A fifteen-year-old boy who has male external sexual organs but female internal sexual organs will be offered prosthetic testicles and undergo irreversible sex-changing treatment, but will still be able to have a baby, a Family Court judge has ruled.
Although children with gender identity conditions can begin reversible first stage treatment without the approval of the Family Court, second stage treatment, as requested in this case, required the authorisation of the Family Court, despite the consensus among the boy’s parents and medical team that to deny or delay such treatment could be “psychologically and socially very damaging” to the child.
The child, given the pseudonym Dylan, is genetically a girl but physically a boy due to a disorder that produces excessive male hormones in the womb.
Family Court judge Michael Kent ordered the teen be allowed to receive testosterone injections to begin male puberty.
Dylan’s endocrinologist has also recommended the child have prosthetic testicles inserted once puberty is complete.
Dylan faces a lifetime of hormone treatment.
Doctors say Dylan may still be able to give birth “should he choose that later in life”.
Dylan’s parents were forced to go to the Family Court to get approval for the sex-change drugs, which are referred to as the “second stage of treatment” following use of puberty blockers.
Family Court approval for second stage treatment is in line with a recent Full Court of the Family Court decision, like Re: Jamie [2013] FAMCAFC 110, whereby first stage ‘reversible’ treatment can be undertaken without Family Court authorisation, although strict standards need to be met, however any second-stage ‘irreversible’ treatment requires the oversight and authorisation of the Court.
Dylan’s sexual status is termed “intersexual”.
Dylan was not diagnosed until the age of 15 months, and his parents waited until the child was 11 to tell him he was “part female”.
At the age of 13, Dylan had a pelvic scan to confirm there were ovaries present.
“It was explained to Dylan that he could potentially be fertile as a female in the future if he wished,” Justice Kent said.
“Dylan and his family are aware that if Dylan continues to live as a male, he will eventually need to have his internal female organs removed.
“However, at the present stage, the medical plan … is to defer such surgery until Dylan reaches the age of 18.”
Dylan will need testosterone treatment for life, either through injections every three months, or a “pellet” can be implanted under the skin or through patches, gels or tablets.
Dylan’s condition is known as congenital adrenal hyperplasia, which triggers a spurt of male hormones while the baby is in the womb.
Dylan’s endocrinologist, who cannot be named for legal reasons, said if Dylan was not given the testosterone female puberty would begin, which would be “psychologically devastating” for the child and may lead to obstructed periods.
Another option would be to give Dylan puberty blockers until the age of 18, which would also be “psychologically and socially very damaging”.
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