One of Australia’s biggest medical insurers has pulled insurance coverage for doctors in private practice prescribing hormonal treatment for children and adolescents.
MDA National, which has 54,000 health professional members, has also dropped cover for private specialists who face court claims if they deem under 18-year-olds as “suitable for gender transition.”
“We consider it appropriate that the assessment and initial prescribing for patients transitioning under the age of 18 years occurs with the support and management of a multi-disciplinary team in a hospital setting,” MDA National said in an email to affected doctors.
The MDA National decision, effective from July 1, is expected to affect about 100 practitioners Australia-wide, including general practitioners, paediatricians, and endocrinologists providing gender-transitioning treatments.
The decision stated: “We will not cover you or make a payment when the claim against you arises in any way out of: (a) your assessment that a patient under the age of 18 is suitable for gender transition; or (b) you initiating prescribing of gender-affirming hormones for any patient under the age of 18 years.”
MDA National’s President Dr. Michael Gannon previously said the move was in response to legal cases overseas, including the high-profile inquiry into Tavistock Centre, Britain’s only children’s gender clinic.
Tavistock, which provides “gender-affirming care” to about 1,000 children, will close on March 2024 and be replaced by two regional hubs.
“One of the problems with long tail insurance is that you might make a decision, or there might be a clinical matter that’s dealt with, and then it takes five, 10, 15, 20 years before that turns into a clinical problem,” Dr. Gannon told NewsGP.
“We’re talking about people who are making life-changing decisions. So, our feeling is that that is a very high level of risk for an individual GP to take on their own.”
“We are worried about the risk that it presents to these individual members and, more broadly, the rest of our members. So, we’re making no … moral judgments, no ethical judgments—we’re making an insurance company decision based on our inability to price an area that we think might be high risk.”
However, under the current MDA National policy, GPs will still be covered for prescribing gender-altering hormones in the following circumstances: if it is based on recommendations from a non-GP specialist as part of a multi-disciplinary team; prescription of puberty blockers with the expectation that it complies with Australian standards; or if it is provided along with counselling and general healthcare involving a patient with gender dysphoria.
Some women’s groups have applauded MDA National’s initial decision.
“Medical insurers are all about risk and at the end of the day, how to pay out the least amount of dollars in claims,” said women’s rights group Binary, in a statement.
“It is no surprise that one of the majors has recognised the risk and is withdrawing before a wave of claims are made by children who become adults and realise they were sold the lie that taking drugs would enable them to change sex.”
The organisation also drew attention to the increasing number of minors being issued drugs from Australian doctors and gender clinics despite a lack of consultation and treatment for any underlying issues.
“Trans regret stories are also increasing on social media where many claim they are not included in the statistics because they simply stop seeing their practitioners,” the group said.
“A Royal Commission is desperately needed for the sake of children in this country.”
The insurer’s decision move comes after the Royal Australian and New Zealand College of Psychiatrists’s (RANZCP) decided it too, would move away from a “gender affirmative approach.”
“The RANZCP does not support the use of sexual orientation change efforts of any kind. There is no scientific evidence that sexual orientation can be changed. Sexual orientation change efforts risk causing significant harm to individuals,” the group said in a 2019 statement.