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Gender Affirming Surgeries Considered for Medicare Benefits Scheme

Over 40, 000 transgender adults in Australia may soon be able to access gender affirming surgeries through Medicare. An application made by the Australian Society of Plastic Surgeons is requesting that the federal government add essential gender affirming surgeries to the Medicare Benefits Scheme (MBS).

For one transgender man, A*, the cost is a massive barrier.

“A lot of the surgeries I would want would cost over ten grand being generous. I believe one of the surgeries can go up to a hundred grand and that’s just not something I can see myself doing within the next few years, so I have to make a financial plan over it.”

Dr. Nicola Dean, the current president of the Australian Society of Plastic Surgeons, says that currently it’s unclear how many patients are undergoing gender affirming surgery due to a lack of data.

“The number of people that are wanting to have these surgeries compared to the number of people that can access them is really out of balance. So we know that some of these surgeries are going on through private hospitals with MBS items, but we don’t really know how many are occurring across Australia at the moment.”

A study on the healthcare experiences of gender diverse Australians found that 42. 5 percent of participants who had undertaken gender affirming surgery reported higher levels of physical and mental health than those who had not. Dr Dean says that she’s hopeful that Australia’s healthcare system will consider the medical evidence for the benefits of having access to gender affirming surgery.

“There are now some good studies from other countries that demonstrate significant improvements in what we call patient reported outcomes measures. Australia has a good healthcare system that looks at the medical evidence for procedures and I think we’re very lucky to have that. And so now there is much stronger medical evidence out there that these procedures should be provided. I’m hopeful that the Australian healthcare system will rectify the lack of access that’s been there for so long.”

Jess, a non binary person who uses they them pronouns, is also seeking gender affirming care along with their brother.

“My brother is also trans and he would like to get top surgery. And I think he put it really well. When I was speaking to him yesterday about this interview, he said, people say, Oh, but why can’t you just bind? Why can’t you just hide your chest with, like, even getting a breast reduction to, like, an A cup? And he said, it’s not about hiding my chest. It’s about getting the chest that I need. And ultimately, neither of us can afford to get top surgery.”

In metropolitan areas, gender affirming care can be easier to access, as there are a large number of organizations and activists working to educate and raise awareness. In rural areas, it can be much harder for gender diverse individuals like Jess.

“I know coming from a rural community, the idea of trans people can be lost on so many, like, older doctors, older medical professionals, or people who don’t believe that they are trans, these people that are coming to them, or they believe that it would be something different, and so they push them aside. And that happens a lot in rural spaces because of the mentality surrounding it.”

For many trans people, access to gender affirming care can literally be life saving. A* says that even if you don’t want surgery, you’re still trans – but for those who do need surgery, it’s life-changing.

“Just because you’re trans, it doesn’t mean you need to have the surgery. You could still 100 percent present in your normal biological self, but still say that you’re the gender you weren’t assigned at birth. That’s still fine. You’re still transgender. But the people who wish to have those surgeries can finally start feeling comfortable in their own bodies, and we may actually be able to save some lives from this.”

To learn more about the process for accessing gender affirming surgery, you can listen to a podcast episode by Dr Nicola Dean here all about it.

*Not his real name or initial.

Photo by Jan Budomo on Unsplash