The Australian Government has announced a new national action plan and a $26 million investment in health and medical research focusing on LGBTIQA+ communities.
The Government said that LGBTIQA+ people have unique and often complex health needs, and difficulty getting appropriate health care, which can lead to poorer physical and mental health outcomes, and the 10 Year National Action Plan for the Health and Wellbeing of LGBTIQA+ people will guide how Australia addresses health disparities and make improvements across the health system.
The Minister for Health and Aged Care, Mr Mark Butler, made the announcement at a media event on 1 March 2023 during the World Pride 2023 Human Rights Conference, following a roundtable on LGBTIQA+ health hosted on Tuesday by Assistant Minister Ged Kearney.
The roundtable marked the first step in a national consultation that will inform the action plan and an LGBTIQA+ Health Advisory Group will be established to guide its progress.
“As World Pride celebrations continue in Sydney, there is no better time to demonstrate how committed this Government is to health equality,” Minister Butler said.
“While many LGBTIQA+ people live happy and healthy lives, others continue to experience discrimination, stigma, isolation, harassment, and violence – all of which leads to poorer health and mental health.
“The sector called on the Government to develop an action plan, we listened, and we have acted.”
The Government also announced the largest ever national investment in LGBTIQA+ health research, with a $26 million grant round funded through the Medical Research Future Fund.
The grants will support projects seeking to improve treatment and care for LGBTIQA+ people.
“The plan will guide the reforms needed to ensure LGBTIQA+ Australians are given every chance to live healthier lives,” Minister Butler said.
“The plan will build on the Government’s commitments to accelerate the elimination of HIV transmission in Australia.”
“We know that there are unacceptable disparities in health outcomes and significant barriers to getting the health care LGBTIQA+ people deserve.” Assistant Minister Kearney agreed.
“I am proud of how far we have come, and I am even prouder to stand beside so many fierce advocates in the LBGTIQA+ community that have fought to get Australia where we are today.
“But the fight is not over: when the glitter washes away, we have real work to do and the new path to better health must be paved together.
“I look forward to working with community members, peak bodies, and clinical experts to make the health system welcoming, supportive and effective for every Australian.”
However, the announcement coincided with the release of a new report investigating the experiences of clinicians involved in providing gender affirming care to young people at the Westmead Children’s Hospital in Sydney, which revealed that despite the existence of strategic guidelines, the evidence base for all aspects of treatment was sparse, especially relating to long term outcomes.
The report, published 7 February 2023 in Children, showed that 22.1% of child and adolescent participants discontinued their gender-affirming hormone treatment for gender dysphoria (GD), and that among those still undergoing treatment, 88% still reported ongoing mental health concerns and educational/occupational outcomes varied widely.
The study highlighted the importance of careful screening, comprehensive biopsychosocial (including family) assessment, and holistic therapeutic support, noting that even in highly screened samples of children and adolescents seeking a GD diagnosis and gender-affirming medical care, outcome pathways follow a diverse range of possibilities.
“For the group of young persons who persisted along the medical pathway, the consequences of receiving gender-affirming medical interventions—especially those that are irreversible—are likely to be life changing,” the authors said.
“If the choice of pathway was the right one for any particular young person, it may well support ongoing adaptation and wellbeing, yet if the choice of pathway was not the right one, it may seriously distort both the young person’s life choices and ongoing sense of wellbeing.
“Using the present cohort as a reasonable sample, one could project that more than a fifth of the sample could have been exposed to inappropriate medical treatment, future regret, and potential harm.”
Alongside their international colleagues, the multidisciplinary team became aware of a recent increase in the number of presentations of what has been termed late-onset, rapid-onset, or adolescent-onset GD.
“This group of adolescents, predominantly female, had no prior history of gender distress during early development and presented with sudden-onset gender-related distress,” the authors said.
“The absence of prior history raised questions that this group of adolescents were being drawn to the construct of gender dysphoria because of some evolving social process.”
Back in April 2021, the team from Westmead revealed that doctors felt forced to compromise their own ethical standards when complying with the current model of gender affirmation, highlighting that a ‘conveyor belt mentality’ and the impact of a ruling by the Family Court of Australia in 2017, was not only putting pressure on clinicians to prescribe hormone therapy but had resulted in almost no engagement with the therapeutic process by families.
“Children did not have the cognitive, psychological or emotional capacity to understand the decisions they were making,” the team pointed out.
“It became apparent to us that children in early and mid-adolescence found it difficult to consider issues concerning parenthood and fertility, along with the impact of medical interventions on their future capacity to bear children, because the issues were not yet pertinent to them at their present developmental stage.”