Advocacy

AUSPATH SUPPORTS INCLUSION OF GENDER IDENTITY IN THE 2021 AUSTRALIAN CENSUS

The Australian Professional Association for Trans Health (AusPATH) was established in 2009 (previously as the Australian and New Zealand Professional Association for Transgender Health) and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.

AusPATH supports the addition of meaningfully inclusive questions on gender identity within the 2021 Census.

Population estimates from cross-sectional studies, such as the National Survey of Australian Secondary Students and Sexual Health 2019, indicate that 2.3% of young people are trans, including  gender diverse or non-binary (TGDNB). However, despite the relatively large size of this population, no national population data exists.

It is well established that TGDNB Australians experience a range of health and wellbeing challenges at higher rates than the general population, but in order to establish the true extent of the issues and respond at an appropriate level, the number of TGDNB  people living in Australia must be known.

It is also well documented that the TGDNB population has a higher prevalence of mental health conditions such as depression, anxiety disorders, violence (including domestic violence), abuse, self-harm and suicide attempts compared to the general population. Knowing the population size and characteristics will allow the design and distribution of necessary health services to areas of need, and appropriate allocation of resources.

TGDNB people are included as a national priority in the 5th National Mental Health and Suicide Prevention Plan, and addressing the above issues is a necessity if this is to be a success. Additionally, while a paucity of data exists at a national level of the prevalence of TGDNB people living with HIV/AIDS, they are also considered a priority population in the 8th National HIV Strategy. Furthermore, for healthy ageing and aged care, TGDNB people are included in the 2012 National Lesbian, Bisexual, Transgender and Intersex (LGBTI) Ageing and Aged Care Strategy.

In light of the Federal Government’s commitment in these important policy areas, it becomes imperative that accurate and relevant data be collected at the national level to help address the diverse needs of TGDNB people. Without comprehensive, inclusive national data, essential planning of resources at a population level cannot be undertaken in these key areas. The 2021 Australian Census of Population and Housing offers the ideal opportunity to obtain accurate data to reflect the reality of the Australian population.

Collecting data on gender using options variables such as ‘male, female or trangender’ is contrary to best practice and is likely to confound analysis given that most TGDNB people are simply male or female. We recommend a two-step methodology, as per well-established and tested guidelines applicable to an Australian and global context.  This approach involves a question about the marker used to register an individual’s birth (male or female) alongside a second question about an individual’s gender identity (male, female or non-binary). These simple questions are easy to understand and would be acceptable to the broader general population.

This approach was not followed in the 2016 Census survey instrument resulting in an inadequate and inaccurate representation of Australia’s TGDNB population. The ABS confirmed this with a statement, ‘This count is not considered to be an accurate count, due to limitations around the special procedures and willingness or opportunity to report as sex and/or gender diverse’.

In summary, AusPATH believes that it is both important and possible to collect data on gender identity in a national census. This is of national importance, and such data will satisfy a vital need in enabling better health service delivery for the TGDNB population. The collection of such data will be acceptable to census respondents, and it can be collected accurately and efficiently. There is likely to be a continuing need for such data in future censuses.

Furthermore, AusPATH endorses previous statements made by the National LGBTI Health Alliance, Equality Australia, and Intersex Human Rights Australia (IHRA) in support of the meaningful inclusion of questions related to sexual orientation, gender identity and intersex status.

AusPATH supports the inclusion of a two-question format related to gender identity in the 2021 Australian Census.

AusPATH Board of Directors

18 December 2019

AUSPATH POSITION STATEMENT ON "RAPID-ONSET GENDER DYSPHORIA (ROGD)"

The Australian Professional Association for Trans Health (AusPATH) was established in 2009 and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.

The term “Rapid Onset Gender Dysphoria (ROGD)” is not a diagnosis or health condition recognised by any major professional association, nor is it listed as a subtype or classification in the Diagnostic and Statistical Manual of Mental Disorders (DSM) or International Classification of Diseases (ICD). Therefore, “ROGD” is an acronym describing a proposed phenomenon, with insufficient peer-reviewed scientific evidence to support its implementation and/or use within clinical, community, social and legal settings1.

AusPATH affirms the rigorous processes by which diagnoses are developed and applied. These academic and clinical processes operate within professional medical organisations, and are developed by expert working groups of  scientists, clinicians, and stakeholders over long periods of time, with high levels of scientific scrutiny of the evidence-based literature. “ROGD” does not meet this standard, and therefore is not recognised by AusPATH.

Whilst many have a clear picture of their gender from a very early age, for others the journey towards understanding their gender is more prolonged. The timing of when an individual discloses their gender to others is a separate consideration and does not necessarily reflect the development of their experienced gender. Many do not disclose their identity, rather hiding it for fear of negative reactions from others, including family rejection, discrimination, stigmatisation and social exclusion. The term “Rapid Onset Gender Dysphoria” is not, and has never been, a diagnosis or health condition but has been used in a single report describing parental perception of their adolescent’s gender identity without exploration of the gender identity and experiences of the adolescents themselves.

AusPATH encourages continued scientific exploration within a culture of academic freedom, not censorship. All TGDNB people are deserving of gender-affirmative, evidence-based care that is underpinned by contemporary, adequately endorsed and community engaged standards of care and clinical guidelines.

