Re Alex

Re Alex : 2004 Fam CA 297 ("Re Alex")
Court	Family Court of Australia
Full case name	Re Alex : Hormonal Treatment for Gender Identity Dysphoria [2004] FamCA 297 (13 April 2004)
Decided	13 April 2004
Citation(s)	Austlii
Court membership
Judge(s) sitting	Chief Justice Nicholson

2004 Fam CA 297, "Re Alex" was a legal case decided in the Family Court of Australia on 13 April 2004. It examined the rights of a thirteen-year-old adolescent affirming his male sex and seeking hormonal medical treatment "Sex Affirmation Treatment."

Case

An application was made concerning a thirteen-year-old referred to as "Alex". Alex was a ward of the State of Victoria. Alex was diagnosed as experiencing the condition called "Gender Indentiy Disorder" (known commonly as Transgender) controversially contained in the Diagnostic and Statistical Manual of Mental Disorders ("DSM IV") maintained by the American Psychiatrists Association.

The key issue was whether the Victorian State Government Department having the responsibility for Alex's care and welfare or the Family Court of Australia should have responsibility for the authorisation of medical treatment involving the administration of hormonal therapies to assist Alex to have a body with secondary sexual characteristics most appropriate to his innate affirmed male sex and, in so doing, relieve him of the extreme suffering he was experiencing as a result of female pubertal development.

At birth and, at the time of the case, Alex was, in the eyes of the law, a female.

Judgment

Chief Justice Nicholson ruled as follows:

• That the hormonal medical treatment sought by Alex was "Special Medical Treatment" as per the High Court of Australia's decision in Marion's Case and that therefore only the Family Court of Australia, and not parents or legal guardians, has the legal authority to authorise such treatment.
• Neither Alex nor any adolescent who is Transgender was capable of "Gillick Competence" to authorise such medical treatment on their own behalf.
• Alex's treating doctors were ultimately authorised by the court to commence a form of hormonal treatment - that did not constitute the full Phase 1 and Phase 2 programme of hormonal treatment (referred to as the "Dutch Protocol") that is administered today if the young person presents for and gains court authorisation for treatment by Tanner Stage 2 of Pubertal development.
• Alex was permitted to be enrolled in school under a male name (although this was strictly necessary and not the role of the court even on this judgement).

Consequences

• As a result of his failure to receive Phase 1 treatment in time, and this judgment, Alex was obliged to undergo a double mastectomy in later adolescence and Alex's State guardian was obliged to again make application to the Family Court of Australia to obtain the court's authorisation.