Today being International Transgender Day of Visibility, Transgender Victoria looks at what has been won – and what is yet to be.
International Transgender Day of Visibility is a fitting day to take stock of what has been achieved for trans and gender diverse (TGD) people and their families in Australia. More importantly, it gives opportunity to what still needs to be achieved to where TGD people are an equal part of Australian society.
So where are we now? First up, all nine areas of government (federal, six states and two territories) now offer anti-discrimination protection for TGD people, in varying degrees. The federal law is both straightforward and comprehensive (especially for those identifying as other than male or female) and gives some degree of extra coverage over existing state/territory laws. It would be to the benefit of all – TGD people, governments and employers – to standardise the definition of gender identity across all jurisdictions based on the federal law.
Also in 2013, changes were made to Medicare to make some general procedures more gender-neutral and ensure a person, regardless of gender identity, was able to claim Medicare rebates for needed procedures. To give an example how this had caused issues in the past, a trans man (recorded female at birth and identifying as male) who had changed their birth certificate to male discovered he had a cyst on ovarian part. Medicare told him that having a “female only operation (sic) for a male would be Medicare fraud” and he would either have to change his birth certificate back to female or not be able to claim a rebate. Thankfully, due to the changes achieved with the co-operation of Medicare and TGD (and intersex) advocates, this is now a thing of the past.
For TGD young people needing the vital process that is puberty delaying medication, 2013 saw another win, this time in the Family Court. Due to another unrelated legal case on body modifications for minors, it had been necessary to receive Family Court approval for Stage 1 of this medication – which is temporary and reversible. The 2013 precedent meant that Stage 1 was not a permanent change; Family Court approval wasn’t required. This change saves time stress and money for TGD young people and their families, clinics had less paperwork to fill out and Family Court resources were freed up for other cases.
Having documentation that reflects a TGD person’s own sense of self is vital in both health and wellbeing as well as practical terms. In 2011, passport regulations were changed so that the marker on a passport would reflect passport holders’ sense of self, regardless of what was listed on their birth certificate at a state/territory level. This led to easier and safer travel for TGD people and equally importantly, created a precedent that has been followed twice; the first in 2013 when the federal government introduced sex and gender guidelines for TGD (and intersex) people based on similar principles. Completion of the implementation of the guidelines across all federal government departments and agencies is scheduled for June this year.
The second usage of these principles was that the Australian Capital Territory altered its birth certificate laws in 2014 to be on a basis of self-affirmed identity. The birth certificate laws of the other seven states and territories are effectively based on surgical status, although a High Court case in 2011 meant enforcement of a surgical approach in Western Australia and South Australia is questionable. The ACT also allowed changes for minors with parental or guardian consent and gave options other than male or female.
So what needs to happen next?
The answer lies in what could be called the obvious current elephant in the room: the Safe Schools Coalition program. While all areas of lesbian, gay, bisexual, TGD and intersex people were effected by making resources harder to access and sections of the areas regarding allies were cut back, it does seem that when looking at the detail of what happened, the TGD (and intersex) were hit harder. This seems to indicate anywhere from a lack of understanding of these issues through to outright fear of ideas about gender and bodies, which go beyond extreme binary thinking. Further, the idea that it isn’t appropriate to talk about bodies at certain ages borders on ludicrous. It’s appropriate to talk about bodies in relation to people with (say) mobility issues, and people experiencing intersex have the bodies they have from birth; logic then says that it is surely appropriate to talk about their intersex and TGD bodies at any age. It is likely we need further education on the truth of TGD (and intersex) issues to progress further towards full celebration of diversity.
A key problem regarding the establishment of ongoing proactive education that is apart from in New South Wales, and partially in the ACT, there is no ongoing funding for TGD-specific organisations. Until TGD-led organisations around Australia are fully funded, education that can increase understanding (and prevent negative situations) will be at insufficient levels.
