Transgender healthcare: Doctors push for more accessible gender-affirming hormone treatment

The doctor in charge of the Royal Children’s Hospital gender clinic has given a rare insight into the practice’s vision, telling an inquest that demand for gender-affirming care will only continue to increase.

The influential hospital clinic’s approach is consistent with a broader push by transgender health clinicians to make access to “cross-sex” hormone treatments easier, more affordable and reduce hurdles.

The Australian Society of Plastic Surgeons has recently asked the federal health department to establish 21 Medicare items for gender-affirming surgeries to make it cheaper for patients.

But the push is at odds with a growing caution among key bodies of psychologists and psychiatrists in Australia, as well as developments in some parts of Europe. Sceptics of gender-affirming care point to lifelong changes that can affect young people’s fertility, sexual function and broader physical health, including liver and heart health. Some changes are irreversible, including deeper voices and body hair in people born female and breast tissue in people born male.

The children’s hospital currently treats people aged eight to 16, administering puberty blockers from as early as age 11, potentially followed by cross-sex hormones. Nguyen said the hospital also worked with youth mental health organisation Orygen, through its Headspace clinics, to provide gender-affirming treatment to children from 12 years old after a large Victorian government grant in the 2021 budget.

Opponents argue that children and young people are unable to consent to treatment that will have life-long effects on their health, including their sexual health.

The suicide cluster inquest was called after five trans people in Victoria, some of whom knew each other, took their own lives. All had mental health issues, including feelings of social isolation during Victoria’s long season of lockdowns, and all were taking gender-affirming hormones.

Professor Jeffrey Zajac, the chairman of medicine and director of the department of endocrinology at Austin Health, conceded that affirming care was not the only solution to many people’s problems. For one thing, for transgender women (people born male): “The libido can be reduced and sometimes reduced to nothing, and this can be a major problem in some individuals – well in most individuals – but some of them worry about it more than others.”

He said most of his patients were on antidepressants both before and after hormone therapy.

“If people come in with an established partner, 80 per cent of the time they’re not with that partner six months later, once they start the transition … despite the fact that the partner is supportive, it just doesn’t seem to work. So that’s a problem,” Zajac told the coroner.

Source: Transgender healthcare: Doctors push for more accessible gender-affirming hormone treatment

2 thoughts on “Transgender healthcare: Doctors push for more accessible gender-affirming hormone treatment”

  1. I wonder why ‘tech’ ‘solutions’ are promoted and funded, whilst other modes of responding to dysphoria do not gain funding nor support nor attention? This is so across the board – for example, the funds sunk into new reproductive technologies rather than into positive fertility approaches – funding for sex education, treatment for sexually transmitted diseases and education about them, better training of doctors so that iatrogenic causes/reasons are not at the base of ‘infertility’; promotion of body-changing operations promoted as life-enhancing – cosmetic surgery … when for example the Brazilian Butt Lift (BBL) so called is recognised as the most dangerous operation anyone can undergo – and has led to many deaths and inquests – Why is ‘treatment’ that requires a lifetime on drugs promoted as ‘good’ when alternatives are not granted attention they need? Why is there one ‘solution’ to a multiplicity of human issues those who are trundled onto these programmes (called ‘healthcare’) which fail to address for example, autism/aspergers, child sexual abuse, depression … Shouldn’t we be demanding to know the credentials of the medicos involved in these programmes – for example, what is their relationship to the drug companies? do they have conflicts of interest? do they follow health care principles or ideological notions? Why aren’t these questions allowed, and why are those who ask them vilified?

    1. I could not be more in agreement with you. But there is a general atmosphere of treating ideology as science. To the extent as a retired academic and feminist from ages ago I have giving up even to go into discussion with people who seem to think that arguments and debates lack “being kind to other people” because everyone has their own beliefs and they are all valid!

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