The Australian Government has requested the National Health and Medical Research Council (NHMRC) develop new national clinical practice guidelines for the care of trans and gender diverse people under 18 with gender dysphoria (Gender Guidelines).
NHMRC has a long history of developing guidelines related to health, and of supporting other guideline developers to do so. NHMRC guidelines are intended to promote health, prevent harm, encourage best practice and reduce waste. They are developed by multidisciplinary committees that follow a rigorous evidence-based approach. NHMRC guidelines are based on a review of the available evidence and follow transparent development and decision-making processes. They are informed by the judgement of evidence by experts, and the views of consumers, community groups and other people affected by the guidelines.
Development of the Gender Guidelines is expected to take 3 years. Interim advice for public consultation on the use of puberty suppression will be available in the middle of 2026. This webpage will be updated as the project progresses.
The terms trans and gender diverse describe people whose gender identity differs from the sex that was recorded for them at birth. While national prevalence data for trans and gender diverse young people in Australia are limited, survey findings provide some insight. A 2021 study reported that around 7% of adolescents aged 14–18 identified as trans or gender diverse,1 a notable increase from around 2% in a 2018 survey of the same age group.2
Gender incongruence is a clinical term used to describe a persistent inconsistency between an individual’s experienced gender and their sex recorded at birth. Gender dysphoria is also a clinical term and describes the emotional distress that can arise from gender incongruence. Both nationally and internationally there are reports of increasing referrals to specialist gender services for children and adolescents experiencing gender dysphoria. Importantly, not all trans or gender diverse people experience gender dysphoria.
Young people under 18 who experience gender dysphoria and seek support, where available, may receive multidisciplinary care through a broad, coordinated approach. This can include psychological, social, behavioural and/or medical care.
Medical interventions as part of medical care for trans and gender diverse people under 18 with gender dysphoria can include the use of puberty suppression and/or gender affirming hormones. Puberty suppression involves the use of medications to delay the onset or progression of puberty. Hormone therapy using estrogen or testosterone can be given to physically feminise or masculinise the body. Only a portion of those who access gender affirming care go on to access puberty suppression and/or gender affirming hormones.
1 Power, J., Kauer, S., Fisher, C., Chapman-Bellamy, R., & Bourne, A. (2022). The 7th National Survey of Australian Secondary Students and Sexual Health 2021 (ARCSHS Monograph Series No. 133). Melbourne: The Australian Research Centre in Sex, Health and Society, La Trobe University.
2 Fisher, C. M., Waling, A., Kerr, L., Bellamy, R., Ezer, P., Mikolajczak, G., Brown, G., Carman, M. & Lucke, J. 2019. 6th National Survey of Australian Secondary Students and Sexual Health 2018, (ARCSHS Monograph Series No. 113), Bundoora: Australian Research Centre in Sex, Health & Society, La Trobe University.
Scope of the Gender Guidelines
NHMRC is developing the new national evidence-based clinical practice guidelines for the care of trans and gender diverse people under 18 with gender dysphoria.
These guidelines will be developed in line with NHMRC Standards for Guidelines and Guidelines for Guidelines, and the international GRADE (Grading of Recommendations, Assessment, Development and Evaluation) approach. The guidelines will focus on ensuring that trans and gender diverse people under 18 receive safe and appropriate care.
How to get involved
NHMRC recognises the importance of consumer and stakeholder input to ensure the Gender Guidelines are relevant and meaningful for young people seeking care, their carers, families and their clinicians. Draft guidelines will be issued for public comment and consultation. Other opportunities for input will be communicated through this webpage and the contact list. See the Communications webpage for more information.
Contact list
NHMRC has created a contact list to provide stakeholders with updates on this project. All interested stakeholders are invited to subscribe to the contact list via the form below. NHMRC will use this contact list during the project to communicate opportunities for stakeholder involvement.
