Sex-affirming surgery should be subsidised by Medicare without the need for a diagnosis of 'gender dysphoria', says Flinders University social studies expert Dr Damien Riggs.
In his new report on the healthcare experiences of Australian people whose gender identity differs from that expected of their natally assigned sex, Dr Riggs found respondents who had undertaken such surgery reported better mental health than those who desired surgery but had, for a range of reasons, been prevented from undertaking it.
"Under current Medicare rules it remains ambiguous as to the extent to which all sex-affirming surgeries are covered, especially in the absence of a diagnosis of gender dysphoria," Dr Riggs, a senior lecturer in the School of Social and Policy Studies, said.
"By comparison, a person who finds out they have the gene for breast cancer can have a prophylactic mastectomy which is covered by Medicare, even without a current diagnosis of pathology," he said.
"It therefore seems unreasonable that a person who wants their breasts removed because they do not identify as female has to be diagnosed with a disorder."
Undertaken between 2012 and 2013, the study canvassed the health care experiences of 188 people whose gender identity differs from that expected of their natally assigned sex.
Among the findings, between 22 and 29 per cent of respondents rated their experience with counsellors, psychologists and psychiatrists as "very negative", while only seven to 15 per cent considered their experience as "very positive".
Participants also reported discrimination from both physical and mental health practitioners, which was linked to lower levels of mental health.
Dr Riggs said the research highlighted the need for more training to educate all health professionals on transgender issues.
"The experiences were really varied – some people said their practitioner was very helpful and understanding, while others reported feeling ridiculed and told they had something wrong with them.
"One of the main reasons for this inconsistency is a lack of mandate for training in Australia, where professional degrees and associations are not required to provide training on transgender issues, which means that a lot of health professionals don't have any knowledge in this area."
While Dr Riggs welcomed the new Federal Government policy allowing transgendered people to change their sex on passports without surgery, he said the same rule should apply to birth certificates, which come under state laws that currently require surgery.
"For some people a passport may be less useful if they are not intending to travel, but birth certificates are for most people very significant, especially with regard to employment and education."
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