This includes costs associated with the surgery, anaesthetic, hospital stay, preparation and recovery. "Until recently, most patients had to travel overseas."īottom surgeries for trans men include metoidioplasty and phalloplasty.Īn insured patient might expect to pay $80,000 out-of-pocket, for what is a complicated and lengthy series of three or more operations. "It's still a relatively new field in Australia," he said. One is Brisbane-based Dr Hans Goossen, whose new patients might expect to wait six to 12 months for an initial consultation.Īfter completing surgical training in urology and reconstruction, he spent two years overseas learning the skills to do gender-affirming surgeries. Not all trans people wish to undergo surgery, and for many of those who do, it is not financially viable - with nearly all surgeries taking place in the private system due to state government policy settings on elective surgery.įor trans men, getting a phalloplasty in Australia is even more difficult, with only two surgeons offering the procedure. Aboriginal & Torres Strait Islander crisis support line 13YARN on 13 92 76.Suicide Call Back Service on 1300 659 467.The difficulties in accessing surgery in Australia mean post-surgery survey sample sizes tend to be small.Ī peer-reviewed analysis of the 2015 US Transgender Survey, which had 27,715 respondents, found the 13 per cent who had undergone gender-affirming surgeries in the preceding two years experienced a 42 per cent reduction in psychological distress and a 44 per cent reduction in suicidal ideation, compared to those who desired surgery but had not had it. In a 2014 peer-reviewed study of 188 trans Australians, the 42.5 per cent of respondents who had undergone gender-affirming surgery reported higher levels of physical and mental health than those who had not had surgery. "It's just quite remarkable how resilient they are, but also what difference you make to their happiness and mental health," he said.Īdvocates point to numerous studies which back the mental health benefits of gender-affirming surgeries for adults. He said private hospitals doing gender-affirming surgery "almost lose money" because the procedures were not listed on Medicare, meaning surgeons have to use different item numbers that don't quite line up with the procedure.īut Dr Hart said seeing the outcomes for trans women made it some of the most rewarding work a surgeon could do. The wait time is around two years, and about 90 per cent of his clients come from interstate. His waiting list has only recently reopened. He has about 150 people booked in for surgery, and 100 for consultations. In Dr Hart's first year in 2018, he performed three gender-affirming surgeries. Kieran Hart, a surgeon at ACT Urology in Canberra, said he had been swamped with requests for vaginoplasty and orchiectomy (removal of testicles) procedures. Surgeons spoken to by the ABC said they would only perform bottom surgeries for people over the age of 18. Surgeons inundated with hundreds of booking requestsĬlinical guidelines written by the Royal Children's Hospital Melbourne and endorsed by the Australian Professional Association for Trans Health (AusPATH) advise delaying genital surgery for trans people until adulthood. In 2021, a petition to federal parliament for gender-affirming surgery to be included on Medicare gained nearly 150,000 signatures - the fifth most-signed petition on the Australian parliament website. Surgeons have told the ABC the lack of specific Medicare item numbers for gender-affirming surgeries means costs are unpredictable and not transparent, and some procedures aren't covered. The department is currently considering if the request is suitable to be considered by MSAC.Ī spokesperson said some Medicare rebates were already available "if the services are deemed by the treating practitioner to be clinically relevant to the care of their patient". A Department of Health spokesperson confirmed it had received an application requesting the Medical Services Advisory Committee (MSAC) consider publicly funding gender-affirmation surgery and consultations under Medicare.
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