Zenon Godridge is about to hit her teens in a body that feels alien to her.
"The way I thought people saw me was masculine, tall and slim," Zenon said.
"When I realised I was gender queer, that felt different and I didn't want people to see me that way."
Last year, Zenon was found to have category-two gender dysphoria, a clinically significant type of distress associated with a strong desire to be another gender.
The 12-year-old from Cairns was referred to Queensland's only gender clinic for children and adolescents.
It should have triggered a specialist assessment within 90 days.
Instead, Zenon is on a waiting list up to 18 months long.
"It's definitely a stressful time … it's not good enough in the slightest," she said.
The Queensland Children's Gender Service (QCGS) based at the Queensland Children's Hospital in Brisbane provides specialist care for children and their families across the state through telehealth and local partnerships.
The service subsidises expensive puberty-blocking medications, which delay the onset of puberty in transgender teens or children diagnosed with gender dysphoria.
But the service has become overwhelmed by referrals and trans health doctors say the lengthy waitlist is creating a mental health crisis among young people with diverse gender identity.
'Incredible distress'
Fiona Bisshop, a GP and president of AusPATH (Australian Professional Association of Trans Health), said trans people at the onset of puberty faced with delayed access to the medication go through changes more difficult to reverse later.
"Those physical changes, or the fear that they are about to happen, can cause incredible distress in young trans people," Dr Bisshop said.
Zenon's mother Pip Godridge said she had spent countless hours on the phone seeking information from the QCGS and Queensland Health since her daughter's diagnosis.
"I have a 12-year-old who is crying to me all the time and just wants clarification and just wants that support, but we're not getting it," Ms Godridge said.
"It's not only my family, families all throughout Queensland are on this waiting list and 12 months or 18 months is a long time for children waiting for gender services and gender support."
'Inequality of access'
Cairns trans health specialist and educator Katie Williamson said other childhood medical conditions that triggered 90-day time frames for specialist attention included severe asthma and unstable epilepsy.
"It would be an absolute outrage if these children were to go on suffering for a year or more without being seen, and that's exactly what's happening with our transgender children," Dr Williamson said.
Furthering the inequality, Dr Williamson said, was the cost of acquiring puberty-blocking medication without a QCGS subsidy — approximately $1,000 every three months.
"There are families in Cairns I know of that are scraping together that $1,000, getting through three months only to find that they're no further along the waiting list," she said.
Ms Godridge said as a single parent, the cost was heartbreakingly out of reach.
"We're looking at over $4,000 per year for Zenon to have these medications and I'm sorry but that's unaffordable for me," she said.
"Ensuring that this is available at a subsidised rate is essential."
Push for decentralisation
The QCGS was established in 2017 to provide a one-stop shop of medical specialists, including psychiatrists and endocrinologists, allied health staff and other support services.
Prior to that, regional health services provided similar supports.
The ABC contacted Queensland's Health Minister Yvette D'ath, whose office did not respond.
A spokesperson for Children's Health Queensland said in a statement that QCGS currently provides direct care for more than 750 young people, with approximately 40 per cent of those from regional Queensland.
The spokesperson said monthly referrals to the QCGS had doubled since 2020.
"We acknowledge that this high demand for our service has meant longer wait times," they said.
"We also acknowledge the additional distress this causes impacted children, young people and their families."
Dr Bisshop said the QCGS was set up with the best of intentions and was a fantastic service for those children it treated.
But she is advocating for a return to regional services that can step in.
"[The QCGS] is staffed by a team of really hard-working, passionate and dedicated professionals, but they've just become overwhelmed by the volume of referrals," she said.
Dr Williamson said the Cairns Sexual Health Service was the perfect example of a regional centre staffed by clinicians, doctors, and psychologists with years of experience in transgender health.
"At the moment they're bound by the Queensland Health rule which is that children and adolescents have to go through this centralised service," she said.
"We really need decentralisation of the service to happen … and the faster that can happen the better because these waiting lists are unacceptably long."
