Speaker 1: And what kind of questions are your patients asking you
Speaker 1: at the moment. What are you hearing from.
Speaker 2: Them, whether I'm going to have to close the clinic,
Speaker 2: if I'm going to be moving away, if I'm still
Speaker 2: going to be their doctor.
Speaker 3: This is a doctor practicing in the United States speaking
Speaker 3: to our producer Shane Anderson. We can't tell you the
Speaker 3: doctor's name, but for three months now her work has
Speaker 3: been under attack. She provides medical care to trains and
Speaker 3: gender diverse young people, and she says since Trump's executive
Speaker 3: orders came in January, providing that care has become much harder,
Speaker 3: and she's watched as her patients have suffered as a result.
Speaker 2: In fact, a lot of my trans kids have after
Speaker 2: tucks because the learning environment has become so hostile. In
Speaker 2: our state books supporting LGBT lifestyles with LGBT characters, I've
Speaker 2: been taken out of the libraries. Teachers are not allowed
Speaker 2: to answer questions about these things anymore. So it can
Speaker 2: be really scary to be a kid in circumstances of
Speaker 2: the US.
Speaker 4: Right now.
Speaker 3: For Schwartz Media, I'm Daniel James. This is seven AM today,
Speaker 3: seven AM. Senior producer Shane Anderson on the ordinary people
Speaker 3: pushing back against Trump's warren trans people and how Queensland
Speaker 3: became the testing ground for bands. Here it's Friday, April
Speaker 3: twenty five, and just a warning, this episode discusses suicide. Shane,
Speaker 3: you are able to speak with a doctor who provides
Speaker 3: healthcare to trans children and teenagers. We're going to use
Speaker 3: a pseudonym to protect her identity because her work is
Speaker 3: under attack right now. But tell me about her and
Speaker 3: what her work involves.
Speaker 4: Yeah.
Speaker 1: So I got into this story because I was really
Speaker 1: interested at looking at executive orders three months on now
Speaker 1: that the dust has settled from that initial blitzkrieg of
Speaker 1: orders back in late January, so I got talking to
Speaker 1: this doctor. Let's call her Sophie for ease of convenience.
Speaker 1: Sophie told me that she lives and mostly works in
Speaker 1: a red state in the Midwest. She's married with a kid,
Speaker 1: and she initially trained to be an obgyn, but expanded
Speaker 1: her practice when her son was little and he started
Speaker 1: wearing dresses to school, which is something that continued through
Speaker 1: until the second grade.
Speaker 2: And I found that there are no local resources for provents,
Speaker 2: so I started learning about it. Medical transition and treatments
Speaker 2: for young kids. Realized that estrogen and testosterone are things
Speaker 2: that I prescribed every single day, and it was very
Speaker 2: possible for me to be able to make an impact
Speaker 2: on the community and provide services.
Speaker 1: And so yeah, that's when she started getting into gender
Speaker 1: affirming care. That was seven or eight years ago, and
Speaker 1: she's been doing that ever since. But even before the
Speaker 1: executive orders came in, she says, it was difficult for
Speaker 1: her to do her job. She would have to travel
Speaker 1: over the state line to a blue state to provide
Speaker 1: care for her younger patients. But now since January, even
Speaker 1: blue states are feeling the effect of Trump's bands, and
Speaker 1: she said she's incredibly alarmed.
Speaker 3: Understandably, man, Can you tell me a little bit more
Speaker 3: about what exactly the executive orders are and how they
Speaker 3: affect her work.
Speaker 1: Yeah, So the main one was signed on January twenty eight,
Speaker 1: his title Protecting Children from Chemical and Surgical Mutilation. I mean,
Speaker 1: as you can hear in the title, it's a motive.
Speaker 1: It's intentionally inflammatory and a gross mischaracterization of what gender
Speaker 1: affirming care actually provides.
Speaker 5: The order states that the US will not fund, sponsor promote, assist,
Speaker 5: or support the so called transition of a child from
Speaker 5: one sex to another, and it will rigorously enforce all
Speaker 5: laws that prohibit or limit these destructive and life altering procedures.
Speaker 1: So it's actually been challenged already in the courts, but
Speaker 1: this order from January twenty eighth had enormous ripple effects
Speaker 1: on her ability to treat children.
Speaker 3: So how is that planning it so far?
