Australian insurer drops cover for doctors giving hormone treatment to kids

• By Avi Yemini

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A leading Australian medical insurer has announced that it will not provide cover for private doctors, including general practitioners, against legal claims arising from the assessment of patients under 18 for gender transition treatments such as cross-sex hormones and gender affirmation surgeries.

The decision by MDA National, which came into effect on July 1, was prompted by the insurer's review of the medico-legal risks associated with such treatments.

It cited "growing global criticism of the research supporting medical and surgical transition of children with gender dysphoria" as a contributing factor.

MDA National expressed concerns about the potential for high-value claims resulting from irreversible treatments provided to children and adolescents.

Gender-affirming hormonal therapies involving testosterone or estrogen may lead to temporary or permanent infertility.

While the insurer will still allow doctors to prescribe puberty blockers for treating transgender youth, it acknowledged the evidence of long-term side effects such as reduced bone density.

While the move was celebrated by critics, the decision raised concerns within the Australian Professional Association for Trans Health (AusPATH) who fear that trans youth residing outside major cities will be particularly affected.

Responding to the decision, MDA National stated, "Children are not able to transition without relying on the assessments of medical professionals." The insurer emphasised the unique vulnerability of doctors in potential litigation cases where their influence on a child's decision to transition is questioned.

As one of six medical indemnity insurers in Australia, MDA National's policy change comes amid a surge in demand for public hospital gender services.

The Queensland Children's Gender Service reported a waitlist of 642 children and young people seeking assessment as of May 9 this year, with 922 patients receiving care in 2022.

The Australian Medical Association and various medical colleges have been approached for comment on MDA National's decision, while the Royal Australasian College of Surgeons highlighted the complex nature of gender affirmation surgery and emphasised the need for specialised training.