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AusPATH STATEMENT ON BLACK LIVES MATTER

The Australian Professional Association for Trans Health (AusPATH), established in 2009, is Australia’s peak body for professionals involved in the health, rights and wellbeing of trans people, including those who are binary, non-binary and gender diverse. The AusPATH membership comprises approximately 300 experienced professionals working across Australia.

AusPATH stands in solidarity with advocates across Australia, and around the world, fighting against anti-Bla(c)k racism, of which those who are trans and also First Nations, Blak or people of colour are disproportionately affected and most impacted, globally. We see this particularly among our trans sisters.

Racism is not an issue confined to the United States. It is a systemic and pervasive problem in Australia that continues to cause harm to the health and wellbeing of trans people of colour and First Nations trans people. The impacts of colonisation in Australia have created inequities that leave Sistergirls, Brotherboys, other trans Aboriginal and Torres Strait Islanders and trans people of colour more vulnerable to discrimination and stigma within healthcare settings, in public, on the street, at home, at work, at school and across the lifespan. This must end.

We know all too well that trans people in Australia shoulder some of the heaviest burdens of poor health and wellbeing. The communities AusPATH serves report highly disproportionate experiences of emotional, financial, physical and sexual violence, disproportionate rates of social isolation, rejection, unemployment, distress, self-harm, substance use and suicidality. We also know that trans people in Australia experience barriers to medical and mental health care. Racism further compounds these experiences for trans people who are First Nations, Blak or people of colour.

Racism and transphobia are key social determinants to ill-health, reduced quality of life and mortality; transphobic racism is bad for our communities’ health.

In recent weeks, our social media and television screens have made the disproportionate policing, criminalisation and incarceration of First Nations, Black and people of colour all the more visible. However, racism has long been entrenched in our education, healthcare, political and legal systems. Even today, trans women, trans men, and non-binary people in Australia, many of whom are Sistergirls and Brotherboys, are held in prisons that do not reflect their gender.

AusPATH will continue to focus our communication platforms on promoting and amplifying trans First Nations voices and the voices of trans people of colour in Australia. The Board of Directors commits to facilitating ongoing education and dialogue within our own organisation and membership and we make a commitment to actively seeking increased representation from trans First Nations people and trans people of colour on the AusPATH Board.

AusPATH calls for Federal, State and Territory governments and policymakers to urgently partner with community-controlled organisations to address the systemic racism and transphobia that contributes to the ill-health of trans First Nations people. AusPATH encourages healthcare providers and the medical community to challenge personal beliefs about race and gender so that the highest attainable level of health can be accessed by all trans people in Australia.

All Bla(c)k Lives Matter. Bla(c)k Trans Lives Matter.

AusPATH Board of Directors and Policy Committee

Thank you to the Sistergirls and Brotherboys who helped us write this statement.

July 2020

PUBLIC STATEMENT IN RESPONSE TO RECENT MEDIA REPORTING

Response to recent media reporting in The Australian newspaper regarding health care for transgender children and adolescents:

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. Our organisation is concerned that the recent reporting in The Australian newspaper regarding health care provided to TGDNB children and adolescents is biased, emotive and is not based on fact. The reporting ignores available scientific evidence which strongly endorses supporting TGDNB children through social and medical transition to improve their mental health outcomes.

A study of the mental health of TGDNB young people living in Australia (Trans Pathways 2017) found very high rates of ever being diagnosed with depression (75%), anxiety (72%) and self-harm (80%), with 48% of these young people under the age of 24 years ever attempting suicide. It is well recognised that these poor mental health outcomes are not inherent to being TGDNB but are due to these individuals experiencing high levels of stigma, discrimination, social exclusion, family rejection, bullying, harassment and assaults.

The evidence for an affirmative model of care has been publicly scrutinised in Australia through both academic and legal processes at the highest level and is currently standard clinical practice not only in Australia but in New Zealand, USA, Europe and across many other countries and regions across the globe.

1. Academic scrutiny of the evidence for social and medical intervention in TGDNB young people

In 2017, AusPATH endorsed the Australian Standards of Care and Treatment Guidelines for Transgender and Gender Diverse Children and Adolescents. This guideline is a collaboration of approximately 50 clinicians and researchers across Australia and NZ and is based on empirical scientific evidence and expert clinical consensus. This was peer-reviewed and published in the Medical Journal of Australia in June 2018. Later that month it was again reviewed and endorsed through an editorial in The Lancet, which stated that;

“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.”

2. Legal scrutiny of the evidence for medical and surgical intervention in TGDNB young people

The Full Bench of the Family Court of Australia has twice reviewed the academic and clinical evidence for medical intervention in TGDNB adolescents through Re Jamie (2013) and Re Kelvin (2017). In Re Kelvin, evidence was submitted to the Full Bench of the Family Court from clinicians supporting the care for TGDNB children and adolescents as well as from those who oppose medical intervention. Overwhelmingly, the scientific evidence submitted to the Court and taken into evidence demonstrated that medical intervention not only improves mental health outcomes, but saves lives by reducing suicide. The Full Court decision removed the legal process from medical decisions to assist with improved access to affirming care, thereby improving mental health outcomes.

The Royal Commission into Victorian Mental Health Services undertaken in July 2019 also heard expert evidence through cross examination and written submissions from current AusPATH members. It is clear that the facts related to the gender-affirming care of TGDNB people have had ample opportunity for public scrutiny.

Whilst the evidence for affirming practice demonstrates improvements in mental health outcomes, there is also extensive evidence that psychological practices, such as conversion or reparative therapies which deny social and medical interventions, lack efficacy, are considered unethical and cause significant harm to the health and well-being of TGDNB people, and their families.

For those who work clinically with TGDNB children and adolescents, we see the benefits supportive care can provide. We also see the harm that inaccurate and biased reporting in the media can have on these young people and their families. Ignoring the facts in the reporting on this issue is irresponsible and, most importantly, not in the best interest of these young people due to the significant harm it causes.

Board of Directors, The Australian Professional Association for Trans Health (AusPATH)

Associate Professor Michelle Telfer, Paediatrician and Adolescent Medicine Physician

Dr Jaco Erasmus, Psychiatrist

Dr Belinda Chaplin, University Lecturer in Nursing

Mr Andrew Ives, Plastic Surgeon

Dr Fiona Bisshop, General Practitioner

Mr Rainer Jardin, Clinical Psychologist

August 2019

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

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