Response to recent social media posts (2025)

I have been alerted by some patients that a couple of people (who are not my patients) posting negative comments and also conflating more than one issue. I am concerned that this may result in unwarranted concern, distress or harm to other patients. However, being social media, I am not given any right to reply or respond to what is being said.

For the past 4-5 years my private practice has been heavily dedicated to supporting the trans community, offering simple, straightforward, low-cost assessments and reports to enable patients to access life-saving medical gender affirmation.

The three issues that seem to be causing debate are:

• The workbook I ask patients to complete.
  
  This was developed for me by a former patient with lived experience who underwent very successful gender affirmative hormone and surgical treatment.
  
  Having the workbook completed provides a lot of background information before the consultation and ensures that I can see you and complete your assessment and reports with just a single consultation (in more than 95% of patients) - saving you time and money.
  
  The workbook has had multiple versions and amendments over the years and is now short and straightforward. I also offer the option for patients to provide me with a written narrative of their journey, or detailed assessments from other clinicians if they prefer.
   
• Patients wanting cosmetic surgery from non-surgeons in Australia.
  
  This is a very unusual situation. However, there are very well understood risks of having a major surgical procedure done by someone who is not a qualified surgeon. The Government is changing the rules about cosmetic surgery and there is more information here .
  
  My advice to patients is that you are planning major and life changing surgery, then you should only be doing this with a surgeon who is a qualified surgeon in the country where you are having the surgery. Finding a qualified gender-affirming surgeon in Australia is not difficult – the best place to look is the AusPATH provider list .
   
• Letters for the Suporn clinic in Thailand.
  
  The Suporn clinic has always been the most challenging clinic to work with, with various inappropriate (under Australian standards) requirements - forcing people to live in a particular way, take hormones etc, when these are no longer contemporary expectations of people seeking medical gender affirmation.
  
  The Suporn clinic have recently become even more directive about what the psychiatrist must write in their letter for the clinic to accept the letter. They claim that this has something to do with Thai laws (yet other Thai clinics accept Australian WPATH letters without question).
  
  The Suporn clinic is now demanding that independent psychiatrists' letters be amended and reworded to their requirements. This includes a requirement that the psychiatrist is directing you to have the surgery (which I am not) and for patients with a past history of mental health difficulties, requiring "certification" of 18 months of "mental wellness", - which is a nonsense. These demands threaten clinician autonomy.
  
  The demands to re-write letters are also directed via the patient and not in the conventional way from medical specialist to medical specialist. Patients are told that they must get the letter changed or there will be no surgery. I would be more than happy to speak to the surgeon (as sometimes happens with Australian and, indeed, other Thai and overseas surgeons) if there are any concerns in my letter. Unfortunately, the Suporn doctors won't engage, and directives and threats to get letters changed are sent to the patient (putting everyone in an uncomfortable position).
  
  The decision to have surgery needs to be an active and engaged partnership between the patient, the surgeon and (to a very small degree) the psychiatrist. Ultimately, making me change my letter so that I seem to be "directing" you to have the surgery appears to be a way of them avoiding their responsibilities in this, and potentially an avenue for them to blame the psychiatrist if things go wrong. Unfortunately, this is not ethical nor acceptable to most Australian psychiatrists.Having taken advice from my medical insurers and colleagues, it is no longer defensible to provide letters for this clinic.
  
  There may well be other  Australian psychiatrists or psychologists still willing to write letters for the Suporn clinic (see the AusPATH directory above). I understand that you can also ask the clinic to connect you with a Thai psychiatrist (and this may be your simplest option) for the assessment. 

If you have an existing appointment with me, I will honour that and do my very best to provide you with a letter that is acceptable to the clinic. I am only declining new referrals.

Also, just to be completely clear, I have no concerns about the expertise of well qualified Thai or other overseas surgeons.

My final comment is – if you have any questions or concerns, please talk to me. You can simply ring my direct line 03 5292 1644 and speak with me (you may need to leave a message for me to ring you back). Also talk to your GP.

Don’t rely on mis-information and ill-informed information on social media.