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Introduction: The Australian standards of care and treatment guidelines aim to maximise quality care provision to transgender and gender diverse (TGD) children and adolescents across Australia, while recognising the unique circumstances of providing such care to this population. Recommendations are made based on available empirical evidence and clinician consensus, and have been developed in consultation with Australian professionals from multiple disciplines working with the TGD population, TGD support organisations, as well as TGD children and adolescents and their families. Main recommendations: Recommendations include general principles for supporting TGD children and adolescents using an affirmative approach, separate guidelines for the care of pre-pubertal children and TGD adolescents, as well as discipline-based recommendations for mental health care, medical and surgical interventions, fertility preservation, and speech therapy. Changes in management as a result of this statement: Although published international treatment guidelines currently exist, challenges in accessing and providing TGD health care specific to Australia have not been addressed to date. In response to this, these are the first guidelines to be developed for TGD children and adolescents in Australia. These guidelines also move away from treatment recommendations based on chronological age, with recommended timing of medical transition and surgical interventions dependent on the adolescent's capacity and competence to make informed decisions, duration of time on puberty suppression, coexisting mental health and medical issues, and existing family support. [ABSTRACT FROM AUTHOR]

To the Editor: Writing recently in I The Lancet i , Byng and colleagues[1] argue that our clinical guidelines on care of transgender children that appeared in the I MJA i [2] use imprecise language, do not consider long term effects, and lack robust evidence. Moreover, withholding gender-affirming treatment via wait-and-see strategies mentioned by the authors is not without harm,[9] and development and ongoing revision of guidelines such as ours will ensure that transgender individuals receive the best care based on up-to-date empirical evidence. Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents. [Extracted from the article]