Putting transgender health on the radar

Murdoch Children's Research Institute fosters a culture of collaboration with the Melbourne Children's Campus partners - The Royal Children's Hospital, The University of Melbourne and The Royal Children's Hospital Foundation to rapidly embed research results in the fabric of everyday clinical care, and enable the careers of many talented clinician-researchers.

Critically, our Clinician Scientist Fellows are funded by The Royal Children's Hospital Foundation to give them valuable time to perform research, whereas previously they conducted unpaid research outside their clinical hours.

The scheme enables and enhances a two-way flow of information to improve research translation. Research findings can be quickly and effectively applied in the clinical setting, with the research agenda directly set by real-life issues that clinicians and their patients face every day.

Associate Professor Ken Pang is one of 18 Clinician Scientist Fellows funded by the Foundation. After starting out as an immunologist and genetic researcher, Ken's clinical and research priorities have evolved into providing the best care possible for trans and gender-diverse children and adolescents.

Transgender healthcare for children and young people is a relatively new field, and more research is urgently needed to better inform the team's clinical work and ensure safe and effective outcomes.

This is especially important given that trans and gender-diverse young people face significant health and social challenges. For example, Australian data show that 80 per cent of transgender young people self-harm and 48 per cent attempt suicide before the age of 24.

Ken (pictured above, with Charlotte, a client at the Gender Service) runs the Institute's Trans20 research project, a longitudinal cohort study that began in 2017 with the generous support of the Foundation.

Trans20 aims to determine the biopsychosocial outcomes for transgender individuals attending the Gender Service, looking at gender identity, transition, dysphoria and gender-related healthcare, as well as mental and physical health, education, quality of life and family functioning.

Over the next 20 years, the team will be able to address important questions, such as the evolution of gender identity and dysphoria, and the role and safety of different interventions, both medical (such as puberty blockers and cross-sex hormones) and psychosocial (such as cognitive behavioural therapy).

In 2020, the Trans20 team released results from studies examining rates of fertility preservation and showed that more than 60 per cent of transgender adolescents assigned male at birth attempted fertility preservation prior to hormone use at the Gender Service - a much higher rate than reported in other studies.

The research highlights the importance of offering affordable fertility preservation to these young people. The Hugh D. T. Williamson Foundation, which has a long-standing relationship with the RCH, recognised the importance of the Trans20 project, announcing in 2020 that it will join the RCH Foundation in funding Trans20 for another three and a half years, through the support of two positions, The Hugh Williamson Foundation Trans20 Research Fellow and The Hugh Williamson Foundation Trans20 Principal Research Fellow.