MDA National is sending the wrong message to gender-diverse teens and their doctors, and it may cost them members as well.
GPs may leave MDA National over its decision to withdraw insurance coverage for gender-affirming care for adolescents under 18, say gender diversity advocates.
MDA National said today it would no longer cover private practitioners prescribing gender-affirming care to adolescents, not for moral or ethical reasons but because “we don’t think we can accurately and fairly price the risk of regret”.
The organisation’s president Dr Michael Gannon was quoted as saying young people experiencing gender dysphoria should be initially assessed by multidisciplinary teams in hospital – not by GPs: “It’s simply not fair to ask individual GPs in the suburbs or the bush to be making these complex decisions on their own.”
One GP who has already left the MDO is Dr Clara Tuck Meng Soo, a transgender GP and gender-affirming care provider. She told TMR MDA National’s decision was “transphobic, frankly”.
“Why are they still providing coverage to cosmetic surgeons?” she said. “There’s much more risk involved in that than in gender-affirming care.
“Why don’t they simply say ‘if you’re going to provide this care, we will charge you a higher premium’? It’s transphobia, frankly.”
Dr Soo said she was a member of MDA National when they contacted her about the policy change.
“I asked their underwriting manager what the evidence was for this risk,” she said. “She said there were six cases globally and one in Australia.
“That is just not statistically valid evidence for anything. They are just acting on supposition and not evidence, and that is not good enough.”
Dr Soo said she was moving from MDA National to MIPS for her indemnity insurance as a result of the decision, and she believed other GPs who offer gender-affirming care would do the same.
“This sends a signal to doctors who were maybe thinking about getting into this area. It will deter some of them. Maybe that’s what MDA National are trying to do,” she said.
Dr Gannon’s concern for GPs being forced to make “complex decisions” was laughable, she said.
“We make complex decisions all the time. And we create multidisciplinary teams all the time as well.
“This decision is all about pushing the risk on to hospital insurers.”
RACGP president Dr Nicole Higgins said she was “deeply concerned” about MDA National’s decision.
“We’re doctors. We make decisions based on well balanced evidence, not on anecdotes. The signal this sends is to both doctors and patients and their families is not a good one.”
AMA president Professor Steve Robson said he was concerned about an MDO inserting itself into the care process.
“We are supportive, always, of compassionate, evidence-based care with the patient at the centre of a multidisciplinary team,” he told TMR.
“We’re concerned about an MDO intruding on that. We’ll be very interested in understanding why MDA National have made this decision.”
Dr Owen Bradfield, chief medical officer for Medical Indemnity Protection Society, told TMR via email that MIPS covered its members for gender-affirming care provided to adolescents.
“However, this is subject to a general requirement in the MIPS’ Indemnity Insurance Policy that all members must have the appropriate training, qualifications, and experience in relation to any healthcare services they provide, and that they adhere to the Medical Board of Australia’s Code of Conduct,” he said.
“This requirement applies to all members providing any healthcare, not just those providing gender-affirming healthcare.”
MIPS had no current plans to remove this cover from its members, Dr Bradfield said.
MDA National, Avant, and MIGA were contacted for comment on this story but did not respond by publication.