While the 2013 Medicare reforms were welcome, a big ticket issue in health care remains the huge out of pocket costs for TGD surgeries not covered by either Medicare or private health cover. The unfunded cost for a trans woman needing surgery in Australia is $15,000. Costs for trans men are harder to ascertain and may involve multiple operations, e.g. chest surgery, hysterectomy. Surgery to add a phallus is not performed in Australia and involves a cost of up to $100,000. This lack of coverage, including the refusal of the public hospital system to allow trans surgeries, is highly discriminatory and probably a breach of federal, state and territory laws. Add in that some private health insurance companies are now requiring a psychiatric diagnosis (further discrimination) and that large numbers of endocrinologists claim trans is still “experimental” (after nearly 100 years – seriously?) and refuse to treat TGD people, much work needs to be done in this area.
Treatment of TGD people by “generalist” health professionals (and other service providers) is also a major issue. Many TGD people who go to a doctor for basic services, such as a flu shot or a sprained ankle, are often forced into being “free learning curves” about TGD when TGD isn’t the client’s presenting issue. Further, the health professional then charges the client. Online education programs for existing health professionals and compulsory inclusion of TGD in future tertiary courses (e.g. doctors, psychologists, social workers) is vital to ensure effective health treatment and ease the load on the few known TGD friendly clinics (which are usually in inner metropolitan areas and less accessible for those in other areas).
The current broad and blanket range of religious exemptions across most jurisdictions also creates discrimination for TGD people (and many other groups). The story of Erik Lock, a trans man who was locked in a room against his will in full view of others at a religious school simply for wanting to wear trousers, is a sad indicator of how viciously these exemptions are used to discriminate against TGD people. At a minimum, organisations wishing to apply exemptions certainly need to be subjected to greater transparency and to apply on a case by case basis.
Similarly, exemptions limiting the ability of TGD people to play sport in their affirmed identity (the exception being Tasmania which abolished these exemptions in 2005 to the benefit of all) are another form of entrenched discrimination – and also often based on misplaced and stereotypical ideas regarding body and identity. The decreased ability of TGD people to participate in sport leads to lower levels of health and fitness. Worth noting are efforts in roller derby and hockey, two sports which have been highly inclusive and shown how easy inclusion can be.
While the issues surrounding marriage equality have been well debated and apply equally to all same-sex couples, one point specific to TGD people is the issue of forced trans divorce. This is where a couple marries with one person being male and the other being female according to each party’s birth certificate. One of them then discloses their need to be their true self re: gender identity. The other partner remains loving and supportive. The TGD person cannot change their birth certificate until the couple divorces (with the exception of those in the ACT) as doing so would “create” a “same-sex marriage.” Marriage equality would eliminate this issue around the country.
Having other jurisdictions make similar changes to birth certificate laws as the ACT is certainly needed and the Victorian government has commenced a thorough process of consultation with TGD (and intersex) people. One improvement on the ACT laws (and the passport regulations) would be the removal of the need for a doctor to write a letter affirming the person’s gender identity. This needs to be replaced with a simple statement by a person who has known the TGD person for a period of time (say 12 months). This is the equivalent of regulations for a new passport for the population at large and therefore gives assurance from a bureaucratic standpoint in ways that are respectful and non-discriminatory.
Finally, any changes to laws and policies and any education all need to take account of “diversity within diversity.” TGD people identify as male, female and non-binary, people of culturally and linguistically diverse backgrounds, sistergirls and brotherboys as part of our original inhabitants, those in regional, rural and remote areas, those who work in the sex industry and all age cohorts. Policies need to cover all areas of life including schools, custody, courts and tribunals, police and security personnel, workplaces and aged care – again, to name but a few. As well, the issues for family members and partners of TGD people certainly need to be a part of any outcomes.
It’s a big list, and work is underway. It can be done with willpower, co-operation, effort and appropriate resources – and then and only the can we achieve full trans and gender diverse visibility for the benefit of TGD people, families and society as one.