Decades-old 'conversion therapy' resurfaces in today's trans youth healthcare debate

When Jayne McFadyen was 10 years old, she was admitted to a state-run psychiatric hospital in Perth. 

Her "condition", as doctors described it, was that she wanted to be a girl.

That was in 1975.

For nearly six months, Jayne lived at Stubbs Terrace Children's Psychiatric Hospital under the care of doctors who considered her "gender disordered".

She was subjected to constant surveillance, clothing checks, and humiliating inspections.

"If I was playing solely with a group of girls, they'd make me then go and play with the boys."

She was also cut off from her parents, except for sleeping at home on one night of the weekend.

"What they did was a form of conversion therapy," Jayne, a transgender woman, said looking back five decades later.

"When I came out, I had suppressed my sense of gender so far down because I was worried that should I express anything feminine … I would be sent back to the psych hospital.

"I was so terrified."

Now 60, Jayne has discovered her experience may have been recorded in a decades-old medical study that is shaping decisions affecting the lives of trans youth today — and she is determined to set the record straight.

A forgotten report, revived

In 1987, the Medical Journal of Australia published a paper titled Gender-disordered children: does inpatient treatment help? by Robert Kosky, then director of Child and Adolescent Psychiatry Services in Western Australia.

It described eight children, all under 12, who were hospitalised at Stubbs Terrace between 1975 and 1980 for what the paper called "gender identity disorder".

The children were separated from their families and treated for months at a time. The paper argued their "cross-gender behaviours" were the result of inappropriate family dynamics — and suggested the hospital program corrected them.

When Anja Ravine, a trans youth health researcher at the Murdoch Children's Research Institute, came across it decades later, she was alarmed.

"It's implicit that they were expecting gender identity to return to what was expected. So that is really within the definition of conversion therapy."

Efforts to suppress or change a person's gender identity or sexuality, often referred to as "conversion therapy", are now illegal in most parts of Australia.

"We know now that people who've been exposed to this actually carry long-term psychological scars. It's very harmful," Dr Ravine said.

Despite being nearly 40 years old, the Kosky paper is regularly cited by opponents of gender-affirming care in submissions to lawmakers, courts and medical regulators around the world.

Even in Australia, the National Association of Practising Psychiatrists, has written a clinical guide on how doctors should care for gender diverse youth that also cites the paper.

Dr Ravine said that the study being used is "deeply troubling".

Meeting Jayne

Through a mutual friend, Dr Ravine was introduced to Jayne, whose own experience resembled one of the children referenced in  Dr Kosky's1978 paper.

"The one I immediately identified with was case study five," Jayne recalled, citing the report, which read '10 [years old], male, wants to be a girl'."

Because of privacy laws, the actual names of the children who were admitted aren't accessible, but Jayne's hospital admission dates and medical records align closely with the clinical details supplied for one of the children.

"It has to be me," she told 7.30.

Jayne disputes some of the details in the report.

The paper claimed that no conscious attempt was made by staff members to encourage masculine or feminine behaviours.

"When I looked at the actual admissions sheet, it actually stated on there that my reason for admission was to stop me from being transsexual in adolescence," she said.

"It was very much trying to get me to be a lot more masculine and to associate with men and other boys."

The paper also claimed that "cross-dressing" had "stopped of its own accord".

"I just thought: 'that is so wrong' … supposedly they'd 'cured' me. Yet here I was, I was trans," Jayne said.

"And I just immediately knew that something had to be done to correct the record."

The cost of suppression

After her release from Stubbs Terrace, Jayne buried her identity as deeply as she could. She conformed outwardly, acting like a "blokey bloke", afraid that any slip into femininity would land her back in the hospital.

Jayne went on to marry and have children. But by her 30s, the weight of suppression became unbearable.

Her wife, Deb, remembers watching her unravel. 

"I said, 'What's going on?' And she told me about Stubbs Terrace.

"So I said, 'Why don't you just move out for a bit and decide who you want to be or who you need to be?'"

Jayne did. It was a major turning point in her life.

"I could only see two ways out," Jayne says. "One was suicide and the other one was to transition."

Twenty-two years after being discharged from hospital, Jayne decided to transition.

"I felt a lot lighter in myself that I could finally see myself being who I always believed myself to be."

Rewriting the record

For Dr Ravine, Jayne's account underscores the damage done by practices like those at Stubbs Terrace.

"One thing that became very clear out of our conversations was that [Jayne] really wanted to ensure that the harm that this paper is now causing is stopped," Dr Ravine said.

"And the best way she could think of doing that was to tell her story."

Now Jayne, Dr Ravine and a team of researchers have written a critique of Dr Kosky's 1987 paper.

It was published on Monday in the Medical Journal of Australia — the same journal that carried the original report.

"It's important for lawmakers, the courts and policymakers to understand that past reports like this are really in the category of misinformation and they should be seen for what they are," Dr Ravine says.

Dr Kosky declined to comment.

Getting on with life

Through the ups and downs, Deb has been by Jayne's side. They remarried in 2019.

"Jayne's outer shell was different, but intrinsically she was still the same person," Deb said.

"It was beautiful for her to be able to be a bride too."

Today, Jayne says she feels at peace.

"I absolutely feel good in my skin now I know who I am. I don't feel uncomfortable anymore. I don't feel like I'm putting on a mask whenever I walk out the doors," she said.

"I'm Jayne. That is it. If you don't like me, you don't like me. If you do like me, you do like me. But this is who I am."

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