Call for MDO boycott over gender care cover

4 minute read

A trans GP and advocate is leading pushback against MDA National’s decision to restrict coverage for treating young gender-diverse teenagers.

A leading queer health advocate and GP has called for a boycott of MDA National by her colleagues following its decision to restrict coverage for gender-affirming care for adolescents.

Dr Clara Tuck Meng Soo, a Canberra-based transgender GP and gender-affirming care provider, told TMR she had “written to as many doctors as I have email addresses for, asking them to withdraw their membership from MDA National”.

MDA National said on 29 May it would no longer cover private practitioners prescribing gender-affirming care to adolescents, not for moral or ethical reasons but because “we don’t think we can accurately and fairly price the risk of regret”. It later expanded on the changes, saying:

“The exclusions don’t relate to the treatment of gender dysphoria broadly but rather the initial assessment that a patient under 18 is suitable for gender transition or initiating prescribing of gender affirming hormones for any patient under the age of 18 years.”

MDA National president Dr Michael Gannon told TMR a practitioner was still covered for “ongoing repeat prescribing of gender affirming hormones (based on the medication regime initiated by a non-GP Specialist as part of a multi-disciplinary team); prescription of puberty blockers with the expectation that the Australian standards of care and treatment guidelines for trans and gender diverse children and adolescents are complied with at all times when treating children and/or adolescents with gender dysphoria; where a practitioner is indemnified by their employer for their work in the area of gender transition, the MDANI policy will continue to provide cover for the legal costs of investigations and inquiries arising from this work; and, counselling and general healthcare involving a patient with gender dysphoria”.

Dr Soo called the move “transphobic, frankly”, and said she had ended her membership with MDA National because of the changes. This week she encouraged her colleagues to do the same, by sending a version of the following letter to the MDO.

“I am writing to you to express my concern about the recent decision of MDA National to deny cover to medical practitioners working outside a hospital multidisciplinary clinic in treating patients with gender incongruence aged 16-18 years either by assessing them as suitable for gender transition or by initiating treatment or by varying treatment that may have benefit started by a hospital multidisciplinary clinic,” the letter reads.

“The paucity of evidence cited to justify this step is very concerning (six cases before the courts worldwide including one case in Australia) and contrasts strongly with MDA National’s tolerance for areas of medicine that are much riskier.

“People aged between 16-18 years old already have enormous barriers accessing care despite to the increasing demand for gender-affirming care and the step that MDA National has taken will put pressure that hospital multidisciplinary clinics don’t have the resources to manage.

“It also sends a message to doctors that this is a particularly risky area to practise in and deters doctors from working in gender-affirming care altogether – a message that the statistics do not justify. This will result in many young people missing out on medical care which could potentially put their health and safety at risk.

“It is also an almost unprecedented intervention by an MDO in the clinical independence of doctors.

“Accordingly, as a supporter of the right for transgender young people to access appropriate care, I am taking the step of withdrawing my membership from MDA National and joining another MDO that is more LGBTIQ+ friendly.”

Dr Soo said she had asked her colleagues to forward the letter to MDA National. She has also posted it to AusPath’s website listserv.

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