If you are a medical practitioner (GP) seeking information about supporting a transgender or gender diverse patient this page may assist you. The Primary Health Network of Western Melbourne has also created a transgender health GP Module that may help GP’s in this field of medicine.
AusPATH: Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy.
To mark Trans Day of Visibility on Thursday 31 March 2022, Australia’s peak trans health body AusPATH has launched the Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy.
These new national Standards of Care are intended to assist and enable clinicians across Australia to better meet the medical gender affirmation needs of their trans women, trans men and non-binary patients. They unapologetically centre the trans person seeking hormonal intervention and empower the clinician to facilitate this access.
These guidelines reflect the consensus of AusPATH’s active membership, and as Australia’s peak body for professionals involved in the health, rights and well-being of all trans people, binary and non-binary, it was entirely appropriate for AusPATH to develop and publish them. The AusPATH Board is proud to have majority trans Directors, with all Sub-Committees inclusive of trans health professionals. AusPATH’s Board and Sub-Committees also include incredible cis allies.
The Trans Hub website includes some fantastic information and education resources to empower medical providers to better informed about health care provision, including prescribing, for trans and gender diverse patients. It also educates patients on what they may expect on their transition journey.
The following documents can help guide a GP when exploring aspects such as Gender Affirming Hormone Therapy. This includes health assessment and pre-screening (inc blood tests), initiating hormone therapy and monitoring ongoing care:
Hormone Therapy -prescribing-guideline-v3-aug-2020 and
written by Thorne Harbour (formerly Victorian AIDS Council) for Equinox and endorsed by AusPATH and Monash Health (Gender Clinic).
All practitioners should carefully explore the risks and expectations of Hormone Replacement Therapy with a patient/client. Consider these extracts from the WPATH Standards of Care as a starting point for discussion:
Feminising Hormones Risks and Timelines WPATH
Masculinising Hormones Risks and Timelines WPATH
Aotearoa New Zealand also has an in depth document titled Guidelines for Gender Affirming Healthcare which utilizes informed consent models and practitioner information for initial assessment, prescribing, and ongoing care.
Guidelines for Gender Affirming Healthcare Aotearoa New Zealand
Primoteston injectable 200mg is NOT on PBS and is written on Private Prescription as of February 1st, 2018. This means any GP can feel confident writing this prescription without requiring a specialist health provider to authorise it.
For persons wishing to access masculinising gender affirming hormone therapy (not including Primosteston), it can be a bit muggy knowing how to access anything but hopefully this clears it up. This is taken directly from the PBS federal guidelines under Medicare:
Of importance are the guidelines which are applicable for most (not all) trans masc:
- Androgen deficiency (THSA note – this is the most applicable to trans masc folk)
- Patient must have an established pituitary or testicular disorder.
- Must be treated by a specialist paediatric endocrinologist, specialist urologist, specialist endocrinologist or a Fellow of the Australasian Chapter of Sexual Health Medicine; or in consultation with one of these specialists; OR have an appointment to be assessed by one of these specialists.
The name of the specialist must be included in the authority application.”
This means a General Practitioner CAN prescribe once a referral has been written and an appointment made to a specialist as noted above.
THSA notes that in no way is this an endorsement not to access some health professionals and specialists. THSA values the work of practitioner specialists such as Endocrinologists and Sexual Health Physicians and encourages folk’ access the services they need in collaboration with their General Practitioner. This does however, empower GPs who feel capable and competent to be able to provide a service, to know they are able to do so without the need of a psychologist or psychiatrist if not deemed required for the individual.
Medication Prescribing for Transgender Women / Trans-Feminine Persons
Medications prescribed to those presumed male at birth (PMAB) do not have the same PBS and Medicare restrictions as testosterone. For example, androgen blockers such as Spironolactone or Cyproterone are considered “General Schedule ” and do not have any “Authority” requirement as are medications containing estrogen/oestrodiol.
Trans Health SA acknowledges this means an appropriately educated medical practitioner (GP) can prescribe these medications.
Position statement on the hormonal management of adult transgender and gender diverse individuals
This following resource can help provide support for Medical practitioners when dealing with prescribing hormones and can be used as a guide in doing so.
you can download it HERE. or follow the link below.