A government-funded transgender health clinic in Victoria, Australia, was set up in 2019 to address several key problems facing trans health, including access and lengthy wait times. The clinic, located in the city of Ballarat, was designed to be a one-stop-shop for trans and gender-diverse people accessing health care. However, in the four years since opening, the clinic has not prescribed any gender-affirming hormones to patients.
The clinics’ priority was to attract and retain doctors with strong knowledge of hormone-driven transitioning, as well as upskilling GPs to improve their confidence in prescribing gender-affirming hormones such as testosterone and estrogen. Despite these efforts, the Ballarat Community Health Clinic has failed to initiate any medical transitions. In fact, in its three-year operation, the clinic has never employed a doctor who has felt confident to initiate patients on gender-affirming hormones.
This lack of access to necessary care has left trans and gender-diverse individuals in the area without access to the medical options they need to affirm their gender identity. Ballarat community organizer KL Joy, who underwent a “gender revolution” in late 2018, tried for years to find another doctor in Ballarat to address their medical needs. “There is not a single doctor in Ballarat, currently, who will do informed consent care for gender-affirming medication or gender-affirming hormone therapy. It’s non-existent in Ballarat,” they said.
The issue is not unique to the Ballarat clinic. The Preston clinic, located in a suburb of Melbourne, has also struggled to retain GPs confident in initiating hormones. General practitioner Nate Reed, who previously worked at the clinic, said that while the model is working as well as it can with the resources it was allocated, there were pressures associated with long waiting lists and not being able to see as many people as desired.
Despite the challenges faced by the clinics, Your Community Health, the Melbourne-based organization given leadership of the $3.4m consortium, has trained 90 GPs in providing gender-affirming care. However, both Dr. Reed and KL Joy have called for training around gender-affirming care to be enshrined in the core education of general practitioners. They argue that doing so will lead to better gender practitioners as well as general practitioners, ultimately resulting in better access to care for trans and gender-diverse individuals.