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The Press Council considered whether its Standards of Practice were breached by an article published in The Australian on 13 June 2023, headed “’Gender affirming’ care is destroying vulnerable kids” in print and “Why ‘gender affirming’ care is destroying our most vulnerable kids” online.   The article is an opinion piece on what the columnist considers to be the controversies of gender affirming healthcare involving children and adolescents, describing it as a “public health crisis caused not by a virus, not by a disease, but by social contagion”. The columnist said the notion that there are not just “two sexes, or that it is actually possible to change sex or be ‘non-binary’ …” has been embraced with enthusiasm by politicians, noting for example, the passing of “laws that allow people to falsify their birth certificates on the basis that they now feel as if they are a different sex to the one in which they were born”.   The columnist said “Other laws have been passed criminalising the work of therapists who try to help children, adolescents and adults become more comfortable with the only body they have” and that when the Family Court (Re: Kelvin) held that the prescription of cross-sex hormones to adolescents no longer required court approval if parents and doctors were in agreement, it “To a great extent … relied on the affidavit of one medical practitioner from the Royal Children’s Hospital in Melbourne” when it reached this decision.   The columnist also said that a “substantial portion” of children who identify as a gender other than their biological sex “are on the autism spectrum”; that “Without puberty blockers, the unequivocal research evidence is that most children resolve their gender identity issues before or while going through puberty” and that “After systematic reviews of the medical evidence, the treatment has been all but banned in Finland, Norway and Sweden outside of strictly controlled research programs.”   In response to a complaint received, the Council asked the publication to comment on whether the article breached the applicable Standards of Practice requiring publications to take reasonable steps to ensure factual material is accurate and not misleading (General Principle 1), and to ensure factual material is presented with reasonable fairness and balance and writers’ expressions of opinion are not based on significantly inaccurate factual material or omission of key facts (General Principle 3).   The Council noted that the complaint had expressed concern that the statements regarding the falsification of birth certificates, that laws have been passed criminalising the work of therapists who try to help children, adolescents and adults become more comfortable with their body and that the Family Court relied on the affidavit of one medical practitioner from the Royal Children’s Hospital in Melbourne are without factual basis. Similarly, the complaint noted that statements concerning autism and its links to gender dysphoria, that those who do not use puberty blockers, resolve their gender issues before or while going through puberty, and that gender affirming healthcare has been all but banned in Finland, Norway and Sweden, are without factual basis.   In response, the publication noted that some Australian states allow changes to birth certificates based upon self-identification and because no legal checks are required if a person chooses to change their gender, it raises the possibility that a birth certificate could be altered under false assumptions. The publication also said that the effect of the various State legislation that makes it illegal to engage in ‘conversion therapy’, is to potentially criminalise the work of therapists who try to help children, adolescents and adults become more comfortable with their bodies. The publication hypothesised that someone could complain to authorities that they regard the therapists’ actions or methods as ‘conversion therapy’ unless the therapist chooses to ‘affirm’ that person’s chosen gender identity.   In relation to the Family Courts decision, the publication noted that the columnist is a Law Professor who has provided detailed analysis in a peer reviewed article on the Court’s decision. In support of its comments concerning autism and a link to gender dysphoria, the publication referred to a number of research studies, including a position statement by the Royal Australian and New Zealand College of Psychiatrists. The publication also referred to a number of studies as evidence to support its comments that there is a high rate of desistance in pre-pubescent children which has not involved the prescription of puberty blockers, or other interventions other than therapeutic support.   In relation to the hospitals in Finland, Norway and Sweden, the publication noted that while the hospitals continue to offer a treatment program, the treatment is strictly controlled and takes place in the context of a research program. The publication said that it recognised that the issue of gender affirming healthcare is a complex and sensitive one and for this reason it has sought to publish a range of views on the matter.  

