Flying blind in gender medicine – by Bernard Lane

There is confusion over whether Australia’s largest medical defence organisation, Avant, will underwrite the gender clinicians’ campaign to expand and fast-track irreversible cross-sex hormone drugs for 16- and 17-year olds who identify as transgender or non-binary.

This uncertainty raises the prospect of personal liability for doctors confronted with future lawsuits brought by regretful detransitioners.

In Australia, the medical defence fund MDA National moved first to take account of the exposure signalled by detransitioner litigation.

In July this year, the fund ceased to shield doctors in private practice against claims arising from starting a minor on cross-sex hormones, which carry risks including cardiovascular disease, sterilisation and sexual dysfunction. The legality of a GP alone initiating hormones for a minor is in doubt.

In response to inquiries from GCN last Friday, Avant’s general manager of corporate affairs, Paul Perry, said the insurer’s position had not changed and its indemnity policy “extends to the provision of healthcare for patients identifying as transgender or gender incongruent,” subject to (unexplained) policy terms and conditions.

Mr Perry did not answer the question whether Avant would cover claims arising from GP members initiating opposite-sex hormones for 16- or 17-year-old patients without the backing of a multi-disciplinary team.

In last week’s online discussion about this issue, one practitioner said she had been told in writing by Avant that she would only be covered if she were working with a multi-disciplinary team involving, for example, a paediatric endocrinologist, fertility specialist and sign-off from two psychiatrists. Even then, Avant reportedly advised it would need to consider any claim before it decided whether it would indemnify the GP.

Other doctors said they were simply told they were covered for under-18 gender medicine patients as long as both parents approved; this is in any case a requirement under family law.

GCN understands that Avant is the indemnity fund defending psychiatrist Dr Patrick Toohey in the negligence claim brought by detransitioner Jay Langadinos. This case in its early stages.

Source: Flying blind in gender medicine – by Bernard Lane

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