Australian Human Rights Commission




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5.2Discrimination in the provision of services


Many participants provided examples of discrimination in relation to the provision of services, including in:

  • aged care

  • health care

  • emergency housing

  • appropriate toilets and change rooms

  • sport.

(a)Aged care


Participants drew attention to research that shows that many older LGBTI people have significant fear of harassment, poor treatment and alienation in aged care facilities.41 For example, GRAI (GLBTI Retirement Association Incorporated) referred to the following research:42

  • In comparison to older heterosexuals, older LGBTI people are two and a half times more likely to live alone, twice as likely to be single and over four times as likely to not have children. As a consequence, older LGBTI individuals may experience greater isolation, loneliness, lack of traditional family support and lack of recognition of partners.43

  • 20% of LGBTI respondents experienced discrimination from health care providers as a result of their same-sex relationship.44

The consultation heard examples of discrimination in aged care facilities, including:

An older transgender woman with dementia, who had lived most of her life as a woman but had never had sex reassignment surgery, was forced by staff of the religious aged care facility where she was being cared for, to live as a man.45

Several participants stressed the importance of education about sexual orientation and sex and/or gender identity for aged care service providers.46

(b)Health care


During the consultation, trans and intersex people raised a range of concerns about experiences of discrimination based on sex and/or gender identity in the provision of health care. Issues raised by participants included:

  • difficulties in accessing and funding sex affirmation treatment in Australia, including a lack of specialists in some areas and the fact that sex affirmation procedures are not funded through the Medicare system:

When I first started testosterone treatment and my body began to change I was really excited. But after a while I began to get more and more uncomfortable with my breasts. I had always been uncomfortable with them but this was different. I started to think that if I didn't have chest surgery soon I would kill myself. I was so lucky that someone helped me to pay for it because I couldn't afford it on my own. And now I just wonder how all of the other trans guys out there who can't afford it cope. It is the worst feeling in the world. I wouldn't wish it on my worst enemy.47

  • not being able to claim Medicare rebates for procedures which were not aligned with a person’s legal sex:

In Western Australia, a person with an ovarian cyst went to hospital and was thought to be male and treated for appendicitis. He could not get a Medicare rebate for treatment of an ovarian cyst.48

Intersex people are often rejected for medical procedures when their official sex is seen to conflict with their anatomical structures; e.g. ovaries in an apparent male and testes in an apparent female.49



  • inappropriate treatment by the medical profession, including disclosure of irrelevant information,50 failure to recognise preferred sex and/or gender on medical records,51 and refusal of medical services:

Toni is a transgender woman living in the inner city. Toni needed to attend a residential drug rehabilitation centre as she had been struggling with alcohol and opiate dependency. Her support worker called the local clinic, this clinic happened to be run by a religious based charity. The clinic informed Toni’s support person that there was an opening for Toni and that they would hold a place for her. When Toni presented at the clinic she was refused service. When asking why she was told there was no spot for her. Toni was sure that this refusal was based on the fact that she is a transgender woman.52

  • degrading treatment by medical service providers:

When I found a lump in my breast I was referred to a breast specialist who refused to see me straight away because “I might scare the women in the waiting room”. I was instead required to wait 7 days before the specialist would see me.53

A person was placed in a male ward in a local hospital. When the receptionist was asked why she was on a male ward, the receptionist replied “because that is how we see him”.54


(c)Emergency housing


The consultation heard of discrimination occurring in access to emergency accommodation sought by trans people. For example, the Freedom! Gender Identity Association described how a trans woman who had not had gender reassignment surgery was refused access to federally funded emergency housing.55 They also described the situation of a trans man who expressed concerns for his safety if his sex and/or gender identity was revealed whilst staying at a male boarding house.56

The National LGBTI Health Alliance described the difficulties of a trans person attempting to find housing:

A trans man in Queensland who has had ongoing health problems, including four surgeries in the past year, has been homeless for 9 months. He has been on the Qld Housing most urgent list for that time, but has seen other people that he knows of housed before him. Requirements for documentation have been onerous in the extreme, with the same documents having to be submitted repeatedly. When discreetly living in a tent in bushland in a public park, he has been ‘moved on’ by police. Accommodation in male boarding houses is risky for him because of his trans status.57

(d)Appropriate toilets and change rooms


Several trans and intersex participants spoke of the difficulties they face in accessing appropriate toilets and change rooms both at work and in public places. For example:

Many transgender people are forced to limit their public social interactions to places they know will enable them to toilet/change without incurring discriminatory behaviour, harassment or violence. This has serious consequences for all travel and, in particular, limits one’s ability to respond to unexpected events in a ‘regular’ way. One of our members had to use toilets on a different floor while transitioning as peers on his floor were uncomfortable about him using either one.58

I brought a dress from a shop in the Canberra Centre last week. The shop only had a women’s fitting room and they refused me permission to try the dress on even though I explained that I was Intersexed. I brought the dress anyway and went home to try it on. It did not fit. So I went back to the shop to ask for a refund. They flatly refused, saying their store policy was no refunds. So I checked with ACT Fair Trading only to discover their policy was that you can't get a refund if you choose the wrong size.59

(e)Sport


The consultation heard that trans and intersex people are often restricted from participating in sporting activities. For example:

In several jurisdictions, an individual can be legally denied the right to participate in their chosen sport on the basis of the sex shown on their birth certificate. Where the sex on an individual’s birth certificate is not the person’s self-identified gender, it becomes extremely difficult for them to participate in even social or amateur sporting activities.60


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