One of the largest medical insurers in Australia, MDA National, has recently made the decision to withdraw insurance coverage for doctors in private practice who prescribe hormonal treatment for children and adolescents. The insurer has also dropped cover for private specialists who may face court claims if they determine that individuals under the age of 18 are “suitable for gender transition.”
MDA National, which has a membership of 54,000 health professionals, stated in an email to affected doctors that they believe it is appropriate for the assessment and initial prescribing of hormonal treatment for patients under 18 to occur with the support and management of a multidisciplinary team in a hospital setting.
Effective from July 1st, the decision by MDA National is expected to impact around 100 practitioners across Australia, including general practitioners, pediatricians, and endocrinologists who provide gender-transitioning treatments. The insurer clearly stated in their decision that they will not provide coverage or make payments for claims related to the assessment of patients under 18 or the prescribing of gender-affirming hormones for patients under 18.
MDA National’s President, Dr. Michael Gannon, explained that this decision was motivated by legal cases overseas, including the inquiry into Tavistock Centre, Britain’s only children’s gender clinic. Tavistock, which serves approximately 1,000 children with “gender-affirming care,” is set to close in March 2024 and be replaced by two regional hubs.
Dr. Gannon expressed concerns about the potential long-term risks associated with insurance coverage for gender-affirming care. He stated that decisions made by doctors or clinical matters could result in future clinical problems that may take years to manifest. Considering the life-changing nature of these decisions, he believes that individual doctors should not bear such a high level of risk on their own.
However, MDA National will continue to cover GPs for prescribing gender-altering hormones under certain circumstances. This includes when the prescription is based on recommendations from a non-GP specialist as part of a multidisciplinary team, when prescribing puberty blockers in compliance with Australian standards, or when provided alongside counseling and general healthcare for a patient with gender dysphoria.
Support for MDA National’s decision has come from women’s rights groups such as Binary, who view the insurer’s move as a rational response to minimizing claims. They argue that many individuals who regret their gender transition are not included in statistics due to discontinuing treatment. Binary also highlights the lack of consultation and treatment for underlying issues in minors who are being prescribed gender-altering drugs by Australian doctors and gender clinics.
In addition to MDA National’s decision, the Royal Australian and New Zealand College of Psychiatrists (RANZCP) has also moved away from a “gender affirmative approach.” In 2019, the RANZCP stated that they do not support efforts to change sexual orientation, as there is no scientific evidence to suggest it can be changed and such efforts can cause significant harm.
As the debate surrounding gender-transitioning treatment for children and adolescents continues, some groups are calling for a Royal Commission to be conducted in order to address the concerns and safeguard the well-being of children in Australia. The decisions made by MDA National and the RANZCP reflect the complexities and ongoing discussions surrounding this topic in the medical field.