Trans Healthcare Is Essential During A Pandemic
With retail and hospitality closed, Melbourne was been stripped down to operating with only essential services. However, despite healthcare being an especially essential service during the biggest global pandemic of modern times, trans specific healthcare has become ever more inaccessible. COVID-19 restrictions have seen cancelations and postponements of even the most basic of trans medical needs.
In Melbourne there are two primary providers of adult trans medical care, Equinox clinic and Northside clinic in the city’s inner north. Northside clinic as part of their COVID-19 policy are not taking any new patients with exceptions made only for those living with HIV or for patients needing HIV testing. This means anyone seeking to initiate a medical transition by seeking hormone replacement therapy (HRT) will need to contact Equinox and be placed on a waiting list or seek assistance from non-trans experienced GPs.
The most common medications for trans women who undertake HRT are oestradiol pills or transdermal patches. Unfortunately, production supplies have been strained due to COVID-19 resulting in transdermal 100 patches being in extremely short supply. At the beginning of the year I was prescribed oestrogen patches because my body wasn’t effectively absorbing the pills I was previously using. Last month I personally had to call six pharmacies in the inner eastern suburbs to fill my prescription for oestrogen patches. I was told that due to the shortage, pharmacies aren’t even able to specifically order the patches in for specific patients. Earlier this year the Australian Department of Health released a substitution notice for transdermal oestrogen patches, this notice was not widely spread with many patients and pharmacies unaware of the substitution.
With patches in such short supply many trans women have had to seek alternative method of oestrogen intake. Less common alternatives to pills and patches included regular oestrogen injections and an oestrogen implant. In October I began using an oestrogen implant which is only available for purchase from Stenlake Compounding Chemist in Sydney. Currently oestrogen implants are not PBS funded and cost $131.95 plus $10 shipping to Melbourne. For this reason, oestrogen implants are highly inaccessible for the majority of people.
As Kace Van Vugt from Woodend told the Star Observer, “I’ve been restricted to pills since I started hormones just before the first wave but my body isn’t absorbing the tablets very well. I haven’t had great success with accessing mental health services either because waitlists to see councillors or psychologists can be months long for one who is experienced with trans people. Because of this it feels like an uphill battle to seek support for my health.”
In addition to GPs becoming less accessible, all trans related surgeries were postponed indefinitely when the state government put a hold on elective surgeries. Gideon Quinn from Strathmore told the Star Observer “all top surgery appointment I had were postponed from March.” The WPATH 7 which is the current global standard for transgender healthcare states that top surgery for trans men and bottom surgery for trans women are considered medically necessary for those who seek to undergo them. The states decision to place these on hold contradict the necessary standard of care trans people require in their transition.
During a global health crisis, medical care should be a primary public focus. Yet in Victoria many areas of public healthcare are not being prioritised. Trans people have fought tirelessly for years to achieve the level of healthcare we receive today. Unfortunately, this level of care we have achieved is not considered essential during a global health crisis. Many trans people across our state have lost access to what for us is considered an extremely essential service, to be told it isn’t is harmful to our entire community.