Conclusion

  The Council recognises that the article is clearly identified as an opinion piece and given the significant public interest of allowing freedom of expression and the undoubted public interest in the debate around gender affirming healthcare, the Council takes the view that such articles are entitled to express opinions with which some or even many may disagree. Nonetheless, even in an opinion piece, the obligation remains to take reasonable steps to comply with the Council’s Standards of Practice.   In regard to the comment that the “…passing of laws that allow people to falsify their birth certificates”, the Council does not accept that there is anything in the material relied on by the publication to substantiate this statement. The Council notes the word “falsify” suggests a level of criminality or deceit that has not been made out by any of the material relied on by the publication. Accordingly, General Principles 1 and 3 were breached in this respect.   In relation to the comment concerning the criminalisation of therapists, the Council notes that by not specifically referring to the illegal practice of conversion therapy, the statement misleadingly and unfairly suggests that therapists could be prosecuted for providing therapeutic care. The Council does not consider there is anything in the material relied on by the publication to substantiate this statement. Accordingly, General Principles 1 and 3 were breached in this respect.   In regard to the statements that there is a link between autism and gender dysphoria; that the Family Court relied on to a great extent, the affidavit of one medical practitioner, and that without puberty blockers, the unequivocal research evidence is that most children resolve their gender identity issues before or while going through puberty, the Council notes that the publication referred to and provided material in support of each of these expressions of opinion and considers that there was a reasonable factual basis for the comments. Accordingly, General Principles 1 and 3 were not breached in this respect.   As to the comments that hospitals in Finland, Norway and Sweden have all but banned gender affirming healthcare, the Council accepts that the publication did not state that this care was no longer provided by the hospitals and notes the publication’s comments that the treatment is strictly controlled in a research setting. Accordingly, General Principles 1 and 3 were not breached in this respect.  

Relevant Council Standards

  This Adjudication applies the following General Principles of the Council.   Publications must take reasonable steps to:   1. Ensure that factual material in news reports and elsewhere is accurate and not misleading, and is distinguishable from other material such as opinion.   3. Ensure that factual material is presented with reasonable fairness and balance, and that writers’ expressions of opinion are not based on significantly inaccurate factual material or omission of key facts.

The Press Council considered a complaint from Townsville Hospital and Health Service (the hospital) concerning two articles published in print and online in The Courier Mail and the Sunday Mail.   The first article is headed “Hospital silent on shooting victim” in print and “Police shot dead Townsville man hours after hospital discharge” online on 23 April 2023. The second article is headed, “HOSPITAL DEATH TRAP /’THEY WON’T HELP ME’” in print on 6 May 2023 and “’They won’t help me’: Teen’s desperate post before suicide” online on 7 May 2023.   The first article reported that “A review will be undertaken into the circumstances surrounding the death of a Townsville man who was shot by police just hours after his release from hospital. The Kirwan shooting on Friday night occurred just a day after police spent two hours negotiating with the same man in a siege situation on Bel Air Ave, before he surrendered and was admitted to Townsville University Hospital.” It said that “Townsville’s Hospital and Health Service chief avoided answering a string of questions on the shocking timeline of events and the hospital’s decision to discharge Steven Angus, 52, after the lengthy siege.” It went on to report that “Townsville Hospital and Health Service chief executive Kieran Keyes confirmed a ‘comprehensive clinical review will be completed by the health service to determine what learnings or actions may result from this tragic incident ... I am unable to provide any details due to patient confidentiality’”.   The second article reported “A young Queensland woman suffering depression and pleading for help was repeatedly told to go home by staff at a Townsville hospital after self-harming and took her own life just hours after being discharged yet again.” It said that the woman’s “care at Townsville University Hospital is now being investigated in a ‘full clinical review’” following her death after she was released from the mental health unit in October.” It reported that “The revelation comes just a week after the same hospital came under scrutiny for sending a veteran “home after trying to harm himself, just hours before he was shot dead by police.”   The article went on to report the hospital’s Chief Executive saying “…Our health service is subject to privacy and confidentiality legislation and for this reason, I am unable to provide any further details about Ms Morison’s care. Intensive mental health care is complex, and it is our priority to ensure the care of each individual person is tailored in a setting that best suits their needs …”.   In relation to the first article, the complainant said it suggests that the man’s death was the direct result of the hospital’s decision to discharge him. The complainant said that despite the publication being made aware on multiple occasions that because of patient privacy and confidentiality legislation, it could not comment on the man’s care, it reported that the hospital “avoided answering questions” to imply that this was a tactic used by the hospital to avoid commenting publicly. The complainant said the publication’s way of reporting has eroded community trust in the hospital’s mental health services creating a genuine risk that someone in need of care may be reluctant to come forward because their confidence in the hospital’s services has been seriously shaken.   In relation to the second article, the complainant said the reporting on a mental health patient who took her own life was sensationalist and reckless. The complainant said the print headline, in particular “… HOSPITAL DEATH TRAP”, and reporting that the woman had died within “hours of discharge” erodes community trust and confidence in the hospital’s mental health service and has also had an adverse effect on the clinical staff who are unable to defend themselves without the benefit of a fair right of reply because of patient privacy and confidentiality legislation.   In response, the publication said that it rejects the accusation that the reporting was sensationalist. It said it takes seriously its reporting on mental health issues in the community and that reporting on such matters is clearly in the public interest. The publication said it is not its job to ensure trust and confidence in public mental health services, but the job of the hospital. It also said that it was not trying to stop people from coming forward for help, but to ask questions and prompt answers, to ensure that when people do come forward they receive the best care possible.   In relation to the first article, the publication said that it was a factual report of what occurred and that it had provided the hospital with a fair right of reply, noting its response to its questions were included in the article. It also said that the hospital has been criticised by the police, the police union and is the subject of a coroner’s investigation. In relation to the second article, the publication said it is a fact that the patient did take her life within hours after leaving the hospital and that the mother and sister of the woman who died had raised questions about the care she received at the hospital. The publication said the hospital was approached for comment, and its response was included in the article.  

