My little brother Anthony took their own life at only 21 years old after being placed on dangerously high doses of hormone replacement therapy (HRT), with no mental health support and only brief check-ins every three months with their GP and endocrinologist. They had a well-documented history of mental health struggles, including suicidal ideation. Despite this, they were prescribed high levels of estrogen without any counselling or ongoing psychological care.

Anthony's death was not just a tragedy—it was preventable. And it’s happening to others, silently, across Australia.

HRT can be an affirming and vital step for many trans and gender-diverse people. It can be life-saving. But the emotional and psychological toll of transitioning, especially without proper support, can be overwhelming. The hormonal changes involved in HRT deeply affect brain chemistry, mood regulation, and emotional resilience. When paired with an existing mental health vulnerability, this can become a fatal mix.

Australia has one of the highest suicide rates among trans and gender-diverse people in the world. A national study by the Australian Research Centre in Sex, Health and Society found that 48% of trans Australians have attempted suicide, and 73% have experienced suicidal thoughts. To put that in perspective: among the general Australian population, the lifetime prevalence of suicide attempts is estimated at 3–4%, and suicidal ideation at 13–15%. That means trans Australians are over 10 times more likely to attempt suicide and 5 times more likely to experience suicidal thoughts than the general population. These are not just numbers. These are brothers, sisters, children, and friends, crying out for help that never came.

Right now, there is no national requirement in Australia for mental health assessment or support to be embedded into the HRT process. Some clinics offer it. Many don’t. It’s a postcode lottery—and that’s not good enough.

We are calling on the Australian Government and healthcare providers to urgently implement:

• Mandatory mental health evaluations before starting HRT
• Ongoing psychological support during and after treatment
  Regular, meaningful mental health check-ins, not just medical dosage reviews
• Training for GPs and endocrinologists on the mental health challenges tied to gender transition

This is not about creating barriers to care. It’s about making care safer.

I lost my brother to a system that failed to see the full picture of who they were and what they needed. No one else should have to bury a loved one because of oversight, silence, or systemic neglect.

Please sign this petition to demand that mental health becomes a non-negotiable part of HRT care. Let’s protect and empower trans and gender-diverse Australians—not just with hormones, but with hope, humanity, and healing.

Sign now. Speak up. Save lives.

Edit regarding pronouns:

Anthony was at the beginning of their transition and had not chosen another name, so they still went by Anthony and were most comfortable with that. They used they/them pronouns, and while they were taking estrogen they weren’t ready to fully change how people referred to them just yet. They didn’t like being called “he,” but they also weren’t comfortable being referred to with traditionally feminine terms like “sister” either. I know it can be a bit confusing, especially when someone is early in their transition, but they were figuring things out at their own pace. I’m just trying to honour where they were at with it.