TransHub is a website owned and operated by ACON.
It was written in extreme haste by Teddy Cook and Liz Duck-Chong. Together they spent 6 months to get it off the ground. Who are they?
Teddy and Liz work for (or better still, they are) the ACON Trans Health Equity Unity.
Teddy is co-inventor of GRUNT, the website designed to bring women into gay male spaces. Liz is a writer and film maker and, “sexual health nerd”. Teddy seems to have done the hard yards working for ACON, but Liz’s qualifications aren’t readily available for some reason. Together they played on the team of trans activists who brought you lots of trans-research.
What does ACON say about medical gatekeeping?
All gender affirming care must be inclusive, self-determined and rights-based.
https://www.transhub.org.au/gatekeeping?rq=gatekeeping
Name another illness, condition or medical management pathway that is “rights-based” or “self-determined”.
One would be pregnancy and obstetric care. Where healthy women routinely submit to medical management to mitigate the risks of childbirth. Women have been fighting for (years, decades, centuries?) for self-determination and control in the labour room. Still we are medicated, ignored and mistreated.
The other is cosmetic surgery. A user-pays model ensures that the process is driven by the customer. This is what transgender care is: cosmetic alteration on demand. With a suicide threat thrown in for good measure.
The footnote index after “tragic consequences” lazily links to a list of sources rather than to the specific source for each claim. Item 1 on the list is a VIEWPOINT article written by TRANSGENDER ACTIVIST Florence Ashley.
What Might Constitute Medical Gatekeeping? (According to ACON)
There are 1 or 2 reasonable red flags embedded in this list. Delaying care without a clear reason is
| Red Flag | Comment |
| Refusing to take on trans or gender diverse patients and clients | Doctors can refuse to take patients they don’t feel equipped to handle. This is the essence of specialisation. Would you rather have a doctor who felt out of her depth, and forced into a care relationship, or a doctor who loved slicing off healthy breasts? |
| Requiring unnecessary steps in order to access gender affirmation, eg. Mandating a psychiatrist or endocrinologist is assessment for all patients | If Transgender is not a mental disease, it is surely a mental viewpoint. Doctors would be doing malpractice if they started medically treating patients who didn’t have the condition being treated. Endocrinologists are specialists who deal in human hormones. They are the ones who manage hormone treatment. How is it a red flag for a doctor to send a hormone-requesting patient to a hormone-specialising doctor? |
| Delaying gender affirming care without a clear health-based reason, or for reasons of “watchful waiting”, a well-established conversion practice | Delaying care without a reason sounds very fair. However “watchful waiting” isn’t delay of care. It is a specific form of non-medical care. |
| Not providing all the information or answers as to why a particular decisions has been made | Quite fair. Patients generally should have access to information about why decisions were made. |
| Requiring trans and gender diverse people to adopt a binary identity, or refusing to accept or learn about non-binary identities | This is just bizarre. “Refusing to learn about”. “Forcing to adopt”. How do they force you to adopt an identity? If you feel “forced” by your doctor to adopt an identity, you can choose another care provider. |
| Requiring invasive and unnecessary examinations or testing in order to access care | This is quite fair. But it is now tinted by the previous items that seem to imply the patient should be the only one driving the medicalisation bus. At this point I wonder what constitutes an “invasive and unnecessary” examination or test. Since referring out to a specialist is seen as a medical red flag, what is it we are actually talking about here? My mind leaps to unnecessary genital contact, but do they actually mean routine blood work? |
| Engaging in conversion or aversion therapy (or Gender Identity Change Efforts) | How does one perform gender identity conversion therapy? Tell a girl that her body is beautiful and unique and she will be an excellent engineer even without hormonal therapy? |
| Any discussion of ‘Rapid Onset Gender Dysphoria’ | This is the item that gives the game away. Any clinician who is interested in their patients will make the link between a teen girl who is the 4th in her friend group to declare a trans identity and Lisa Littman’s research on ROGD. This is the cutting-edge science. It’s the science they don’t want you to know about because it casts their beloved transgender identities as vapid trend-based stereotypes. |
| Over-inflation of regret rates | And how, oh how, would the patient know what the regret was was? Despite all efforts to blank out this evidence, there ARE regretters, desisters, detransitioners. Famously, Walt Heyer’s website https://sexchangeregret.com/ receives multiple emails a day from people who change their minds. |
In Conclusion
TransHub want us to believe that gatekeeping is dangerous. They want us to believe that gatekeeping is a defined set of behaviours. However many of their red flags can be explained as something else (such as not wanting to take on a complex patient) or as due diligence (referring to a specialist).
TransHub’s list of gatekeeping behaviours is designed to cast suspicion on any medical practices that might result in a patient hearing a “no” or a “wait” or a “I think there might be other problems to deal with”.
This list is designed to open the express route to a medical pathway. it benefits the over-eager patient, it benefits the pharmaceutical company and it benefits the surgeon.
It does not put the need for holistic care front and centre.
The Lady Kit Kowalski 