Conclusion

  The Council’s Standards of Practice require publications to take reasonable steps to avoid causing or contributing materially to substantial offence, distress or prejudice, or a substantial risk to health or safety, unless doing so is sufficiently in the public interest (General Principle 6), and that reports of suicide should not be given undue prominence, especially by unnecessarily explicit headlines or images. Great care should be taken to avoid causing unnecessary harm or hurt to people who have attempted suicide or to relatives and other people who have been affected by a suicide or attempted suicide. This requires special sensitivity and moderation in both gathering and reporting news (Specific Standard 7 – Coverage of Suicide).   In relation to the first article, the Council acknowledges that the comment that the hospital “avoided answering questions” could infer that the hospital was intentionally withholding information on the man’s care. The Council also acknowledges the complainant’s comments that the reporting on this matter, including the headline, caused significant distress to members of its staff. However, although the Council recognises that the hospital’s patient confidentiality obligations limit its ability to respond to media enquiries, it notes the hospital’s response to the enquiries was included in the article.   The Council also considers that, to the extent the reporting on the matter did cause substantial offence or distress, or a substantial risk to health and safety, this was outweighed by the significant public interest in reporting on the shooting and the events which preceded it.  Accordingly, the Council finds that the publication did not breach Principle 6.   In relation to the second article, and specifically in relation to the print headline, the Council accepts that it could have been less emotive given the sensitivities of the issue. However, the Council notes that the immediate family of the woman who died by suicide were highly critical of the hospital.  Accordingly, the Council finds that the publication took reasonable steps to comply with Specific Standard 7 on Coverage of Suicide and finds no breach of this Standard of Practice.   Note: If you or someone close to you requires personal assistance, please contact Lifeline Australia on 13 11 14.  

Relevant Council Standards

  This Adjudication applies the following General Principle of the Council.   Publications must take reasonable steps to:   General Principle 6 – Avoid causing or contributing materially to substantial offence, distress or prejudice, or a substantial risk to health or safety, unless doing so is sufficiently in the public interest.   This Adjudication also applies the following Specific Standard on Coverage of Suicide.   Specific Standard 7 – Reports of suicide should not be given undue prominence, especially by unnecessarily explicit headlines or images. Great care should be taken to avoid causing unnecessary harm or hurt to people who have attempted suicide or to relatives and other people who have been affected by a suicide or attempted suicide. This requires special sensitivity and moderation in both gathering and reporting news.