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Patricia Karvelas here, I usually host RN Breakfast but for the last few months I've also been working on a special episode of Four Corners on a debate that has become increasingly polarising and combative.

Medical transitions for young people who are transgender have galvanised campaigns around the world, but we wanted to explore what is happening in Australia's health system.

The gender "affirmation" model of care for young people diagnosed with gender dysphoria – offering a path to medical interventions — is under scrutiny, review and change around the world.

From Western Europe to the United States there have been changes to restrict access to puberty blockers and cross-sex hormones.

At the heart of the debate is whether these medical interventions should be given to young people.

The fight is now boiling over in Australia. It's playing out dramatically at Westmead children's hospital in Sydney.

Over the last few months we have spoken to many insiders who have told us that the dispute over care is affecting their ability to help children languishing on their waiting list.

We also wanted to hear from the critics of the affirmation model. Some argue that with the passage of time and therapy, gender issues will resolve. This approach is strongly refuted by most gender doctors.

At the center of all this though are families desperate to do what's right for their distressed children.

We've spoken to young people who are just starting the process that can lead to transitioning.

Their accounts are powerful because for them it is not an academic abstract debate – it is their experience and their story.

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