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Information on how education and care services support same sex attracted, gender diverse, transgender and intersex children and young people and affirm their gender identity.
An increasing number of children and young people are reporting a gender which differs to that which society would typically expect of the sex they were assigned at birth. Being gender diverse or transgender is not a mental health issue; however mental health issues can arise for these children and young people due to societal and cultural ideas about gender. They can feel confused, scared, marginalised, sad and often experience a lack of support. They also come up against negative attitudes, as well as laws and other institutional barriers which discriminate against gender diverse and transgender people. These experiences can be hard for a child to cope with without support.
An emotional wellbeing care plan HSP400 (DOC 111KB) can be developed by a treating health professional in consultation with parents to describe additional care or supports required to support same sex attracted, gender diverse, transgender and intersex children and young people in education and care services.
What does it mean for a child to be transgender or gender diverse?
Children and young people whose gender differs to what society would typically expect of their gender assigned at birth are often referred to as gender diverse or transgender.
Transgender generally refers to a child who was assigned as male at birth but is female, or a child who was assigned female but is male.
Cisgender refers to a child who identifies with the gender they were assigned at birth
Gender diversity refers to a child who may have a range of gender identities and practices, combine different genders, or identify as having a non-binary gender. Gender diverse children may express themselves in many different ways.
Non-binary refers to a child who may not be exclusively male or female. They may use pronouns to signal their non-binary gender, such as ‘they’.
Gender dysphoria is the distress some transgender or gender diverse people feel when their body differs from other peoples’ of their (typically assigned at birth) gender.
Intersex variation refers to a person who was born with chromosomes, genitals, and/or reproductive organs that do not fit into the narrow ideas of what constitutes ‘male’ or ‘female’. Intersex individuals are different from transgender or gender diverse people.
Sexual orientation refers to who you are attracted to sexually. Gender is different from sexual orientation. Someone who is transgender or gender diverse may be heterosexual, gay, lesbian, bisexual, pansexual or asexual.
Sexual diversity refers to a diverse range of different sexualities, identities, and romantic or sexual attractions. This term includes those who may identify as same sex attracted, lesbian, gay, bisexual, pansexual or who may use other terms. Sexual orientation is defined in legislation as meaning a person’s sexual orientation towards:
- persons of the same sex; or
- persons of a different sex; or
- persons of the same sex and persons of a different sex.
The language used to affirm the identities of gender diverse and transgender people is constantly evolving, but it is a vital part of how we show our respect and support. Parents of Gender Diverse Children (PGDC) have developed a selection of terms that might be helpful.
Issues gender diverse or transgender individuals face
Mental health challenges
Gender diverse or transgender individuals may experience mental health challenges due to discrimination. For example, they may not be treated with respect or valued in society.
Individuals who are gender diverse or transgender are at very high risk for poor mental health, self-harming and suicide attempts.
Telethon Kids Institute TransPathways 2017 study determined:
- three out of four experience anxiety or depression
- four out of five have engaged in self-harm
- almost half have attempted suicide
Accessing appropriate health services
Gender diverse and transgender people find it difficult to access health services with:
- 60% feeling isolated from medical and mental health services
- 42% having reached out to a service provider who did not understand or respect their gender identity.
Issues with health services included a lack of education about gender diversity, transphobia and not knowing where to refer clients.
Negative school experiences
While some gender diverse and transgender people have positive experiences of school, this is often not the case. Negative school experiences include difficulties with peers and friendships, harassment and violence, fears for safety, social exclusion, issues in relation to uniforms, toilets and sports, and other forms of discrimination.
Individuals may miss school or change schools in order to avoid such negative experiences, resulting in disrupted schooling, with potentially long-term consequences for their mental health, educational achievement, and future employment.
Fear of puberty
Physical changes in puberty like developing breasts, menstruation, body and facial hair, a deepening voice and other characteristics, can be particularly distressing for gender diverse and transgender children.
It is unlawful under state and federal laws to discriminate against a person on the grounds of their sexual orientation, gender identity or intersex status.
- require schools to take reasonable and proportionate measures to eliminate discrimination on the basis of sexual orientation, gender identity or intersex status, including by taking positive steps to promote an inclusive school environment
- prohibit direct and indirect discrimination on the basis of sexual orientation, gender identity or intersex status.
Direct discrimination occurs when a person treats a person with a protected attribute (such as a gender identity, intersex status or sexual orientation) unfavourably because of that attribute. For example excluding a transgender student from using the toilet that matches their gender because of the sex they were assigned at birth.
Indirect discrimination occurs where a requirement, condition or practice is applied to all children and young people equally but its application is likely to have the effect of disadvantaging someone with a protected attribute (such as gender identity, intersex status or sexual orientation), and it is not reasonable, for example, to apply a uniform policy with only ‘male’ and ‘female’ options. The result of that policy might be a child with a non-binary identity being required to wear the uniform of their sex assigned at birth rather than their gender identity.
Refer to the Department for Education intranet site (staff login required) for the supporting same sex attracted, intersex and gender diverse students policy and transgender and intersex student support procedure.
An emotional wellbeing care plan HSP400 (DOC 111KB) can be developed by a treating health professional in consultation with parents to describe additional care or supports required in education and care services.
