Health Care for Intersex, Transsexual, Transgender and Gender Diverse Australians

Issue

Particular requirements of Intersex, Transsexual, Transgender and Gender Diverse people when accessing the health care system.

Response

The Australian Government is committed to improving the health of all Australians, including sex and/or gender diverse people.

The National Male Health Policy and the National Women’s Health Policy 2010 (the Policies) released in 2010 seek to improve the health and wellbeing of all Australians through addressing particular health issues, focusing on the social determinants of health inequalities and encouraging the health system to be more responsive to priority groups. Lesbian, gay, bisexual, transgender and intersex (LGBTI) communities are identified in the Policies as priority groups for targeted action in regard to their health and wellbeing.

The Australian Government is aware that transgender and intersex Australians have particular health needs. To help meet these needs, the Australian Government funds the National LGBTI Health Alliance ($661,321.00 GST inclusive over three years commencing in 2012-13) to ensure the needs of the LGBTI community are appropriately represented in the development of health policy, to strengthen the evidence base for LGBTI health and wellbeing, to improve the capacity of the LGBTI community to deliver targeted health promotion activities and health-related services, and to enhance the capacity of health-related services to be inclusive of LGBTI consumers and their needs.

The Australian Government has also provided additional funding to the Alliance of $1.1 million over two and a half years to June 2013, under the Taking Action to Tackle Suicide - Community prevention for high risk groups measure, for the MindOUT national mental health and suicide prevention project. This project will establish networks and links between the LGBTI sector, mainstream mental health services and other significant suicide prevention and mental health projects, programs and research.

Under this project the Alliance will be seeking opportunities to increase representation in policy advisory and consumer forums and aims to improve understanding of the varying issues faced by sub-groups of this population, to break down barriers to help-seeking, and promote inclusive service provision to better support LGBTI people in need.

There are a number of procedures under the Medicare Benefits Schedule, which is funded by the Australian Government, which may be performed as part of a gender reassignment operation if determined by the medical practitioner to be clinically relevant. In addition, Medicare covers a range of specialist consultations including with plastic and reconstructive surgery, and psychiatric and family group therapy which may be relevant in the context of gender reassignment surgery.

The Australian Government is also increasing funding for public hospital services. Under the National Health Reform Agreement, from 2014-15 the Commonwealth will fund 45% of efficient growth in public hospital services, increasing to 50% in 2017-18. This will provide states and territories with at least $16.4 billion in additional funding over the remainder of the decade. This is in addition to Australian Government funding of up to $3.4 billion for hospital projects and beds under the National Partnership on Improving Public Hospital Services.

In addition to these health initiatives, and in response to the Australian Human Rights Commission’s Sex Files report, the Australian Government has committed to ensuring that all people are able to participate in society and receive the protection of the law, regardless of their sex or gender. This commitment is currently being implemented as follows:

The Government has committed to including protections against discrimination on the basis of a person’s gender identity or sexual orientation as part of its project to consolidate federal anti-discrimination laws into a single Act. In November 2012, the Government released the exposure draft of the Human Rights and Anti-Discrimination Bill 2012 for public consultation. This bill includes new protections against discrimination on the basis of sexual orientation and gender identity and extends the protection against relationship discrimination to same sex couples in any area of public life. This bill is currently being considered by the Senate Legal and Constitutional Affairs Legalisation Committee. Further information about the project is available on the Attorney General’s Department website.

Under Australia’s National Human Rights Action Plan, the Government is currently developing Guidelines to standardise the gender classification system and evidence required to change gender on personal records for Australian Government departments.

In September 2011, the former Minister for Foreign Affairs and the former Attorney-General launched a new passport policy for sex and gender diverse applicants. Under the new guidelines, sex reassignment surgery is no longer a prerequisite to issue a passport in a person’s preferred gender. Instead, sex and/or gender diverse people now have the option of presenting a statement from a medical practitioner supporting their preferred gender. More information about Australia’s passport policy can be found on the Australian Passport Office website.

In addition to these Australian Government policies, many members of the sex and/or gender diverse community have significant concerns about the process for legally changing sex. This is largely an issue for the states and territories, given their responsibility for their respective Registries of Births, Deaths and Marriages. However, the Australian Government has a strong interest in developing a nationally consistent approach to change of sex. The Attorney-General’s Department will work with relevant federal, state and territory agencies to consider this issue.

Further support is being provided by the Government aimed specifically at older LGBTI people.

In April 2012, the Government released the Living Longer Living Better aged care reform package. The package includes $2.5 million to implement a national roll-out of LGBTI Aged Care Awareness Training. The training will raise awareness across the aged care sector of LGBTI people and their ageing related issues, and provide the knowledge and skills for organisations to work to become more LGBTI inclusive.

Funding is also available through the Aged Care Service Improvement and Healthy Ageing Grants Fund to improve the skill and knowledge of aged care providers to meet the care needs of diverse populations. This will include staff training, information sharing and access to expert assistance.

Furthermore, the Minister for Mental Health and Ageing, the Hon Mark Butler MP, released the National LGBTI Ageing and Aged Care Strategy on 20 December 2012. The Strategy will be used to inform the way government responds to the needs of older LGBTI people and better support the aged care sector to deliver care that is sensitive to their needs. The strategy contains goals for implementation from 2012 to 2017. The Department of Health and Ageing will report progress against these goals annually. A formal review of the Strategy will feed into the broader review in 2017 of the implementation of Living Longer Living Better aged care reforms.

These measures build on the aged care reform amendment to the Allocation Principles under the Aged Care Act 1997, which recognised LGBTI people as ‘people with special needs’ to help focus on the care of LGBTI people. This amendment became effective on 1 July 2012.

Reviewed: 12 March 2013