We congratulate NSW Health on the State’s first LGBTIQ+ Health Strategy

We warmly congratulate NSW Health on the launch of the State’s first LGBTIQ+ Health Strategy. As the Minister for Health has noted, this is the first such strategy in New South Wales. Its development has been a lengthy and productive process.

In specific sections on the health of people with intersex variations, the Strategy, Evidence Summary and Implementation Plan acknowledge a high prevalence of poor health, the human rights implications of prior and continuing medical treatment, and the necessity for specific attention, and individualised trauma-informed care. The Strategy states:

There is a need to recognise and respond to practices of unnecessary and deferrable medical interventions, undertaken in infancy and childhood, to ‘normalise’ the appearance of intersex bodies…

Further, promoting and embedding best practice measures in NSW Health services will support intersex people to have autonomy over their bodies and ensure they can make informed decisions about their health.

The Summary of Evidence notes a lack of specific services, limited knowledge by healthcare providers, a need for trauma-informed care, and recognition that:

The consultations also highlighted barriers such as the high costs of mainstream services and the absence of intersex-sensitive mental health services in NSW.

The Implementation Plan allows for the implementation of health and human rights ‘measures’, taking account of developments across jurisdictions, such as in ACT and Victoria.

Implementation of the Strategy will also reform data collection methods in line with a 2020 ABS Standard. Current approaches are inconsistent and sometimes construct intersex variations in inappropriate ways.

The situation in NSW is troubling. In a 2020 journal article, NSW paediatric endocrinologists identified ‘surgical options’ as an acceptable rationale determining sex assignment in situations of doubt, and framed both an absence of clinical consensus on so-called ‘normalising’ surgeries and ‘a lack of universal interpretation of “medically necessary surgery”’ as justifying continuation of existing practices that facilitate early surgical and hormonal interventions without personal informed consent by people with intersex variations. The local paediatric endocrinology association continues to believe that existing practices are acceptable, while this is rejected in a major 2021 report by the Australian Human Rights Commission, and by intersex-led community organisations.

We congratulate ACON on receiving funding for its LGBTQ health centre, and Twenty10 for funding for youth support. Neither of these funding lines addresses the specific support that people with intersex variations need across the lifespan, nor do they facilitate psychosocial and peer support for people with intersex variations, and parents and families of people with intersex variations. We acknowledge the journey taken so far. We hope for continued engagement with the Ministry of Health and the Parliamentary Group of Friends of LGBTI People on these issues, and in relation to law reform and resourcing. We also congratulate Alex Greenwich MP on his announcement of an omnibus bill to address many of these and other matters.

Our executive director Morgan Carpenter was part of the advisory group for development of the Strategy, and we are also grateful for contributions by Bonnie Hart as the then IPSA President, and for survey and interview contributions by community members.

Further information

NSW LGBTIQ+ Health Strategy, Evidence Summary and Implementation Plan