For Kyro McDonald, a 19-year-old from Western Australia, accessing gender-affirming medical care felt like a prolonged standstill. At 16, when he came out to his family as a trans man, hormone therapy could have been within reach. Instead, he waited two more years.
The reason was straightforward, though emotionally complex: his mother was not yet ready. While she loves her son unconditionally, she struggled with the idea that he was not going through a phase brought on by his peer group. Without her consent, the law would not allow him to proceed.
In Western Australia, young people under 18 can access puberty blockers and hormone treatment only with the written consent of both parents or legal guardians. This parental gate differs from the blanket bans now in place in Queensland and the Northern Territory, where access has been frozen entirely for minors. But for families where parental agreement is delayed or fractured, the WA requirement creates its own version of a waiting game with serious consequences.
McDonald's experience illustrates the tension between two competing concerns that have dominated policy discussions across the country. Parents ask: how can they ensure their child is making a decision they will not later regret? Young people ask: why must I delay treatment when my distress is acute now?
After turning 18, McDonald had his first appointment and began hormone therapy in February 2025. Yet even after starting, he continues to wait. He has had to schedule an initial surgical assessment appointment for November 2026, more than a year away. "You shouldn't have to wait a year for a surgery when you're already feeling like shit for years and years and years," he said.
The strain on Perth Children's Hospital's Gender Diversity Service is evident in the numbers. As of March 2026, the multidisciplinary service was supporting 215 children and adolescents as young as 11, down from 392 in 2020. According to publicly available records, wait times for initial psychological assessment previously stretched to 4.5 years, with three-month waits just for a first appointment. Yet referrals to the service far exceed its capacity, and many older adolescents cannot be seen before they age out of the paediatric service.
The Child and Adolescent Health Service, which operates the Gender Diversity Service, notes that every young person undergoes a comprehensive mental health assessment and multidisciplinary team evaluation. Treatment options are explored based on the young person's physical development, gender experience, wishes, and existing supports. All decisions require written informed consent from both the young person and both parents or legal guardians.
The parental consent requirement reflects a deliberate legal principle established through Australian court decisions. In 2020, the Federal Circuit and Family Court ruled in Re: Imogen that medical practitioners cannot initiate puberty blockers or gender-affirming hormonal treatment without first obtaining written consent from all parents or legal guardians, even if the young person is deemed mature enough to make their own medical decisions.
This rule seeks to ensure that significant medical decisions are made with full family engagement. The underlying logic reflects a genuine concern: parents have historically borne the responsibility for their children's medical welfare, and the irreversibility of some hormone effects warrants caution. Yet the same principle creates profound difficulties when one parent delays agreement, is absent, or simply does not believe their child's gender identity is authentic.
Paula Gerber, a Monash University law professor and author of Sex, Gender & Identity: Trans Rights in Australia, sees the issue differently. She argues that giving parents final veto power over treatment undermines young people's autonomy and can create serious harm. "Not all parents are going to be understanding and supportive of their children," she noted. While she recognises the complexity of medical decisions, she suggests "it's probably best left to the young person and their health carers, rather than having parents being able to veto it."
Gerber also raised concerns about blanket government bans. Pointing to data on mental health outcomes for trans and gender-diverse youth, she highlighted the risk that preventing access to treatment "some children are just not going to be able to survive going through puberty in the wrong gender."
Sandi McDonald, Kyro's mother, has come to support her son's decision, though she acknowledges that the loss of the daughter she had expected to raise was difficult to process. Yet she firmly opposes blanket bans on these treatments. "If the child and parents have been counselled and gone through all the right steps, they should be given the right to utilise the blockers if it fits their circumstance," she said. She sees the parental consent requirement as important, but not as a blanket prohibition.
The landscape has shifted markedly in recent months. Queensland has extended a ban on puberty blockers and hormonal treatment through 2031, pending results of a UK clinical trial. The Northern Territory announced a similar ban in December 2025. In contrast, Western Australia continues to allow access with parental consent, but faces severe resource constraints.
The core issue facing WA is not ideology but capacity. The Gender Diversity Service lacks the funding and staffing to meet demand. Families seeking care often report navigating the public and private health systems through trial and error, experiencing extended distress as they search for appropriate services. Geographic sparsity makes access particularly difficult outside Perth.
For young people like Kyro, the result is a system that neither fully trusts their agency nor provides swift relief when families do agree on a path forward. The question Western Australia faces is whether its framework of mandatory parental consent without adequate service capacity actually serves the interests of young people or simply extends their period of suffering while decisions are made elsewhere.