Speaker 1: So the thing that Sophie explained to me is that
Speaker 1: the wording of the order leaves the door open for
Speaker 1: criminal charges for anyone providing gender affirming care promises to
Speaker 1: quote rigorously enforce all laws, even though it's not really
Speaker 1: specific what those laws are, and so it's generated this
Speaker 1: atmosphere of fear and paranoia around potentially what could come next.
Speaker 1: So the federally funded clinic that she works for has
Speaker 1: just gone into caretaker mode. They're not taking on any
Speaker 1: new patients, Sophie said. Clinics are shutting down, pausing care.
Speaker 2: Many people's psychiatrists, many transkind psychiatrists, dropped them as patients
Speaker 2: or stopped documenting gender tsporia completely as part of their
Speaker 2: care because they weren't afraid that they would be suoned
Speaker 2: for aiding and abetting transition care for any particular patient,
Speaker 2: and she.
Speaker 1: Said that this extends to parents as well, being too
Speaker 1: scared to go to the pharmacy and pick up medication
Speaker 1: for their children. And at the end of the day,
Speaker 1: she said, the impact, particularly you know, on children and
Speaker 1: families that don't have the means to work around all
Speaker 1: of these restrictions, it's been really significant.
Speaker 3: It sounds really scary for these families, for the people
Speaker 3: who are trying to work around these limitations. What does
Speaker 3: that look like. Is it's still possible to get gender
Speaker 3: affirming care.
Speaker 1: It is still possible. I specifically asked her what she
Speaker 1: is telling young people and their patients about how her
Speaker 1: ability to give them care is being impacted.
Speaker 2: I tell them that they should focus on being kids
Speaker 2: and let me worry about the legal stuff.
Speaker 1: But for adults she has changed tack a little bit.
Speaker 1: For example, if someone is considering gender reaffirming surgery, she's
Speaker 1: advising some of her patients that maybe they should hold
Speaker 1: off on making a decision about these surgeries just in
Speaker 1: case they lose access to those hormones over the next
Speaker 1: couple of years. Another thing that I had heard a
Speaker 1: lot about was report to people's stockpiling medication. So I
Speaker 1: asked about whether or not she was giving people advice
Speaker 1: around that, and she told me that actually, the stockpiling
Speaker 1: of medication is probably one of her biggest concerns for
Speaker 1: the safety of her patients.
Speaker 2: These medications aren't safe to use without labs and without
Speaker 2: physician supervision, So trans mails can get blood clots in
Speaker 2: their legs, they can have a stroke if there aren't
Speaker 2: too much testosterone.
Speaker 1: She said she's even seen patients this year where she's
Speaker 1: gotten the blood work back and found that their testosterone
Speaker 1: levels are putting them at risk of further serious health impacts.
Speaker 2: Now, if you were to ask me, what's the risk
Speaker 2: of not being able to access testosterone at all, for example,
Speaker 2: versus you know, being able to access it and having
Speaker 2: this small risk of having a stroke because you're taking
Speaker 2: too much, that's a really, really sad question that I have
Speaker 2: to answer.
Speaker 3: So Sophie's ultimately trying to keep doing her job even
Speaker 3: though it's obviously risky to do that. Trump's executive orders
Speaker 3: threaten criminal charges for doctors. So what did she say
Speaker 3: to you about how she feels about taking on that
Speaker 3: kind of legal risk.
Speaker 1: It's a huge risk and you know, she's going into
Speaker 1: it with open eyes. Her clinics have engaged lawyers. She
Speaker 1: told me. The advice that they've gotten is that there's
Speaker 1: really no way to know what the consequences of these
Speaker 1: executive orders are until you're actually sued.
Speaker 2: My goal is to continue to provide the care as
Speaker 2: best I can. My goal is not to violate laws.
Speaker 2: I am prepared to be sued in my home state
Speaker 2: and have contingency plans if I lose my license or
Speaker 2: if I'm incarcerated. We hope that it doesn't come to that.
Speaker 2: We're actually looking at moving to Australia things get really bad,
Speaker 2: but it's difficult because you work in the US. You
Speaker 2: end up spending a lot of money to become a doctor,
Speaker 2: and so the thought of having to start over is intimidating.
Speaker 2: But these kinds of things make me incredibly angry, and
Speaker 2: so if I don't do something, then I don't nuts inside.
