Olivia Donaghy, a founding clinician at the Queensland Children's Gender Service at the Brisbane Royal Children's Hospital, is contemplating resigning because of the state's ban on puberty blockers in the public system.
The move reflects wider tensions between clinical expertise and government policy. Donaghy noted that "if you don't have enough money to go to private care, you don't have gender-affirming care in Queensland anymore" and that "it's created this real inequity."
In January 2025, Queensland's Health Minister Tim Nicholls announced an immediate halt on access to puberty blockers and hormone therapy for new public-system patients under the age of 18 who were experiencing gender dysphoria. The policy includes an immediate pause of hormone therapy for public patients under the age of 18.
Donaghy's professional concerns align with her clinical observations. In her work completing a PhD on satisfaction among people who received gender-affirming medical treatment, she has heard "over and over from young adults who come to see me a real sorrow that they didn't have access to puberty blockers."
The policy has created significant barriers for families. The decision has left at least 491 children stranded without access to care. Those unable to afford private treatment face extended waits or no treatment at all.
In December, the government announced the ban would remain in place until at least 2031, pending the results of the UK Pathways Trial. Health Minister Tim Nicholls said the ban will remain in place until the results of the PATHWAYS trial in the UK are known in 2031, where an indefinite ban has been in place since December 2024.
The policy has faced sustained opposition from professional medical bodies. 415 signatories, including more than 140 medical professionals, signed an open letter in December calling for the government to reinstate healthcare for trans youth, saying the decision defies expert medical consensus, global guidelines, community expectations and the government's own human rights obligations.
Workplace stress at the clinic itself predates the current ban but has intensified. The evaluation report extensively comments upon the psychological stress experienced by QCGS clinicians, including being under constant criticism and scrutiny resulting in lower productivity, reputational damage, high rates of sick leave, resignations and vacancies.
The constitutional and legal dimensions add another layer of complexity. In October, the Queensland Supreme Court found that the ban was unlawful as it was made under improper political direction from the Health Minister and without the legally required consultation with affected health services. Yet seven hours after the ban was overturned, Nicholls had issued a new directive reinstating it.
The findings of the independent Vine review do not recommend a blanket ban on puberty blockers or hormone treatments, recognising the complexity of care and the need for careful, individualised, multidisciplinary decision-making. This gap between expert review findings and government policy implementation remains a source of professional frustration for clinicians.
For Donaghy and her colleagues, the core tension remains unresolved: they work within a regulatory and professional framework requiring evidence-based practice, yet operate under a policy they believe contradicts that evidence. Whether she stays or leaves, that conflict will shape the future of youth gender healthcare in Queensland.