Tuesday, 29 July 2025

Gender services

David LIMBRICK (South-Eastern Metropolitan) (19:07): (1767) My adjournment matter is for the Minister for Health in the other place. When a person decides to attempt to change their gender, it is a life-changing decision. As a libertarian I believe that people own their own bodies, and I support the right of adults to make these decisions for themselves. However, I also believe that parents should be in charge of their children. There are many decisions children cannot make without endangering their safety. Nobody knows their children’s needs better than parents, and nobody cares for them more. This is why the new regime in Victorian schools, where they can sometimes automatically affirm the stated gender of children without the knowledge of their parents, is a disastrous precedent. It forces teachers to keep secrets and puts kids in a school-to-clinic pipeline. This can and does lead to infertility. It affects brain and bone development and turns young people into medical patients for the rest of their lives. Nobody should allow this without very, very good evidence about the benefits.

To that end, I direct the minister to the results of an application by the Australian Society of Plastic Surgeons to put several items for gender-affirming surgery for adults on the Medicare benefits schedule. The results were released last week by the Medical Services Advisory Committee, and I encourage the minister to read this report. In summary, their assessment is that evidence in favour of the benefits of surgery is severely lacking. It reported that procedures like phalloplasty have medical complications such as infections, fistula and partial loss in 30 to 40 per cent of cases and surgical revision rates of up to 45 per cent of the cases. The rate of complications associated with vaginoplasty was 11 to 32 per cent, and the most commonly occurring major complications were infection, sepsis, pneumonia and rectal or urethral injuries. The evidence presented to MSAC about nearly every aspect of the benefits of surgery, including the impacts on self-harm, could not be assessed because of the poor quality of these studies. The main cause of this was attrition bias and subjective outcome measures. People who had bad outcomes had simply been ignored.

MSAC also noted that the relevant studies were excluded. This is the evidence that the Victorian government relies on for their gender policies in schools. These damning findings echo the findings of the Cass review, which found major problems with clinical appraisals from the Royal Hospital for Children, and criticisms from a court case more recently by Justice Strum. My request for action is for the minister to read the summary of findings from the Medical Services Advisory Committee, application number 1754.