Last weekend, Labor Senator for WA Louise Pratt made headlines for lending her support to a petition lobbying the government to finance the costs of “gender affirming” surgery via Medicare. As the organisers of the petition explain:
Transgender people and other people in need of gender-affirming surgery must pay a lot of money, up to $30,000, so they can finally have their outward appearance match how they truly feel on the inside.
At the moment, Medicare does not subsidise cosmetic surgical procedures. In response, trans advocates argue that “these surgeries are essential for the mental health and well-being of select people in the LGBTQ+ community”.
Transfolk WA chair, Hunter Gurevich, explains the need for gender affirming surgery as analogous to knee reconstruction surgery: a person “might be limping along with the body as it is, but we can do so much better for them if we support them through Medicare”.
Internationally, the belief that unquestioning “affirmation” of trans or non-binary identities guarantees good outcomes is being revisited. Sweden, Finland, the UK and the US state of Arkansas are among the first to apply caution to gender transitioning, particularly for minors. As WFA has previously written, Australian gender clinics appear to be slow in following their lead. Despite the growing numbers of formerly trans individuals who have desisted and express deep regret about irreversible changes to their bodies, LGBT advocacy groups continue with reckless optimism about the benefits of medication and surgery.
Surprisingly, even non-binary activists who experience gender fluidity still argue that surgery is necessary for them. Nevo Zisin, poster child of the Safe Schools program and now an early career activist, is inclined to resent the intrusion of unwelcome medical opinion into a decision that they say should be purely personal:
I remember my surgeon saying to me ‘you know, once you do this you cannot go back. This is it. You cannot have your breasts again, you can’t’ … and I was like ‘that’s a lie’. Like, that’s not true. Like, yeah, ok, so I won’t have my breasts but if I really turned around one day and thought ‘Oh, you know, I actually want breasts again’, I could get them. It’s not that hard … The fact that so many others have to be a part of your decision-making when it’s about you and your life, it’s a very unique situation I think to trans people.
Like Zisin, Andrea Long Chu rails against the medical ethics that require doctors to “first do no harm”:
As long as transgender medicine retains the alleviation of pain as its benchmark of success, it will reserve for itself, with a dictator’s benevolence, the right to withhold care from those who want it.
Long Chu believes that treatment has made her dysphoria worse, rather than better and that the same is true for many other trans people. Long Chu sweeps this aside as irrelevant, arguing that “surgery’s only prerequisite should be a simple demonstration of want”.
If this is so, then where do we draw the line between “cosmetic” and the “medically necessary” surgery activists now want subsidised? If we follow the advice of Zisin and Long Chu, Medicare might be called upon to fund surgery one day, and later to fund the reversal of that surgery. The list of possible procedures is extensive:
- Genital surgeries: Vaginoplasty; Vulvoplasty; Phalloplasty; Metoidioplasty.
- Chest surgeries: Top surgery (MBS Item Number: 45240 x2); Breast augmentation.
- Gonad surgeries: Hysterectomy (MBS Item Number: 35653 or 35657); Orchiectomy/Orchidectomy (MBS Item Number: 30642).
- Facial surgeries: Brow Lift Browplasty; Cheek Enhancement; Forehead Reduction (and hairline lowering); Lip lift and Reshaping; Rhinoplasty; Scalp Advancement; Chondrolaryngoplasty.
All of this aside from voice therapy, counselling and hormones, which are already subsidised by Medicare, and fertility plans, which are not. The estimate of $30,000 per person begins to look conservative.
The total cost to the public – in a healthcare system already overloaded by the response to covid – is unknowable and the benefit highly questionable if not overtly detrimental.
Though the media never seems to canvass their opinions, many Australian parents of “trans” or “non-binary” children are actively grateful for the fact that “gender affirming” surgery is currently expensive. With the rise of “rapid onset gender dysphoria”, more and more parents are finding themselves surprised by the sudden announcement of a trans identity in daughters who never previously demonstrated any discomfort with their femininity.
At the moment, the cost of surgery serves to forestall the headlong rush of these young women to affirm a novel masculine identity with double-mastectomies and hysterectomies. Parents have even been known to remove their children from private medical funds in the hope that the time needed to accumulate the savings will give their daughters time to reconsider irreversible surgeries they may later regret.
Only imagine how betrayed such parents would feel if the government were to agree to the current petition and use tax payer money to facilitate – as they see it – the mutilation of their healthy children?
Women’s Forum Australia is an independent think tank that undertakes research, education and public policy advocacy on issues affecting women and girls, with a particular focus on addressing behaviours and practices that are harmful and abusive to them. We are a non-partisan, non-religious, tax-deductible charity. We do not receive any government funding and rely solely on donations to make an impact. Support our work today.
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