Is informed consent the primary ethical foundation for treatment of gender diverse young people?

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This is one of two research projects studying the ethical aspects of medical treatment for gender diverse young people. The University of Melbourne is the home institution for this project. To view the Manchester-based partner project, click here.

The provision of hormone treatment for children and adolescents (young people) who identify as trans or gender-diverse is highly contentious and has been the subject of heated public debate in both Australia and the United Kingdom.

In both countries, courts have been involved in determining whether individual children or adolescents can have access to hormone treatments to suppress puberty, or to oestrogen or testosterone for gender-affirming care.

Courts in both countries have focused particularly on whether the young person who wants the hormone treatment has the capacity to give their own consent to that treatment (that is, “Gillick competence”).

This has been regarded by the courts as the key determinant of whether it is permissible for clinicians to provide hormone treatment. It is possible that this focus on the law may have inappropriately narrowed or skewed thinking about the ethics of hormone treatment.

This PhD project will bring the question of hormone treatment for gender-diverse young people back to the broader ethical context of medical treatment in general for children and adolescents.

In paediatric health care, the capacity of a young person to consent to medical treatment is not the primary consideration. An ethical decision about any form of medical treatment is based on the interests and well-being of the patient (psychosocial as well as physical), and then informed consent of parents is sought, through a process of shared decision-making.

The child or young person should be involved in shared decision-making, to the extent that they are able and willing. Agreement from the child or adolescent is ethically desirable, but not the primary consideration because parents are regarded as having the ethical and legal standing to provide formal consent for treatment that will benefit their child.

Project goals

The specific objectives of this project are:

  1. Analyse the legal framework used by courts in the UK and Australia in relation to hormone treatment for gender-diverse young people, with a focus on how the concepts of valid consent and duty to inform are used in the context of Gillick competence.
  2. Review the ethics literature to develop an account of ethical considerations seen as relevant to hormone treatment for gender-diverse young people, and map this onto the standard account of the ethics of medical treatment in general for young people.
  3. Based on interviews with clinicians and lawyers, develop a model of the ethical thinking that is employed by those working in the field.
  4. Critically interrogate these three conceptual frameworks to produce an ethically sound, legally informed and practical guide for making decisions.

Supervision team

*Click on the researcher's name above to learn more about their publication and grant successes.

Who we are looking for

We are seeking a PhD candidate with the following skills:

    • Demonstrated experience in the field of paediatrics/nursing practice
    • Demonstrated experience in empirical bioethics
    • Demonstrated ability to work independently and as part of a team
    • Demonstrated time and project management skills
    • Demonstrated ability to write research reports or other publications to a publishable standard (even if not published to date)
    • Excellent written and oral communication skills.
    • Demonstrated organisational skills, time management and ability to work to priorities.
    • Demonstrated problem-solving abilities.

Further details

The PhD candidate will benefit from the combined expertise of the project supervisors, and the embedding into two research environments.

This PhD project will be based at the University of Melbourne with a minimum 12-month stay at the University of Manchester.

The candidate will be enrolled in the PhD program at the Department of Paediatrics at the University of Melbourne and in the PhD program at the School of Social Sciences at the University of Manchester.

The candidate will work closely with and under the supervision of Prof Lynn Gillam, who has particular expertise in empirical bioethics, and through her leadership role in clinical ethics at the Royal Children’s Hospital, has strong collaborative relationships with gender service clinicians. The co-supervisor, Dr Ken Pang, a paediatrician who works in the RCH Gender Service, will assist in recruitment, and provide guidance and support for conducting interviews. The candidate will be physically located at the Royal Children’s Hospital, in the Children’s Bioethics Centre (of which Prof Lynn Gillam is the Academic Director) and will have extensive opportunities for involvement with the RCH Gender Service clinicians, including attending clinical meetings, research meetings and ethics consults, as well as one on one conversations. This will provide invaluable depth of understanding of the clinical context, which is vital for successful empirical bioethics research.


To apply for this joint PhD opportunity, and to view the entry requirements, visit How to apply.

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