In Distress

Transgender and gender-diverse individuals do not identify with the biological sex they were assigned at birth and/or do not fit into the traditional gender binary. As a result, many suffer from a psychological disorder called gender dysphoria, which is defined as distress caused by the incongruity between an individual’s birth sex and their gender identity. The treatment of gender dysphoria includes the process of undertaking social and/or medical transitions, such as changing their name, legal documentation, and pronouns, to hormonal replacement therapy and gender reconstruction surgery. Now, imagine you seek the help of a doctor or psychologist, but every time you reach out, they assume you are overreacting, or that a childhood trauma or psychological disorder is to blame. All you require is the treatment you desperately need, but it is unattainable. This is the constant experience of the transgender and gender-diverse community in Australia.

A Lack of Reliable Statistics

An inadequate data collection system by the Australian Bureau of Statistics, and the practice of combining gender and sexuality data, results in a lack of inaccurate demographic information for transgender and gender-diverse individuals. With the little data that is available, studies estimate that 8% of the population identifies as transgender or gender-diverse. If the treatment of gender dysphoria is inadequate, it can lead to the development of psychological disorders such as anxiety, depression, suicidal thoughts, self-harm and a higher risk of drug dependencies. Transgender and gender-diverse individuals are also at a much higher risk of discrimination, bullying and alienation occurring in the media, politics and personal/public spaces. Teddy Cook from ACON, Australia’s largest HIV and sexuality and gender diverse health organisation argues that: “Right now, young trans people around Australia are seeing the news and hearing that they are not worthy of protection.”

A Lack of Funding & Recognition

A further challenge is the lack of funding, which has resulted in inadequate resources and services to assist this community. There has been an increase in difficulties in accessing gender-affirming care. This is due to a lack of proficiency in transgender care, which has left transgender and gender-diverse individuals unable to receive needed medical and mental assistance. Many individuals are thereby unable to treat their gender dysphoria. The Australian government does not recognise gender reconstruction surgery as a necessity, resulting in individuals having to pay out-of-pocket for surgery or through private health insurance; a significant barrier for people of low socioeconomic status. Top and bottom reconstruction surgeries are required to change legal documentation. It is therefore unfeasible for the vast majority to amend their legal documentation so that they can authentically represent their gender identity.

A Lack of Protection

The transgender identity seems to have driven a certain degree of political ammunition which has resulted in an unprecedented number of transphobic acts occurring across the country. Recent instances include a transgender woman being brutally attacked in Western Australia, two transgender women who were physically assaulted and robbed in Melbourne, and a Neo-Nazi protest in Melbourne’s CBD. Furthermore, on the 11th of March 2023, an anti-transgender presentation was held in Sydney, which was led by a prominent transphobe and far-right figure Kellie-Jay Keen. These continued anti-transgender demonstrations not only highlight the increased transphobia that is on the rise in Australia, but they also have a detrimental impact upon the mental health of the community. For example, a study conducted on 928 transgender adults in Australia highlighted that 73% received a depression diagnosis, 63% had inflicted self-harm and 43% reported a suicide attempt. These events and statistics highlight how the media and government bodies fail to address the need to protect and acknowledge Australia’s transgender and gender-diverse community.

A Lack of Lifetime

The aforementioned factors that contribute to the mental health crisis have in turn lowered the life expectancy of transgender and gender-diverse individuals compared to cis-gendered individuals (person whose gender identity matches their biological sex). In a study that was conducted between 1972-2018 in The Netherlands, it was recorded that the transgender and gender-diverse community’s mortality rate is 628 deaths per 100,000 per year, compared to the average rate of 40.9 deaths per 100,000 people in Australia. Notably, cardiovascular diseases, HIV and suicide are the leading causes of death for the transgender and gender-diverse community. This could be due to a higher level of substance abuse and engagement with behaviour that is considered risky; behaviour that is often linked to mental health disorders. While these studies were carried out in two different countries, they highlight the vast difference in mortality rates and how these demonstrate the need for greater action so that we can fully identify the underlying root cause.

Intersectionality Within the Community

Intersectionality plays a crucial role in a transgender individual’s experiences of discrimination and gender dysphoria. First Nations transgender women, for example, are at the greatest risk of murder and mental health deterioration due to the continued impact of colonialism and historical disadvantage. Crucially, the resulting postcolonial implications have meant that the prevalence of transgender and gender-diverse culture within the First Nation community has continued to be disregarded, despite this culture being historically recognised and accepted by the First Nation community.

What is “Passing?”

Transgender and gender-diverse individuals who fit into traditional gender norms experience lower rates of discrimination due to their ability to pass. For example, a transgender man can sometimes be perceived as a cis-gendered man. The desire to pass can contribute to mental deterioration when certain individuals pressure themselves to fit into a strict gender identity; further exacerbating their gender dysphoria.

Templates Beyond Australia’s Shores?

In Australia’s immediate neighborhood, New Zealand recently passed the ‘Births, Deaths, Marriages and Relationships Registration Act 2021’ which abolished the requirement for reconstruction surgeries and psychological diagnosis to update gender identity on legal documentation. Further afield, Argentina and Denmark both grant transgender and gender-diverse adults gender reconstruction surgery and hormonal therapy as a part of public health care.