Written by Alexander Dalton, youth advocacy council member, headspace Werribee and Kirsten Fobi, Orygen youth advisory council member.
There are some great healthcare services in Australia, but many leave a lot to be desired by the LGBTIQ+ community.
For example, finding a GP who knows about PrEP (pre-exposure prophylaxis) or hormone replacement therapy gets increasingly difficult the further out you live from major cities.
Sometimes it’s not the access to information that’s an issue, it’s the experiences LGBTIQ+ individuals endure when trying to access health care itself. To get a referral to a specialist gender service the Alex had to explain what he’d done so far to transition and justify why he ‘felt’ he was transgender at 13, and was then placed on a waiting list for close to two years.
Alex then found it difficult to find a GP outside of Melbourne’s CBD who could prescribe his testosterone medication. He still hasn’t found one. Then, finding a different GP who was willing to perform the intramuscular injection was another task in itself.
The barriers trans and gender diverse young people face in healthcare are barriers that simply should not exist. There needs to be more training in what trans* health care is and what it looks like. If that can’t be provided within a service, the service should be able to provide the details of somewhere close by that does.
But that isn’t reality. Alex said many specialist services he encountered didn’t know if there were services for queer healthcare in his local area and tried to refer him to services too far to be feasible for him to attend.
For another young person, who does not wish to be named, the assumption that they are cis-gender and heterosexual prevents them from accessing services comfortably. They have “not felt comfortable with telling people I am non-binary/gender-queer because of the stigma around it… even when doctors ask or there is a spot to put my preferred gender down, I often feel like it’s there just so they look inclusive but not necessarily are inclusive.”
The LGBTIQ+ community encompasses a huge range of experiences. However, there are fundamental principles of care that all healthcare services can follow to ensure communities are supported in their general health and mental health.(2)
For example, research has shown that many young LGBTIQ+ young people often feel more comfortable in a healthcare service if there are visible signs of allyship and LGBTIQ+-related information shown within waiting rooms and offices.(1)
Overt recognition of LGBTIQ+ healthcare and having trained staff in this field is essential. It shouldn’t be niche, or a specialisation, to have basic knowledge in this area or to know of someone who does – sometimes even that is enough, having a point of call to say ‘you can go here and I know that this person knows how about LGBTIQ+ healthcare and how to go about it.'
There is also limited research about the healthcare needs of trans and gender diverse people, and they are often not included in research involving the LGBTIQ+ community. This can affect how doctors and other health professionals treat and care for their trans and gender diverse patients, including words of choice by health professionals.
LGBTIQ+ young people have reported that some language used by health professionals has resulted in the young people having feelings of anger and discomfort.(1, 3)
LGBTIQ+ young people may also put off seeking medical help and disclosing their sexual orientation and gender identity due to this lack of knowledge and inclusivity.
By completing professional and service development in inclusive and affirmative healthcare, health professionals can support and build positive mental health outcomes in LGBTIQ+ young people.
Orygen is currently working with young people and health and community partners to develop resources to support the youth mental health workforce to work with trans and gender diverse young people.
To learn more about working inclusively with LGBTIQ+ young people, see Orygen’s clinical practice point: Working safely and inclusively with sexuality diverse young people.
1. Gandy ME, McCarter SA, Portwood SG. Service Providers' Attitudes Toward LGBTQ Youth, Residential Treatment For Children & Youth. 2013 30:3, 168-186, DOI: 10.1080/0886571X.2013.813344
2. GLVH @ ARCSHS, The Rainbow Tick guide to LGBTI-inclusive practice, LaTrobe University, 2016. Available from: https://www.rainbowhealthvic.org.au/media/pages/research-resources/rainbow-tick-guide-to-lgbti-inclusive-practice/2565067543-1564632572/rainbow-tick-guide-to-lgbti-inclusive-practice-web.pdf
3. National LGBTI Health Alliance, National LGBTI Health Alliance submission to the Productivity Commission’s draft report on mental health, 2020. Available from: https://www.lgbtihealth.org.au/submission_productivity_commissions_draft_report_on_mental_healt