The wellness, stress and distress questionnaire (WSDQ) HSP426 (XLSX 264KB) is a brief emotional and behavioural screening questionnaire for children and young people. The tool can capture the perspective of children and young people and their teachers.
Education and care services must work with children and young people transitioning or affirming their gender identity to prepare and implement a health support agreement HSP120 (DOC 243KB). The Health Support Agreement should clearly identify cultural, spiritual and language needs.
The support plan should be developed in consultation with the individual and their parents (where possible*) and should be reviewed periodically to ensure it reflects the needs of the person at the different stages of their transition.
*There may be circumstances in which children and young people wish or need to undertake gender transition without the consent of their parents and/or without consulting medical practitioners. Where parental consent is not able to be confirmed the education or care service leader can determine if the child or young person is mature enough to make their own decisions.
Legally the Family Court of Australia has forgone its need to prove ‘Gillick Competency’ (used in medical law to decide whether a child (under 16) is able to consent to their own medical treatment, without the need for parental permission or knowledge) which is now passed to the treating practitioner and family when:
- the transgender teenager has been diagnosed with gender dysphoria;
- the transgender teenager’s treating practitioners agree the child is Gillick competent; and
- there is no controversy regarding the application (eg disagreement between the parents or doctors about the treatment).
It is important the child is at the centre of creating their support plan and consulted in all decision making. When developing the education and care service considerations should include:
- maintaining appropriate privacy and confidentiality – not everyone needs to know the child is transgender. Consider the privacy of the child and only share information to those who have an appropriate reason to know
- consulting on and confirming:
- the referencing of and recording of child’s name, gender identity, and pronouns (he, she, they etc.)
- the use of toilets, showers and change rooms that meet the needs of the child. This should be based on the child’s gender identity and whichever facilities they feel most comfortable using. Children without a disability should not be required to use disabled toilets or facilities
- the appropriate uniform that reflects the gender identity of the child and meets the education or care dress or uniform code
- developing a communications plan that includes what information staff members and other children and young people need to know
- providing support to staff through professional learning and briefings on the arrangements for the child where appropriate
- updating school policies to include support for transgender and gender diverse children and responses to transphobic bullying
Publications that may assist education and care services include
• Guide to supporting a student to affirm or transition gender identify at school Safe Schools Coalition Australia
• Safe schools do it better. Supporting sexual diversity, intersex and gender diversity in schools Safe Schools Coalition Australia
• Guidelines for Supporting Sexual and Gender Diversity in Schools Equal Opportunity Commission of Western Australia
An emotional wellbeing care plan HSP400 (DOC 111KB) may be completed by a health professional in consultation with parents or legal guardians for children and young people with requiring support in education and care services.
Health support agreement
A health support agreement HSP120 (DOC 243KB) and safety and risk management plan HSP121 (DOC 147KB) may be completed where a parent indicates their child requires additional support and assistance. There does not need to be a care plan completed by a health professional in place. The support agreement is completed by the parent and education or care service to document specific risk minimisation strategies, individualised management and treatment for the child in the context of the education or care service.
The guide to planning health support – HSP125 can assist in the development of the health support agreement by prompting through a series of questions and considerations.
Education and care services must take reasonable steps to eliminate discrimination on the basis of sexual orientation, gender identity or intersex status. Education and care services must support same sex attracted, gender diverse, transgender and intersex children by:
- providing a positive, supportive and respectful environment
- respecting privacy and confidentiality in relation to all children
- supporting children who want to affirm or transition gender identity at school
- challenging all forms of homophobia and transphobia to prevent discrimination and bullying
- giving proper consideration to the impact of any requirement to participate in education and care activities according to gender identity or an assumption of heterosexuality (e.g. school formals, sports activities, camps).
Even though being transgender or gender diverse itself is not a mental health issue, getting support from a mental health professional may be helpful.
The Australian Psychological Society recommends mental health practices that affirm transgender people’s experiences. The find a psychologist service on the APS website can be used to identify a psychologist using the search option ‘gender identity issues’.
Parents of Gender Diverse Children have resources and online supports for parents.
The Rainbow Owl has books and resources for embracing and supporting trans and gender diverse children and young people.
The Student Wellbeing Hub has resources for educators, parents and students that promote student wellbeing and the development of respectful relationships.
Proud 2 Play seeks to encourage LGBTQI+ young people as well as their allies, friends and families to participate in sport and exercise by providing structured opportunities and pathways.
When Transgender Kids Transition, Medical Risks are Both Known and Unknown an article about helping children who identify as transgender negotiate their journey into adulthood.
Health support agreement
- HSP120 Health support agreement (DOC 243KB)
- HSP121 Safety and risk management plan (DOC 147KB)
- HSP122 Offsite safety and risk management plan (DOC 148KB)
Planning and management tools
- Parents of Gender Diverse Children (selection of terms)
- Guide to supporting a student to affirm or transition gender identify at school
- Supporting sexual diversity, intersex and gender diversity in schools
- Guidelines for Supporting Sexual and Gender Diversity in Schools
- HSP125 Guide to health support planning (DOC 87KB)
- HSP426 Wellness, stress and distress questionnaire (WSDQ) (XLSX 264KB)
Disability and complex needs team
Phone: 8226 3620
Email: education.health [at] sa.gov.au