Senate Community Affairs Legislation Committee [Part 2], , 58:53 to 1:04:43
Officials explain the definitions of gender incongruence and gender dysphoria as established by the World Health Organization and discuss how these terms are applied in medical and legal contexts.
Topics: Health
Speakers: Senator Malcolm Roberts, Daniel McCabe, Senator Nita Green, Prof Michael Kidd, Duncan McIntyre, Senator Ellie Whiteaker, Speaker 7
>> Sure. So, just uh thank you, Senator. Just on the issue of gender in congruence, this is a term that's included as you're mention mentioning um in the World Health Organization's international classification of disease. So it's a very wellestablished uh term. It's not new terminology.
>> Excuse me. Why does something the World Health Organization use make it well
>> Uh because it's uh used uh all over the
>> instead of gender dysphoria.
>> Gender dysphoria is used as well. Um, gender in congruence is I can read the definitions if you like or I can share
>> session read them is fine.
>> Uh, gender in congrance, an objective difference or misalignment between your internal sense of gender and your biological sex assigned at birth. Uh, gender dysphoria, the psychological distress, discomfort, or anxiety that can result from gender in congruence. Not everyone with gender in congruence experiences severe distress. and dysphoria is not an inherent requirement to identify as transgender.
>> Okay. So, Minister, can sex be changed
>> Um, Senator, um, the definitions that we're talking about, um, sex is what someone is, that's their characteristic at birth. And then, um, we we talk about gender in a few different ways. And that's um not necessarily dependent on whether someone does or doesn't have surgery. Uh I'd probably point you we're getting outside the realm of the health department's responsibilities here, but I'd point you to state and territory based laws that look at certain characteristics that people have um when deciding um whether to issue a new birth certificate, for example. And then of course the sex discrimination act recognizes a range of people's
>> attributes as opposed to sex at birth which is
>> it recognizes gender and the attributes that relate to that those genders.
>> So because it's in the law it's right.
>> Well it's a law that's been in place for quite some time. Senator
>> 2011 I think with Julia Gillard
>> supported by the opposition at the time as well. Yeah.
>> They're ruing the day. Um, decisions to add an item to Medicare are made using a legislative instrument in this this this case. Can you confirm the decision will be dealt with by way of a disallowable
>> That's a question for the department. I'm not sure what that legislative instrument usually would be.
>> Is it going to be legislation or regulation?
>> Yeah, we'll confirm that for you, Senator, so you're you're fully aware.
>> Senator, um, I'd suggest though we're getting ahead of ourselves at the moment. there's an application and um as an application to MSAC there's a wide range of documents including summaries of all of the consultations that MSAC has had that are available on MSAC's website which is with the department um of health and so you can go there and read the various positions of the different um uh uh interested stakeholders. Those are the issues that MSAC will consider again at their November meeting as they progress the application. All of this is before any advice has been put to government and uh the form of legislation or regulation would only be um uh set if the application were recommended and we're not at that point yet.
>> Thank you. Because if um if it is a disallowable answer, I'm going to look forward to that debate. So
>> sir, just to add to Mr. back of tires testimony. Um the the medical services advisory committee needs to make assessments about whether the the clinical efficacy of these surgeries which I've mentioned before uh then they will need to make judgments on the cost effectiveness. It's not an automatic uh assumption or decision that they will then recommend uh to government for these services to be established on Medicare. That is still something that is well that is in deliberations and we are very early in the um assessment process.
>> Right now we've got things changing overseas. Uh we've got things changing in Australia. More and more people are turning to peer-reviewed papers which are questioning the treatment of gender dysphoria or affirmation as a treatment of gender dysphoria. Will will the uh council um be consulting peer-reviewed papers and and specialists?
>> So the way this uh committee works senator is that the uh applicant needs to put evidence uh to that committee and in their submissions uh that um step through as I said the clinical ethicacy uh and then ultimately the cost effectiveness uh of the procedures that they're proposing. Uh, I believe, but I'd need to double check with my colleagues that there has been some information and Mr. McIntyre indicated there's a whole heap of submissions already available on our website that explain what's been done u previously. Um, but as I reiterated, we are very early in the process of of this um assessment. Uh, and ultimately the committee will have to um deliberate and make decisions about whether they want to recommend services. So, are the
submissions made to the council and are they open to the public?
>> Yes, senator. They're on the website. If you uh go on the medical services advisory committee website, you can find the application and you can also find the um information on what MSAC has done to date, which includes public consultations and targeted [clears throat] consultations and reports prepared for MSAC to help them understand the evidence and other pathways and issues with uh this proposal.
>> Okay. Thank you. and Mr. Comley, I want to uh compliment the witnesses for their answers. >> Thank you. >> Thank you, Chair.
>> No further questions from you, Senator Roberts.