AusPATH recognises the harms caused by conversion, reparative and aversion treatments and opposes any such efforts to invalidate an individual’s experienced gender. AusPATH supports affirmative responses to young people whereby self-reported gender is respected, and young people are able to safely explore their gender and expression without judgment, pathologisation or predetermined outcome. AusPATH urges caution in the use of any term that has the potential to invalidate a person’s gender.

AusPATH Board of Directors

30 September 2019

  1. WPATH (World Professional Association for Transgender Health) position on “Rapid-Onset Gender Dysphoria  (ROGD)” 4 September 2018

AUSPATH POSITION ON AFFIRMATIVE MODEL OF CARE

The Australian Professional Association for Trans Health (AusPATH) is an organization which actively promotes communication and collaboration amongst professionals involved in the health, rights and well-being of people who identify as trans, including gender diverse and non-binary (TGDNB). As such, we acknowledge and applaud contemporary research in this field which informs a better understanding of how best to assist TGDNB people of all ages.

An affirmative model of care for children and young people who identify as TGDNB is standard clinical practice in Australia and NZ. In 2017, AusPATH endorsed the Australian standards of care and treatment guidelines for transgender and gender diverse children and adolescents, a guideline based on empirical scientific evidence and expert clinical consensus. This was published in the Medical Journal of Australia and later endorsed through an editorial in The Lancet. As The Lancet editorial states, “Children and adolescents with gender dysphoria often experience stigma, bullying, and abuse, resulting in high rates of mental illness, including depression, anxiety, and self-harm. But with supportive, gender-affirming management, as laid out by the Australian guidelines, these consequences can be minimised.”

Gender-affirming care encourages clinicians to listen to the child or adolescent, and their families, and to support them to explore and express their identity as they wish to do so. For children who desire to socially transition, research demonstrates that following transition, these children can demonstrate levels of emotional functioning and self-worth which is comparable to their cisgender peers, and clinical observation supports the role of social transition in ameliorating distress within this population. Social and medical transition in adolescents is also associated with improved mental health outcomes as well as educational and vocational attainment equivalent to their cisgender peers.

There is extensive evidence that psychological practices undertaken in an attempt to change a person’s gender identity to be more aligned with the sex assigned at birth (known as conversion or reparative therapies) lack efficacy, are considered unethical and can cause harm to people’s health and well-being. Denying or withholding care is also potentially harmful and should not be considered a neutral stance. Any group or organisation that promotes practices that deny a person the opportunity to express their gender identity and access support and medical intervention to improve their health and well-being should not be endorsed nor their practices condoned.

ANZPATH Executive Committee
September 2018

AUSPATH STATEMENT ON LEGAL RECOGNITION OF GENDER IDENTITY

The Australian Professional Association for Trans Health (AusPATH) recognises the right of all people to legal identity recognition and to identity documents consistent with their gender and/or sex identity. Further, for optimal physical and mental health, all persons must enjoy the right to freely express their gender identity, whether or not that identity conforms to the expectations of others.

Legally-recognized documents matching self-identity are essential to the ability of all people to find employment, to navigate everyday transactions, to obtain health care, and to travel safely; Gender diversity should not preclude individuals from enjoying the legal recognition all citizens expect and deserve. Barriers to legal recognition may harm an individual’s physical and mental health.

AusPATH opposes surgery or sterilization requirements to change legal gender markers. No particular medical (including hormonal) or surgical procedure is an adequate indicator of a person’s gender identity. These should not be requirements for legal gender change. Living as one’s own identity for a year should suffice.

AusPATH recognizes that there is a spectrum of gender identities, and that choices of identity limited to “Male or Female” inadequately reflect them all. AusPATH supports the option of “X or Other” as a personal choice.

Marital status should not affect legal recognition of gender change, and appropriate legal gender recognition should be available to gender and/or sex diverse youth. The right to legal recognition of gender extends to those incarcerated or institutionalized. Court hearings create financial and logistical barriers to legal gender change, and may also violate personal privacy rights or needs.

Therefore, the Australian Professional Association for Trans Health urges governments to eliminate unnecessary barriers, and to institute simple and accessible administrative procedures for gender diverse people to obtain legal recognition of gender, consistent with each individual’s identity.

AUSPATH SUPPORT FOR THE WORLD PROFESSIONAL ASSOCIATION FOR TRANSGENDER HEALTH'S STATEMENT ON DE-PSYCHOPATHOLOGISATION OF GENDER VARIANCE

The WPATH Board of Directors strongly urges the de-psychopathologisation of gender variance worldwide. The expression of gender characteristics, including identities, that are not stereotypically associated with one’s assigned sex at birth is a common and culturally-diverse human phenomenon which should not be judged as inherently pathological or negative.

The psychopathologisation of gender characteristics and identities reinforces or can prompt stigma, making prejudice and discrimination more likely, rendering transgender and transsexual people more vulnerable to social and legal marginalisation and exclusion, and increasing risks to mental and physical well-being. WPATH urges governmental and medical professional organizations to review their policies and practices to eliminate stigma toward gender-variant people.

©Australian Professional Association for Trans Health - Privacy Policy & Legals

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