Models of Publicly Available Gender Affirming Surgery Forum

Annette Bromdal; Frances Mulcahy; Joseph Debattista; Vicky Batchelor; Daniel Brown; Jaiden Clarke; Kirstie Daken; Parker Forbes; Graham Neilsen; Billie Stimpson; Emerson Zerafa-Payne; Amy Mullens

doi:10.26192/zq17q

The aim of the Gender Affirming Surgery Forum (hereafter Forum) was to explore and assess opportunities for developing a sustainable health response for trans Queenslanders that reflects the State’s commitment to human rights and international best practice. Integral to this health response is creating publicly available and accessible gender affirming surgery, referring to several procedures intended to align the person’s body with their gender, including but not limited to singular and plural numbers of chest surgery, genital reconfiguration surgery, facial procedures, and voice surgery, among others. The Forum agenda consisted of four panels representing four overlapping stakeholder groups: 1) lived experience; 2) clinicians and health practitioners; 3) community stakeholder organisations; and 4) those representing human rights, law, policy and politics--each with specific and relevant skills, expertise, and experiences concerning gender affirming surgery. The Forum, and this resulting report, has made several recommendations, based on the discussions across the four panels. It recommends that: ▪ The final report of the Forum be widely distributed; and ▪ The contributors to this Forum formulate a process to establish an advocacy action group (AAG) with the intention that the AAG develop an action plan inclusive of: ▪ Seeking out or commissioning health economic modelling to inform the contention that provision of gender affirming surgery by Queensland Health is economically viable; ▪ Researching the availability of gender affirming surgery and the models of care delivery utilised within other inter/national jurisdictions. Make representations to Queensland Health for the development of a state-wide framework for the care of trans, gender diverse and non-binary persons, inclusive of publicly accessible gender affirming surgery; ▪ Examining the possibility of applying discrimination and Human Rights law to leverage change in Queensland Health; ▪ Assessing the legal obligations set out by the Queensland Human Rights Act (2019), and anti-discrimination legislation to ensure the right to equitable access to gender affirming health services, specifically to provide for publicly accessible gender affirmation surgery; ▪ Informing the existing Queensland LGBTIQ+ Roundtable and community-led LGBTIQ+ Alliance of the essential nature of publicly available gender affirming surgery as part of the implementation of any whole of government strategy to include LGBTIQ+ persons; ▪ Given the evolving cultural landscape and the changing makeup of the health work force, advocating to all training and accreditation bodies within the healthcare sector of the need for continuous vigilance to the risks of increasingly discriminatory views and behaviours towards LGBTIQ+ persons; ▪ Advocating the need for trans, gender diverse and non-binary-affirming, sensitive and focused training/professional development for the developing health workforce for culturally responsive care and reducing stigma from health professionals; ▪ Exploring the possibility of zero-interest ‘health loans’ as a means of facilitating access to the private health sector for gender affirming surgery; and ▪ Assessing the impact of medio-legal concerns held by individual medical practitioners as an impediment to offering gender affirming surgery. These recommendations are made with the following important caveats: ▪ All actions must, as far as possible, meaningfully involve persons with lived experience of being trans, gender diverse or non-binary (inspired by ‘nothing about us without us’); and ▪ Support the notion that change favours those best positioned to take advantage of it. Thus, equity requires that support changemakers also act to assist those less advantaged to access new services.

Models of Publicly Available Gender Affirming Surgery Forum

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