Australian universities have been ¡°pathetic¡± and their senior leaders ¡°culpable¡± for eschewing the public debate around youth gender medicine, according to academics who endorsed a call for a pause on chemical and surgical transitions among children and young people.

The wider academic community¡¯s silence on the issue was ¡°a failure of moral courage¡± ¨C albeit an understandable one, given the ¡°inevitable blowback¡± and threats to ¡°job security or personal safety¡±, they said.

Twenty-four academics were among the 112 doctors, politicians, lobbyists and others who signed the 29 January??to prime minister Anthony Albanese and other key politicians.

It describes the use of puberty blockers, cross-sex hormones and gender reassignment surgery as a ¡°potential public health disaster of generational significance¡±, saying there was no clear evidence supporting procedures that risked ¡°irreversible harm¡± to young people¡¯s bone density, fertility, sexual function and brain development.

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The letter cites last year¡¯²õ??by UK paediatrician Hilary Cass, which found ¡°remarkably weak¡± evidence for youth gender interventions. Britain¡¯s then Conservative government subsequently?halted?the routine prescription of puberty blockers to people aged under 18 ¨C a ban since?extended indefinitely?by Labour.

The open letter also cites an??by 23 academics led by two University of Sydney researchers. It found that guidelines encouraging medical interventions for gender dysphoria had defied worldwide concerns about safety, burgeoning adolescent caseloads and reports of ¡°harm and regret¡± from former patients.

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The letter also cites??in the work of the World Professional Association for Transgender Health (WPATH), whose guidelines had been found to ¡°lack developmental rigour¡± by the Cass review.

¡°The safety and well-being of Australian children depend on a swift response to this public health crisis,¡± the letter says, demanding an independent inquiry to examine ¡°how this was allowed to happen¡±.

The letter emerged a day after??paused puberty blocker and cross-hormone treatment for new patients aged under 18, pending an independent review. Federal health minister Mark Butler??that guidelines on youth gender treatment would be reviewed and replaced.

In the US, the Trump administration proclaimed a??for medical gender transition of people aged under 19, in an executive order decrying the ¡°horrifying tragedy¡± of ¡°chemical and surgical mutilation¡±.

Supporters of gender transition treatment say it protects young people from great harm, including suicide. The Australian Human Rights Commission??the Queensland ban risked the ¡°physical and mental well-being¡± of children awaiting care.

¡°A fundamental human right is access to healthcare, and gender-affirming healthcare is part of this right,¡± said sex discrimination commissioner Anna Cody. ¡°Trans and gender-diverse children and young people should feel supported to affirm their gender by the adults in their lives and healthcare providers. These treatments are supported by evidence and¡­guidelines endorsed by medical experts.¡±

Times Higher Education?sought comment from four academics who have campaigned against ¡°transphobic ideology¡± among their colleagues, and from an academic consultant to an organisation that advocates for ¡°clear and easy¡± access to hormone therapy and surgical interventions. They declined to comment or did not respond.

But one used social media to attack the federal government¡¯s ¡°horrendous inquiry¡± and criticised Queensland¡¯s ¡°horrifying¡± decision in the??news website. ¡°The overwhelming expert consensus on these matters is that providing healthcare to young trans people is a lifesaving necessity.¡±

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An??warns that transgender youth will not be the only victims of Queensland¡¯s ¡°unacceptable¡± decision. ¡°In the US, targeting the healthcare of trans young people was the first step in the far-right¡¯s campaign to take away people¡¯s right to make decisions about their own lives and bodies ¨C including the right to an abortion,¡± it says.

Academic signatories to the Australian open letter said they had harboured concerns over the issue for several years. ¡°I would not offer an opinion on which side is right in the clinical debate over youth gender medicine, although it seems to me as a non-expert that the Cass review takes a sensible position,¡± said Clive Hamilton, professor of public ethics at Charles Sturt University.

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¡°The vociferous and often fanatical campaign by pro-trans activists has stampeded organisations like government departments and universities into capitulating to their demands. Well-qualified experts are raising serious questions about youth gender medical interventions and the possibly disastrous consequences, but they are being shouted down.

¡°I have expertise in the power of ideologies to damage evidence-based policymaking, especially in the climate change arena, and that is why I was asked to put my name to the letter.¡±

Cordelia Fine, professor in the history and philosophy of science at the University of Melbourne, cited longstanding ¡°uncertainty¡± about clinical approaches to gender dysphoria. ¡°Even while scientists and clinicians were grappling and debating this very difficult issue, the gender-affirmative model of care was being embedded within institutions and dissent was being labelled ¡®transphobic¡¯.¡±

She said her doubts about gender science had ¡°deepened¡± as she ¡°observed editors capitulating to activist campaigns, clear double standards and editorial gatekeeping¡±. She criticised assumptions that anyone with such concerns must be ¡°a conservative anti-trans bigot¡±.

Fine said academics on the left with similar views should ¡°speak up publicly to help depoliticise the issue. I have been on the political left my entire life. Medical science should fully embrace¡­the equality and well-being of trans people ¨C not by chanting slogans, but by producing reliable knowledge and safe and effective interventions.¡±

Henry Kha, a family law specialist at UNSW Sydney, said the legal position on ¡°gender affirmation¡± had changed significantly since 2020. ¡°Judges are not medical experts. I felt that it would be beneficial¡­if proper standards [were] put into place to resolve this issue in a more coherent and evidence-based manner.

¡°The letter demonstrates that this is a mainstream issue. The signatories come from a wide range of backgrounds and¡­a divergence of ideological views.¡±

Kate Phelan, a political scientist and philosopher at RMIT University, said some academics with concerns about youth gender medicine had been ¡°too afraid to put their heads above the parapet¡± after witnessing the treatment of the University of Sussex¡¯²õ?Kathleen Stock?and Melbourne¡¯²õ?Holly Lawford-Smith.

Academics ¡°who didn¡¯t have strong views either way¡± had learned that ¡°this is a discourse not to be questioned¡±, Phelan said.

Phelan continued that universities as institutions did not have a responsibility to advocate on transgender issues. But individual academics¡¯ reluctance to speak up suggested universities had failed in their responsibilities to promote academic freedom and ¡°cultivate intellectual virtues ¨C curiosity, desire for truth, commitment to free and open inquiry ¨C in students¡±.

Alan Davison, academic lead of the Australian Catholic University¡¯s Governance and Public Affairs Centre, said self-censorship and the ¡°almost unchallenged views¡± of advocacy groups had ¡°muted¡± universities ¡°as sites for genuine debate¡± on gender medicine. ¡°Academics have an ethical and intellectual duty to bring their skill sets and privileged positions¡­to enquire into issues for the public good. They are paid to think.¡±

Davison said the university sector and especially its senior leaders had been ¡°culpable¡± on the issue. ¡°There has not been sufficient open and transparent discussion about harm from relevant experts. Our media outlets and universities have not been providing the environment for such a discussion to occur.¡±

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Hamilton said universities had been ¡°pathetic in this debate, in some cases throwing their scholars to the wolves. There are plenty of savages in the ivory towers.¡±

john.ross@timeshighereducation.com