Speaker 1: And she stressed to me that really these decisions go
Speaker 1: beyond the legal considerations for herself as well. Right like
Speaker 1: when she thinks about what might happen to her patients,
Speaker 1: especially her younger patients, if medical care isn't available, she
Speaker 1: says it's ultimately a matter of life or death. And
Speaker 1: can you just spell out and really explain for me
Speaker 1: what happens to the young people that you can't treat.
Speaker 4: If they have.
Speaker 2: A sense of hope in their lives that things will
Speaker 2: get better, things can get better, and a lot of
Speaker 2: them end up finding a lie these days, then sometimes
Speaker 2: they can muddle through, but many of them end up
Speaker 2: attempting suicide and their lives follow quote and they die.
Speaker 2: So we lose people all the time.
Speaker 3: After the break the Queensland kids facing healthcare.
Speaker 6: Bands Hi Ruby Jones here, seven am tells stories that
Speaker 6: need to be told. Our journalism is founded on trust
Speaker 6: and independence and now we're increasing our coverage Every Saturday
Speaker 6: until the election, will bring you an extra episode to
Speaker 6: break down the biggest political moments of the week. If
Speaker 6: you enjoy seven Am, the best way you can support
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Speaker 6: and supporting our work.
Speaker 3: Shane Trump's executive orders are having a chilling effect on
Speaker 3: trans rights in the United States. We're also now seeing
Speaker 3: setbacks in other Western countries too. But what is the
Speaker 3: situation in Australia.
Speaker 1: Basically the same day as Trump's directive. Back in January
Speaker 1: twenty eighth, Queensland state government put an immediate holt on
Speaker 1: all people under the age of eighteen receiving puberty blockers
Speaker 1: and hormone therapies in the public system.
Speaker 4: So when the band came in, it was a real shock.
Speaker 1: I spoke to doctor eloui's Brook about this. She's the
Speaker 1: CEO of OSPATH, which is a professional association for trans health.
Speaker 4: We've been worried for some time that there was going
Speaker 4: to be an opportunity for some state governments and territories
Speaker 4: to remove general fimincare. General fimin care is quite literally
Speaker 4: the safest and best way to support young people to
Speaker 4: get the best outcomes. So when that kind of gets
Speaker 4: closed down, everyone's shocked, everyone's horrified.
Speaker 1: We know that at the time the band was put in,
Speaker 1: there were four hundred and ninety one young people on
Speaker 1: the weightlist for the Queensland Gender Service and they really
Speaker 1: have two options now. They can go into the private system,
Speaker 1: which can be prohibitively expensive. We're talking you know, multidisciplinary
Speaker 1: care with psychiatrists and endocrinologists and medication alone, which can
Speaker 1: be worth thousands of dollars every couple months, or they
Speaker 1: can just not get care, which comes with a big
Speaker 1: mental health risk. And so this had a pretty devastating impact,
Speaker 1: especially on families who were, you know, just weeks or
Speaker 1: months away from starting puberty blockers. And Eloise actually shared
Speaker 1: with me a testimony from one of these families.
Speaker 4: Our heart broke for our little person who is due
Speaker 4: to start blockers in the first week of March.
Speaker 1: This is a family who'd already sat on the waitlists
Speaker 1: and at the very last moment had had support disappear
Speaker 1: in front of their eyes. And Eloise described their distress
Speaker 1: at not being able to afford private health care and
Speaker 1: some of the options the mother was even considering.
Speaker 4: All I could do was cry and have panic attacks
Speaker 4: about what this could mean for them. I thought at
Speaker 4: one stage that if I wasn't alive, my husband could
Speaker 4: use my super to pay for it.
Speaker 1: But the thing that really separates the situation in Australia
Speaker 1: from the situation and the States is how the federal
Speaker 1: government is responding. Mark Butler, the Health Minister, he immediately
Speaker 1: called on Queensland to pause the ban and he commissioned
Speaker 1: the National Health and Medical Research Center to do a formal, independent,
Speaker 1: scientifically backed review of the use of puberty blockers for children,
Speaker 1: and everyone I spoke to had a lot of hope
Speaker 1: that this review would follow what the science says that
Speaker 1: these medications are safe and vital for good mental health
Speaker 1: outcomes for young people. But this review is going to
Speaker 1: take a long time. I think twenty twenty six is
Speaker 1: when we'll expect to hear back from that.
