MDA National, under fire for excluding some gender-affirming care from coverage, has now lost the country’s future doctors.
The Australian Medical Students’ Association has disaffiliated from medical defence organisation MDA National over the insurer’s decision to exclude cover for doctors initiating gender-affirming hormonal treatment to under-18s.
“[The policy change] sets a harmful precedent for the future of trans and gender-diverse healthcare, and perpetuates the treatment inaccessibility and healthcare inequities currently faced by trans and gender diverse patients,” AMSA said in an announcement, signed by the national chair of AMSA Queer Dineli Kalansuriya, AMSA president Tish Sivagnanan and the president of AusPATH Professor Ashleigh Lin.
On 29 May MDA National announced it could not “accurately and fairly price the risk of regret”, and that “it’s simply not fair to ask individual GPs in the suburbs or the bush to be making these complex decisions on their own”.
That led to a call for a boycott of MDA National by gender-affirming care providers.
MDA National’s policy change rescinding cover is based upon the risk of liability for doctors in cases of “transition regret”, the AMSA statement says, citing evidence that the actual rate of regret was “very low”.
This evidence “includes a meta-analysis of several thousand surgical cases showing a rate of ‘regret’ from surgery of less than 1%, a significantly lower rate of regret than many other common procedures”, the AMSA statement says.
“‘Transition regret’ and re/detransition are not synonymous. A person may detransition without regret, or may regret an aspect of their care while still living as a trans person.
“Reasons for ‘transition regret’ are diverse, and may not represent a desire that the transition was not attempted at all. As evidenced in pertinent medico-legal literature, when doctors have provided supportive care according to informed consent models, previous case law, legislation, policy and community authored guidelines, they can be assured they have provided the best management possible.”
AMSA says that based upon high-quality evidence and an orientation towards rights-based medical care, all safe gender-affirming treatment should be covered by indemnity insurers.
“We are accountable to our members through our policy base which is voted upon by representatives from all the Australian medical schools,” it says.
“As the peak representative body for Australia’s future doctors, AMSA stands in solidarity with transgender and gender-diverse communities.”
