One of the country’s biggest medical insurers will no longer cover private practitioners prescribing gender affirming care to adolescents.
MDA National, one of four major medical indemnity providers insuring GPs and other private practitioners against legal claims, updated its policy this month to exclude cover for claims ‘‘arising from aspects of gender transitioning treatment for under 18-year-old patients’’.

Dr Michael Gannon, the organisation’s president, said young people experiencing gender dysphoria should be first assessed by multidisciplinary teams in hospital.
‘‘This is the same hospital system that is very, very comfortable placing greater demands on general practitioners,’’ he said. ‘‘It’s simply not fair to ask individual GPs in the suburbs or the bush to be making these complex decisions.’’
Gannon said the decision was made in response to legal cases overseas, including the inquiry into, and subsequent closure of, Britain’s only children’s gender clinic:
‘‘We’re not taking a moral stance or an ethical stance – this is very much an insurance decision. We don’t think we can accurately and fairly price the risk of regret.’’
Dr Portia Predny, a GP at Rozelle Medical Centre and vice-president of the trans health advocacy body AusPATH, said she was concerned the change would further limit the options available to transgender adolescents by discouraging private practitioners from treating them.
‘There are very few clinics who actually service this group of patients,’’ she said. ‘‘There’s already barriers to care for this age group – this is care that’s often life-saving, and that’s not an exaggeration.’’
She said AusPATH had been reassured by two other major insurers, Avant and Medical Indemnity Protection Society (MIPs), that they would continue to cover GPs prescribing hormones to transgender patients under 18.

Predny said GPs were working with other healthcare providers, such as psychiatrists and endocrinologists, to provide safe care. ‘‘To state that the only way for people to access interdisciplinary care is through a multidisciplinary clinic [at a hospital] is misleading,’’ she said.
NSW has funded gender clinics at Westmead Hospital and Maple Leaf House in Newcastle.
Associate Professor Ruth McNair, of the University of Melbourne’s department of general practice, said requiring every young person experiencing gender dysphoria to go through a public gender clinic first would strain waiting lists.
McNair said GPs who prescribe hormones to underage patients were already cautious, and any patients with complex clinical histories, such as pre-existing mental health problems or past trauma, were urgently referred to public clinics for specialist treatment.
‘‘It’s a bit short-sighted really. They’re trying to capture the [minority] of cases [where patients regret].’’
MDA National will still cover GPs providing repeat prescriptions for gender-affirming hormones and general healthcare for patients with gender dysphoria.
Source: The Sydney Morning Herald