Gender-affirming surgeries could be made more accessible to Australians if a proposal to cover them under Medicare is approved.
The Australian Society of Plastic Surgeons has lodged an application for gender-affirming procedures, including double mastectomy, phalloplasty, orchiectomy and vaginoplasty, to be eligible for financial rebates.
The Medical Services Advisory Commission (MSAC) first reviewed the proposal in 2023, noting a lack of data about outcomes for Australians but acknowledging the need for such services. A final recommendation will follow further research by the Department of Health, Disability and Ageing.
For many transgender Australians, the cost of surgery is a major barrier.
Nineteen-year-old transgender woman Rachel McCoy said her plans for gender-affirming care are shaped by the financial burden.
“If there was a button that could just do vaginoplasty for free, I would go for it. Otherwise, I’m not interested in these surgeries. It’s a lot of money,” Ms McCoy said.
“Having it cheaper would make the option way more worth considering. These are medical interventions that help people … we are talking about a demographic that is, on average, more afflicted by poverty. To have options with such high rates of satisfaction, they should be covered.”
Thirroul student Lucas Bowles, a 20-year-old transgender man, said his double mastectomy had a positive impact but left his family with a significant financial strain.
“I got a double mastectomy at 17 and it was great. The benefits vastly outweighed the side effects,” Mr Bowles said.
“I believe the cost was $15,500. The only way my parents were able to afford it was that my mother had recently come into an inheritance. All of it went to my surgery.
“It would do so much good for the community as a whole to have that lift on financial burden … that is the reason why people aren’t getting these surgeries.”
Gender-affirming procedures in Australia can cost between $8,000 and $80,000 depending on the surgery and surgeon. Research shows the operations reduce rates of suicidal ideation among transgender people, who already experience higher rates of mental health struggles compared to the wider community.
Advocates argue expanding access would not only improve health outcomes but support transgender people’s right to bodily autonomy.
