Labor's Budget Leaves Trans People Behind

Today’s post discusses the issue of transgender healthcare in relation to Australia’s recent budget. The author - who has asked to remain anonymous - argues that transgender healthcare remains financially inaccessible under this budget, and that this has both direct and ripple effects on the lives of trans and gender-diverse people. This post was sourced by the Antipoverty Centre.

AMAB (Assigned Medicare at Budget) - issues related to transgender healthcare

There are plenty of issues with the budget currently being discussed, but I just thought I'd raise one discussed less often; much of transgender healthcare remains financially inaccessible under this budget, and the issues it fails to address hurt trans and gender-diverse people disproportionately. There are plenty of other issues with the state of transgender healthcare in Australia, but I will try and keep this concise.

The Labor Party proclaims that Medicare makes healthcare accessible for all, but for trans and gender-diverse (TGD) people seeking life-saving gender-affirming healthcare, this is simply not the case.

The provision of gender-affirming healthcare is mostly limited to a small number of private GPs and endocrinologists with severe gap payments. This may also involve an approval letter obtained after multiple sessions with a mental health care provider. 

Gender affirmation surgeries (which, like hormone treatment, can be life-saving) still have little to no Medicare coverage, meaning they are often prohibitively expensive and can leave people in tens of thousands of dollars of debt[1].

Estradiol valerate injections, in many cases the best and healthiest form of HRT for trans women and transfeminine people, and the most commonly prescribed form of HRT in other countries, is still not covered by the PBS and can therefore cost hundreds of dollars each month from a compounding chemist.

Many of the (once again I must stress, life saving) procedures designed to address the medical condition that is gender dysphoria, such as facial feminisation surgery, are also classified as cosmetic and therefore not covered at all[2].

The same can be said for other non-surgical treatments which, in addition to addressing gender dysphoria, can in some cases be vital for a trans person to have any chance at existing openly in society, such as laser hair removal, are also not covered at all, and can cost yet more hundreds or thousands of dollars. The total cost of transition (including clothing, medical treatment, etc) can add up to over $100,000 for some people[3].

It is important to remember that It would take almost zero effort for the government to address this. Make no mistake - every single death that this causes is a political choice.

Money Money Money, Must be Funny, in a Cis Man’s World

It’s not just gender-affirming healthcare where the budget falls flat for trans people, Many of this budget's more general shortfalls - medical or otherwise - also impact trans and gender diverse people disproportionately.

One in five trans and gender diverse people in Australia will experience homelessness in their lifetime. However, despite the government’s ‘one million affordable houses’ claims, this budget will provide for the construction of at most 20,000 public houses and 30,000 social houses[4].

Almost half of trans and gender diverse people aged 14-25 have reported attempting suicide in their lifetime, and yet mental health care is still not sufficiently covered by Medicare. The few mental health care providers who deal with transgender mental health issues specifically are also providers with expensive gap payments. Without seeking out one of these specialist mental health care providers, trans and gender-diverse people often find themselves having to educate their psychologist or counsellor, as they may have no prior knowledge about the specific mental health challenges faced by TGD people, and may never have dealt with a TGD patient.

Two in five will experience employment issues[5], yet JobSeeker still punishes recipients with punitive mutual obligations and unlivable rates.

This is before the many hidden costs of being trans in today’s society, such as having to take a taxi or rideshare home because of risks to one’s own safety.

A Personal Note

I’ve mainly written about the issues in this article omnisciently, but these issues are all too real. Without the support of family, the costs of doctor’s/specialist’s appointments, treatments and other costs such as clothing, place tremendous weight on my finances while working and studying. I must recognise that I am lucky even to be able to afford what I can.

It’s perhaps no surprise that when economic conditions worsen, the most marginalised people experience the worst impacts. We seemingly have come to accept that the Labor government will do little to help those who need it. We are conditioned to accept that they do not care about us. As I said before, however, we must remember that all of the harm caused here is a political choice.

References

[1] https://www.transhub.org.au/grs

[2] https://www.transhub.org.au/surgery

[3] https://www.abc.net.au/news/2018-03-02/the-hidden-$100,000-price-tag-on-being-transgender/9498918

[4] https://www.abc.net.au/news/2022-10-25/federal-budget-million-affordable-home-rental-target-explained/101575038

[5] https://www.transhub.org.au/surgery

Content moderator: Antipoverty Centre