Federal government considers adding gender-affirming surgery to Medicare rebate list

When Max Jahufer became a dad, his plans of undergoing gender-affirming surgery took a back seat. 

Max and his partner Paris welcomed little Windsor into the world on a chilly winter's day in July. 

From that moment, his young family became his number one priority. 

However, being his authentic self for them is something Mr Jahufer, a transgender man, is still coming to terms with. 

It is something that is particularly pertinent when he thinks of his newborn son. 

"I do have moments in time where I think, 'Am I going to be adding confusion to his life if my body doesn't represent who I'm living my life as?'," Mr Jahufer said.

Having chest masculinising surgery, known in the community as "top surgery", is something that Mr Jahufer has long desired.

But the costs associated are prohibitive.

Mr Jahufer has been quoted upwards of $20,000 through a private surgeon, something that is hard to swallow when balanced with the increasing costs associated with his growing family.

He said news that the federal government was considering adding gender-affirming surgery to the Medicare rebate program was like "a light at the end of the tunnel".

"I think it would change so many people's lives in ways that I don't think a lot of people can understand," Mr Jahufer told the ABC's Victorian Statewide Mornings.

"It's something that I've been needing and wanting to do for a very, very long time.

"And to be honest, if it's something that's going to come into play relatively soon, say within the next 12 months, I would consider waiting [for it] because it is a huge financial burden."

Not just about looks

The federal government will consider an application by the Australian Society of Plastic Surgeons (ASPS) to add 21 Medicare items for gender-affirming surgeries, such as chest surgery and genital reconfiguration. 

Such surgery is often performed on people experiencing gender incongruence or gender dysphoria, where individuals experience an incongruence between their experienced gender and assigned sex. 

The ASPS's application estimated that in 2023, more than 125,000 people would eligible for such surgeries — more than 47,000 of which would utilise the surgery in its first year under the scheme.

Doctors in the field and trans people say there are only five Australian surgeons regularly performing some of these procedures.

"The objective of these amendments and additions to the Medicare Benefit Scheme is to facilitate a multidisciplinary best model of care framework for patients pursuing medical interventions for gender affirmation that extends before and after any surgery," the ASPS application stated. 

The federal government's Population, Intervention, Comparator and Outcome (PICO) Advisory Sub-committee, a subcommittee of the independent Medical Services Advisory Committee, is scheduled to discuss the ASPS application on Thursday, December 7.

A Department of Health and Aged Care spokesperson said the government was committed to supporting all Australians' access through Medicare. 

"There are several MBS [Medicare Benefit Scheme] items for surgical procedures, which may be performed during a patient’s gender affirmation process, if the treating practitioner deems these procedures to be clinically relevant to a patient’s care," the spokesperson said.

"There is also a range of GP and specialist consultation items, which may be relevant to patients undergoing a gender-affirming process."

The best is yet to come

For Mr Jahufer and Paris, their journey as a family has only just begun.

They have shared their family journey on Instagram as part of their advocacy work in the IVF and transgender awareness spaces.

Mr Jahufer said the surgery would allow him to finally look the way he felt, and not feel a sense of shame when he looked in the mirror.

"I think being able to have the surgery is really going to take me one step closer to that authenticity, and really looking in the mirror and not having to look away," he said.  

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