Speaker 3: And in the meantime, how are people in Queensland trying
Speaker 3: to push back.
Speaker 1: Well, there is one legal challenge that's just taken its
Speaker 1: first steps. There is a mother who's put in an
Speaker 1: application to the Supreme Court trying to get more information
Speaker 1: from the Queensland Health Director General about the decision making
Speaker 1: that went into this snap ban. Another initiative underway is
Speaker 1: called Project four nine one, which was launched by doctor
Speaker 1: Elouise Brook from Ospath and they came up with this
Speaker 1: project which raises funds to bequeath to those families to
Speaker 1: get private treatment. To this date, they've raised over one
Speaker 1: hundred grand and they've only just launched a couple of
Speaker 1: weeks ago. On the thirty first of March Transgender Day
Speaker 1: of Visibility and so far they've helped support two families.
Speaker 3: I mean, that is amazing, but it's also not something
Speaker 3: that will be able to help the hundreds of families
Speaker 3: that may actually need support as well. So what does
Speaker 3: it say to you, Shane, that we're in a situation
Speaker 3: where a state government is making a decision like this
Speaker 3: and what is the likely impact for the future gender
Speaker 3: affirming care in Australia.
Speaker 1: I think it shows that people are learning from what's
Speaker 1: happening in the States and speaking to everyone in the
Speaker 1: process of making the story. I got the sense that
Speaker 1: the lesson is that it's kind of everyone's responsibility not
Speaker 1: to let the transgender diverse community become this political football
Speaker 1: in Australia and not to let, you know, this ideologically
Speaker 1: driven set of politics of the day kind of stand
Speaker 1: in the way of quite a significant body of medical
Speaker 1: research showing the safety of pubity blockers and hormone therapy.
Speaker 1: So and the backlash to what's happening in Queensland, especially
Speaker 1: at the federal government level, you know, does make some
Speaker 1: people cautiously optimistic that maybe there isn't that appetite for
Speaker 1: that kind of politics. More broadly in Australia, the same way,
Speaker 1: and to the same extent that it's happening in the
Speaker 1: US and the UK and the community support the groups
Speaker 1: like Project four nine to one have seen. I think
Speaker 1: our testament to that as well, and so while there
Speaker 1: was a lot of cautious optimism, there is also a
Speaker 1: warning to not get complacent.
Speaker 4: So really want people to keep focusing on how we
Speaker 4: support our young people. I am looking forward to that
Speaker 4: point when Project four nine one no longer is necessary,
Speaker 4: but I'm not sure when that might be.
Speaker 3: Shane, thank you so much for your time.
Speaker 1: Thanks for having me on, Daniel.
Speaker 3: If this episode has raised issues for you, or if
Speaker 3: you're concerned about someone you know, you can call Lifeline
Speaker 3: on thirteen eleven fourteen. You can also call q Life
Speaker 3: on one eight hundred one, eight four five two seven.
Speaker 3: Support is also available at Switchboard, Queer Space, Transcend Australia,
Speaker 3: Transgender Victoria and Minus eighteen. Also in the news, most
Speaker 3: doctors say they won't move to full bonk billing, despite
Speaker 3: promises by both major parties. ABCWS surveyed more than eight
Speaker 3: hundred gps and combine their findings with data from the
Speaker 3: Royal College of General Practitioners. Ninety percent of doctors told
Speaker 3: the ABC they wouldn't move to full bulk billing, with
Speaker 3: many saying the eight point five billion dollar scheme pledged
Speaker 3: by Labor and match dollar for dollar by the Coalition
Speaker 3: shows a lack of understanding for how general practice works.
Speaker 3: They warned the policy could incentivize shorter consults and compromise care,
Speaker 3: and the Prime Minister says there's no place for violence.
Speaker 3: After a series of incidents at pre polling booths this week, Yesterday,
Speaker 3: a teenager in Anthony Alberizi's electric was charged over an
Speaker 3: alleged assault of a man at a polling booth. The
Speaker 3: man was wearing a Maga hat. Prominence to Alberzi stressed
Speaker 3: the need for respect of polling booths and wished the
Speaker 3: man a swift recovery. I'm Daniel James. This is seven
Speaker 3: am and we'll be back tomorrow with the full rap
Speaker 3: of all the biggest political moments of the week. See
Speaker 3: it then
Speaker 6: You w