T.L.C. & Medicine: The Facts

Author Unknown

(The Gender Centre advise that this article may not be current and as such certain content, including but not limited to persons, contact details and dates may not apply. Where legal authority or medical related matters are cited, responsibility lies with the reader to obtain the most current relevant legal authority and/or medical publication.)

Our Desired Goal is a Transgender Health Service, designed by tranys to cater for our needs, staffed by trany-friendly and trany-sensitive professionals and run by our community.

It was amazing to see some of the allegations in the last issue of Polare about T.L.C. and surgery. They were so far wide off the mark that one might think that they were from a different planet. So we would like to set the record straight, and to bring tranys up to date on what is actually happening in the area of medical services.

First of all, T.L.C. has never, and we repeat never, opposed surgery. In fact, the only statements made by a T.L.C. spokesperson on the subject were by Aidy Griffin, when she was the spokesperson. This was "that surgery should be made available on Medicare" - this is one of the recommendations of the 1993 Transgender Lifestyles and H.I.V. / AIDS Risks Report, co-authored by Roberta Perkins and Aidy Griffin.

Here is an update to further clarify misinformation spread on recent developments in trany health:

• At the beginning of 1996, T.L.C., along with numerous other members of the trany community, informed the Department of Health of what changes we saw as desirable concerning its review, conducted by David Lowe, of guidelines relating to sex modifying procedures (S.M.P.'s). This process is known in bureaucratic circles as "the terms of reference". The Gender Centre gave written support to these "terms of reference".
• A wide array of community members, including T.L.C. and the Gender Centre, advised psychiatrists of our wishes of changes concerning S.M.P.s. One psychiatrist, Dr. Sandy Murray, made a submission based on his consultations with tranys. This submission became part of the final recommendations David Lowe has made to the Department of Health.
• T.L.C. made a submission to the Love Inquiry into guidelines around sex reassignment surgery last year. T.L.C. argued for surgery available on Medicare at a university teaching hospital. T.L.C. proposed that tranys should be allowed to decide for themselves whether they wanted surgery or not. (This is referred to as a "Client Autonomy Model" in Lowe's Report).
• We argued it was critical that informed consent was given by tranys. The best way to ensure this was by attending gender transition classes where people would be given a range of lifestyle alternatives available to tranys, whether they entailed surgery or not. Anyone who attended such classes would be in a position to give informed consent, and they should be supported no matter which option they chose. Attendance of these classes would be entirely voluntary. Tranys who chose not to attend these classes wouldn't have their chances of approval for surgery or hormones jeopardised.
• In no way do any of these developments in trany health effect the availability of hormones to tranys. As far as we are aware of there have been no changes to hormone policy as slanderously forwarded in the last edition of Polare. Any rumour spreader should know that policy pertaining to services such as the availability of hormones is regulated at a federal and not a State level and it is at a State level that the transgender community, T.L.C. and the Gender Centre have been involved in consultations on health matters. Changes to a health policy on a State level never affect Federal health policy or any Federal Department policy for that matter because Federal Laws and policies always have jurisdiction over State Laws and policies.

So the claims that have been circulating are false. Indeed, at the recent Gender Centre convention, The Gender Centre Projects Manager, one of the prime sources of these unsubstantiated rumours agreed that he had been acting on false information and apologised to T.L.C. for this. If anyone still retains any doubts about what we are saying, copies of both these reports are available at the Gender Centre and anyone interested can read it for themselves. We hope that, at last, this clarification can shed some light on these false rumours. It's sad that so many have been misinformed and misled.

So we can move to matters more real, relevant and exciting.

Following the withdrawal of Dr Greenway from the area, it has become more difficult for tranys to get approval for surgery. Dr Greenway's withdrawal followed the December 1995 working party on changes to "standards of care for persons seeking sex modifying procedures (S.M.P.'s)". Greenway refused, unlike other psychiatrists, to consult with the transgender community on the issue and, unlike other psychiatrists, insisted on using the contentious "gender dysphoria" illness model to define tranys. When we objected to this, he stormed out of the working party.

This lack of access to trany friendly psychiatrists was brought to Aidy Griffin's attention by Elizabeth of the Gender Centre. Griffin's immediate reaction was to ask some psychiatrists from the Gay, Lesbian, Bisexual Interest Group of psychiatrists to fill the gap made by Greenway's departure. From the outset it was made clear that at least some of them would be expected to give surgical approvals. They responded positively.

These people were not chosen because of their (perceived) sexualities. For two years now, tranys, including Roberta Perkins, Jill Hooley and Aidy Griffin have been giving papers at their conferences. They are interested in trany issues and in tranys. That is the primary reason. Among other reasons for their choice are:

• they were prepared to listen to tranys first, they welcome education in trany issues from tranys;
• they do not want to use the D.S.M.-IV/gender dysphoria model that sees tranys as pathological or sick; and
• because of their own personal histories, they understand issues around coming out, discrimination and ostracism and thus, are in a better position to relate to tranys with issues in these areas.

A meeting was arranged with representatives of the Gender Centre (both staff and management committee) to take this process further. Everyone seemed to get along well. We all (the transgender community, the psychiatrists and the Gender Centre) agreed that the process required some kind of community approval to continue - so the ideas were put to the Gender Centre's Convention in January and received overwhelming support.

In early February, a meeting between 9 tranys (both M.T.F. and F.T.M., pre-op, post-op and non-op) and about six psychiatrists occurred. This was the first in a series of dialogues between tranys and the psychiatrists so that we can educate them about what kind of services we want them to supply. A representative of the Royal Australian & New Zealand College of Psychiatrists is now actively involved in this process.

For as long as we've been around, tranys have been expressing dissatisfaction with services from psychiatrists and other medical professionals. How many times have we all heard tranys say, "They never believe you when you tell the truth and only believe you if you lie"?

This process is a chance for us to change it all for the better - and we will all be the better off for that. To make it work, it needs your involvement, your views and your energy. Every contribution by a trany will make the final result better. So you are urged to contact the Gender Centre and get involved.

Our desired goal is a transgender health service, designed by tranys to cater to our needs, staffed by trany-friendly and trany-sensitive professionals and run by our community. You may share this goal or you may have another, and who knows, better idea. Now is your chance to put it forward and make it a reality.

Polare is published in Australia by The Gender Centre Inc. which is funded by the Department of Community Services under the S.A.A.P. Program and supported by the N.S.W. Health Department through the AIDS and Infectious Diseases Branch. Polare provides a forum for discussion and debate on gender issues. Advertisers are advised that all advertising is their responsibility under the Trade Practices Act. Unsolicited contributions are welcome, though no guarantee is made by the Editor that they will be published, nor any discussion entered into. The editor reserves the right to edit such contributions without notification. Any submission which appears in Polare may be published on our internet site. Opinions expressed in this publication do not necessarily reflect those of the Editor, The Gender Centre Inc.I, the Department of Community Services or the N.S.W. Department of Health.