Teenage girl who wants to be a boy wins right to have breasts removed

May 6 2009

Reports than a teenage Australian girl has won the right in court to have both breasts surgically removed, have made the headlines around the world and evoked some very strong criticism.

The 17-year-old, known as Alex in court and referred to as a boy, was born female but lives as a male, has a psychological condition that makes him/her unhappy with his/her gender.

The Family Court in Melbourne has decided that the removal of both breasts would help Alex to build a new life as a boy but the decision has evoked anger from many who say it is irresponsible.

According to reports Alex has "gender identity dysphoria", a psychological condition where a person believes they are the opposite sex and has been on hormone treatment since he was 13 to prevent menstruation.

Alex apparently applied to the court for a double mastectomy before he turned 18 - the age at which he would not need the court's consent and which he would no longer receive social support services as a minor.

Family Court chief justice Diana Bryant says Alex lives life as a male, was socially constrained by the breasts, avoided being hugged and wore binding at the beach and the breasts were an impediment to his social development, which everyone thought was very important.

Judge Bryant was quoted as saying that the evidence 'overwhelmingly' showed, that it was in his best interests and the order was made quickly so that he could have the operation straight away.

Many critics say that such radical surgery on a 17-year-old is irresponsible and premature and many experts say the desire to change sex is a psychological disorder and not one that should be treated medically.

Professor Nicholas Tonti- Filippini, the head of bioethics at the John Paul Institute in Melbourne says it is not at all clear on the basis of the medical evidence that this is in her best interests.

In 2003 the court gave Alex permission to have hormone treatment that would begin the sex change process.

Dr. Tonti-Filippini suspects in this case that the Family Court has been given limited expert opinion and that surgery is not what is called for and most psychiatrists who treat people with gender dysphoria do not recommend surgery and transsexual changes, and such a person may not be socially well adjusted and that is what should be dealt with.

Dr. Michael Robertson, a senior research fellow at the centre for values, ethics and the law in medicine at the University of Sydney says there are some people who are confused or distressed about their gender and it reflects a mental illness, such as a psychotic illness or a severe disturbance of personality - but the large majority, in his experience, live lives in very rational and reflective ways as a different gender and do not have a psychological disorder and he believes the key issue in this case was whether Alex could give consent.

Dr. Robertson says it is a simple question of whether capability or capacity was resolved in this case.

Jenny Millbank, a family law expert at the University of Technology Sydney says she believes it was a responsible decision as such youngsters have very high rates of self-harm and often fail to reach adulthood.

The Family Court says the decision will be published soon.