If Joanna* had access to Gateway Health’s Gender Service when her seven-year-old son was questioning his gender, it could have saved “years of heartache”.
The Border mum, who shared her story anonymously to protect her child’s privacy, found she was shouting into a black void when she reached out for help almost a decade ago.
She said it was a fight to find a professional at a local health service who understood what her family was going through.
“There was no help for me up here,” she said.
“(At the service) they told me there was nobody there that could help me, and I refused to leave.
“I was beside myself, because I did not understand what was happening to my child.
“They got someone to come speak to me and we saw her for about six months; she was learning as we were learning.”
A Canberra psychiatrist was flown down to see Joanna and her son, the catalyst for this specialist to visit regularly to meet with Border families.
“We cut through the red tape and she got us into the Royal Children’s Hospital Gender Service, because at the time you couldn’t be seen by them unless you were an in-patient of theirs,” she said.
“My child was placed on puberty blockers and even then we had to travel down there to get a prescription, it wasn’t allowed to be sent up.
“It’s just so hard living here in Wodonga, travelling so far on a regular basis – every six to eight weeks we would travel all the way there, even to sit and wait for a blood test.”
Joanna persisted, and it paid off.
“My child is now very happy, outgoing and confident,” she said.
“It’s been a very long, difficult journey, but thank God we have this centre here now in Wodonga, and hopefully others won’t be able to go through what we did.”
The Royal Children’s Hospital Gender Service is the only comprehensive clinic in Australia for children requiring specialist gender support.
It acts as the point of expertise for the country on gender dysphoria in youth aged up to 17, and offers treatment including puberty blockers and cross hormones.
There is no framework for the establishment of gender services outside of Melbourne.
It became clear to Sarah Roberts, Gateway’s WayOut Wodonga project worker, back in 2013 that there was lacking access to support for people in North East Victoria.
“The WayOut project started in May 2013 and in October we held a forum for community members, and we had a number of parents and gender-diverse young people there,” she said.
“We had really good discussions around key issues and one of the big things that came up was around access to services.
“Often young people are not supported by their family.
“It can be a very isolating, overwhelming and confronting experience.”
“At the time in 2013, at any mention of gender you would be referred straight to the RCH – there was no local support.”
From that forum, a community reference group was formed – but Ms Roberts said it wasn’t until recently that the pledge to open a service in Wodonga was made.
“At the start we didn't think it would culminate with this ... the idea came about in May 2015,” she said.
“We pushed the idea of bringing more of the work here the RCH offers, and they really endorsed that because of their wait lists – at the time they had over a 12-month wait period to access their service.”
That year-long wait for young people and their families can be damaging, said Rachel Richardson, a member of Gateway’s Gender Service community reference group.
“This is a time-critical area of medicine,” she said.
“It’s really important that families are made aware of what the situation is, that a proper professional assessment is made early and decisions can be made about what to do.
“This is about dealing with young people whose internal sense, their core sense of gender, is different to that which is indicated by their sex at birth.”
Kerry Lee-Power, also a reference group member and passionate counselling student, said those young people experiencing gender dysphoria needed support around them to maintain their well-being.
“Transgender children and adults have the highest risk of suicide in the country,” she said.
“It ripples right through the family – there’s marriage breakdown as often one parent doesn’t see the way the other parent does, and there’s conflict.
“The biggest problem most families have, is they simply don’t know who to ask.”
Having someone to ask has been a huge relief for the four young people that have so far visited the Gateway Health Gender Service nurse Ange Davidson since the start of March.
Ms Davidson, whose team includes two pediatricians and a psychiatrist, can also provide advice to schools and other health providers.
Gateway Health chief executive Leonard Peady said he was planning for the future of the Gender Service.
“We are excited to be the first in regional Australia to offer a multidisciplinary service for our community’s transgender and gender-diverse children, adolescents and their families,” he said.
“We have made a range of changes to our Wodonga office including installing all-gender restrooms and training for staff, to create a more inclusive service.
“The Gender Service nurse co-ordinator position is funded until December 2017, and we are seeking opportunities to secure the Gender Service into the future.”
With the Royal Children’s Hospital expecting 300 referrals this year alone for gender support, it will be unlikely some form of need will not resonate in the North East.
Dr Richardson said it was crucial Gateway Health continue with their venture.
“There is definitely un-met need here on the Border,” she said.
“Those families are going to get real value out of knowing there is actually a service and someone they can talk to, and that’s what really matters.”
The Gender Service is open on Wednesdays and Thursdays from 9am to 5pm. Appointments can be made at (02) 6022 8888.
*Joanna is not her real name.