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Clinic helping transgender kids make the transition

Mac Zamani knew from an early age the gender he was assigned at birth wasn’t the one he identified with.

The 18-year-old always felt different to other girls, a self-confessed tomboy who lived in shorts and t-shirts. 

It wasn’t until high school when language around gender intensified that Mac began researching what he had long suspected but couldn’t quite express. He was transgender and wanted to make the transition.                                                             

After conversations with his parents, school counsellor and GP he was referred at the age of 13 to the First Assessment Single Session Triage (FASST) clinic at The Royal Children’s Hospital Gender Service (RCHGS).  

The FASST clinic was established in 2016 to provide information and support quicker to transgender young people, aged 8 to 17 years, and their families. Led by a clinical nurse consultant, FASST has reduced initial wait times by 10 months and triages patients onto a secondary waitlist for additional multidisciplinary care with mental health clinicians and pediatricians.

Mac, who also uses a wheelchair due to a disability, would have been waiting more than a year for support if the FASST clinic didn’t exist.

“I didn’t know what to expect but I went in with an open mind and found it really rewarding,” he said. “The nurse talked me through socially transitioning, mental health concerns, medications, and what other names and pronouns were possible options. 

“It was refreshing to have such an easy conversation as you feel these things are still taboo to talk about. “The clinic made me more confident and validated my feelings that this wasn’t a phase, which made me a lot less stressed.”

Mac said while the relationship with his parents was always one of acceptance the clinic made their bond even stronger.

“My parents appreciated the support too from the nurse as it put them at ease that they were doing and saying all the right things,” he said. “They had a lot of questions and the nurse reassured them, which allowed them to block out all the negative and removed any doubts.”

After attending the FASST clinic, Mac was referred to a psychologist, pediatrician and speech therapist at the RCHGS, where he is still a patient today.

“I’d be in a very different place without this clinic over the past four years,” he said. “I consider myself to be one of the lucky ones. I have friends who had very different experiences, parents who weren’t supportive and had to wait years to see a psychologist.”

A new study, led by the Murdoch Children’s Research Institute (MCRI) and published in Pediatrics, found the FASST clinic has boosted mental health, family functioning and quality of life due to due to transgender young people being able to access help much sooner.

Across the globe, increased awareness and understanding of gender diversity have contributed to a substantial rise in the number of transgender children and adolescents seeking specialist care. This has placed substantial pressure on clinical resources and wait times for assessment have substantially increased.

Senior study author MCRI’s Associate Professor Ken Pang said participants found attending the clinic provided validation, not only for themselves, but also their families, classmates and wider communities.

“This validation had flow-on effects, improving their sense of self, boosting their confidence, and increasing parental understanding, acceptance and support,” he said.

Associate Professor Pang said having a child identify as transgender was a momentous change and often highly stressful for families.

“We found that family functioning prior to attending the clinic was at an unhealthy level for many of our participants’ families,” he said. “But after attending the clinic, this significantly improved.”  

For more on the RCH gender service visit www.rch.org.au/adolescent-medicine/gender-service/