mental health of trans children in Australia can be found in both these surveys.    

If medical professionals have determined that a child needs access to stage 1 or 2 treatment, it is important that they receive it in a timely fashion.  Without treatment, a child may begin to develop physical characteristics of the gender they do not align with.  For example, if a child is assigned male sex at birth, but their gender identity is female, there is a risk their voice may break before they receive treatment.  This may cause them extreme distress. 

When does the Court have to authorise stage 1, 2 and treatments? 

There are some conflicting approaches in decisions of the Court regarding when Court approval is required.    

Given the conflicting approaches, it is prudent to proceed on the basis that all three stages of treatment for gender dysphoria in children and adolescents require consent from all parties who have parental responsibility over the child or adolescent.  

A medical practitioner should not initiate any stage of treatment without first determining whether those with parental responsibility or the legal guardians consent to the proposed treatment. This is the case even when the child is assessed by the medical practitioner as being “Gillick” competent – that is, they have sufficient understanding and intelligence to enable them to understand fully what is proposed.  

Currently, a child will need to seek a court order to gain access to stage 1, 2 or 3 treatment in the following circumstances:  

  • where there is a genuine dispute between parents, or people who have parental responsibility for a child, as to whether treatment should proceed; 

  • where there is a dispute between the child and / or their parents and medical staff as to whether treatment should proceed; 

  • where there is a genuine dispute between the child and their parents as to whether treatment should proceed (if the child is not competent); 

  • where a child is under the protection of a state welfare authority. 

How long can the process of going to court take?

Including the time it takes to obtain medical reports and affidavit evidence from parties, it will take several months before the matter is finalised.  It may take longer if one party actively opposes the treatment proceeding.  An application will not go straight to a substantive hearing.  There will usually be several “procedural” hearings early in the matter to set up the timetable for the matter and deal with any preliminary issues.   

What is the process of applying to the Federal Circuit and Family Court for stage 2 treatment?

If an application is required, an application to the Court can be made by: 

  • a parent/guardian of the child; 

  • the child themselves; 

  • a grandparent of the child; 

  • any other person concerned with the welfare of the child. 

An application must be served on the “prescribed child welfare authority”, which is currently the Department of Families, Fairness and Housing.  

To make the application, affidavit evidence must be collected from medical and psychiatric experts, parents, guardians, and other individuals involved in the child’s upbringing. The matter will then be listed for hearing. 

Who has to attend the hearing?

If the application is being made by a parent then they will usually have to attend Court for the hearing. The lawyers and barristers will be talking directly to the Judge and answering their questions.  If a parent/guardian has filed an affidavit in support of the application, they may be cross examined when the hearing progresses. 

It is not possible for the child to enter into a Court session without permission from the Judge. 

The child can provide evidence in the form of an affidavit, if they have made the application, or if the Court gives them permission.  

What will the Court decide during the hearing?

What the Court needs to decide will depend on the facts before it.  The Court may only need to declare that the child is Gillick competent.  Or the Court may consider it is necessary to look at the medical evidence and authorise the treatment.   

A party can request that the hearing be “closed”, meaning that no one other than the parents or guardians of the child and their lawyers can enter the Courtroom and listen to the proceedings.  It is also common practice for the Court to “anonymise” the case, meaning the child and parties will be given a pseudonym so they cannot be identified. 


Lawyers are required by law to protect client privacy and confidentiality throughout the entire process leading up to, including, and after the Court hearing. 

During the Court hearing, the names of all participants (including the child, their family members, and lawyers) will be suppressed by an order of the Court.  This means that no-one will be able to access any information that could identify any of the individuals involved in the case, nor will they be able to access the Court’s records.  

Which identity documents can I change my gender on in Victoria?

Birth Certificate

The Victorian Registry of Births, Deaths and Marriages can issue a birth certificate to sex and gender diverse applicants, and will allow most sex descriptors, as long as they are not offensive or impractical. There is no longer a requirement to have sex affirmation surgery in order to apply to have a change of sex recognised on a birth certificate. An application can be made irrespective of any treatment that has or has not occurred. However, a child will need both parents named on their birth certificate to consent to the application, or, a court order approving the application. For more information please refer to the Births Deaths and Marriages Victoria website. 


The Australian Passport Office can issue a passport to sex and gender diverse applicants, identifying them as male, female or X (indeterminate/intersex/unspecified). Surgery is not a prerequisite for a passport to be issued in your preferred gender. 

To apply for a passport in your preferred gender, you would need a declaration from your treating medical professional, or a revised birth certificate from an Australian Registry of Births, Deaths and Marriages. For more information, please refer to the Australian Passport Office’s website. 

Services Australia

Centrelink will allow a record of gender as male, female or non-binary. Most people can update their gender details for Centrelink through their online account or by phoning. The parent who provides the highest percentage of care for the child can also update the child’s gender details on their behalf.  Most people will not need to provide any supporting documentation. For more information, please refer to the Services Australia website. 

Medicare Card

Medicare can register your gender as either male or female. If you have a different gender identity, Medicare can record it as a note on your record. To update the record, you will need to provide a declaration from a treating medical professional, or an updated form of identification such as a passport or a birth certificate. For more information, please refer to the Services Australia website.  

More services and support for trans children

Justice Connect can help you in finding legal assistance. 

There are also many other support services available for trans and gender diverse individuals, their partners, families, and friends, including: 

  • Minus18 Australia’s largest youth led organization for gay, lesbian, bisexual, trans and gender diverse youth 

  • Transcend Support: Peer led support network and information hub for transgender and gender diverse children and their families 

  • Transgender Victoria: Transgender Victoria strives to achieve justice, equity and quality health and community service provision for trans and gender diverse people, their partners, families and friends 

  • Zoe Belle Gender Collective: An online not-for-profit seeking to provide support, training & resources for the Victorian trans and gender diverse community 

  • Parents of Gender Diverse Children: Provides peer support to parents and those parenting trans and gender diverse children 


Apply for help for seeking access to treatment.

Justice Connect can put you in touch with lawyers who will help you through the legal process on a pro bono basis (for free!)

Call Justice Connect on 1800 STAGE2 (1800 782 432)

  This resource was last updated on 1 September 2019. This is legal information only and does not constitute legal advice. You should always contact a lawyer for advice specific to your situation. Please view our disclaimer for more information.

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