• November 20 marks Trangender Day of Remembrance. (Ted Eytan, Flickr, Creative Commons)Source: Ted Eytan, Flickr, Creative Commons
Melbourne has been voted the world's most liveable city for the sixth year in a row, and the city's first trans health clinic cements its reputation as the friendliest city for the trans and gender diverse communities, writes Emily McAvan.
Emily McAvan

29 Aug 2016 - 1:30 PM  UPDATED 29 Aug 2016 - 1:30 PM

Recently, Melbourne was voted the world’s most liveable city, for the sixth year in a row. Melbourne’s easily accessible public transport, vibrant cultural life and general safety have made the Victorian capital city one of the world’s great cities.

What was not included on that poll explicitly is the fact that Melbourne is undoubtedly the country’s friendliest city for trans people to live in (sorry Sydney). Recently, Victorian premier Dan Andrews made headlines by proposing a bill that will make Victoria the most liberal state in Australia in allowing transgender people to change their birth certificates easily. Andrews has also promised a $15 million LGBT Pride Centre, “a hub for LGBTI advisory, health and support services, and also showcase queer art and history” as SBS puts it.

Victoria gets $15 million 'Pride Centre'
The Victorian government has announced it will fund and establish Australia's largest LGBTI community centre.

What is even better is that Melbourne has just opened an Australian first: a health clinic catering solely to the needs of the transgender and gender diverse community. Located in Fitzroy, the Equinox Gender Diverse Clinic is a peer-led trans-focused clinic that launched at the end of July. Run by the Victorian AIDS Council, the clinic is bulk billed, making the service accessible to the entire transgender community, not just its most privileged members. Starting off with a GP service, Equinox plan to expand into a counselling service in November 2016, and beyond that into addressing trans homelessness.

It is a much needed intervention for an often marginalised and pathologised community. Transgender access to quality and affirming health care has long been an issue in Australia and elsewhere. A journal article in BMC Public Health found that transgender people report “1) being denied services, 2) accessing practitioners with little or no knowledge of the issues facing gender diverse people, 3) being subjected to inappropriate terminology by health professionals, 4) having their own knowledge discounted, and 5) experiencing considerable waiting periods to access services.” An American survey found one in four trans people had been denied care by medical professionals, a staggering statistic.

In other words, transgender people cannot count on medical and psychological care being appropriate and respectful of their gender identities. Prejudice against transgender people is still widespread - it is no accident that one of the key ideas pushed by the Australian Christian Lobby is about “innocent” children being “turned” transgender by LGBTQIA+ activism - and medical professionals, sadly, often hold many of the same prejudices as the broader community.

Comment: The right to the right document for trans and gender diverse
Seven of Australia’s eight states and territories require surgery to change the sex marker on a birth certificate. But those laws could soon change, much to the relief of trans and gender diverse people.

Peter Locke of Equinox tells me via email that “Equinox aims to reduce the access barriers to good health and well being that the transgender/gender diverse community often face. We recognise the need for a safe community space where trans-affirmative medical and well-being services are offered without judgement to all of our clients regardless of their gender presentation.” Transgender advocate Starlady has recently remarked that, “I feel like the transgender community needs to have levels of ownership over our own healthcare pathways.”

This is especially true for trans people from culturally and linguistically diverse backgrounds, who may find language an additional barrier in accessing medical treatment. Locke notes that “Equinox clients come from an array of backgrounds including from CALD communities. We understand that gender identity and representation has different meanings within different cultures and communities and support all of our clients in accordance with their personal choices and cultural practices.  With advance notice, we can arrange for telephone interpreter services to support non-English speaking clients during appointments.”

Hundreds protest in Istanbul over murder of transgender woman
Hundreds protested peacefully on Sunday in Istanbul calling for justice after the brutal murder of a transgender woman earlier this month in Turkey.

While it is heartening to see a service like Equinox emerge, it is only the first step for transgender health in Australia. Transgender health care for those who live outside the capital cities is next to non-existent. Not everyone can afford - or even desires - to live in a city like Melbourne, where LGBT+ resources are increasingly plentiful. In the long term, we need to see more trans centric - and indeed LGBT+ in general - health centres emerge. Equinox hope to eventually be able to educate doctors in the respectful treatment of trans people, and it is this that may well prove to be some of the centre’s most important work. Trans people deserve to be able to access quality medical and psychological care, where-ever they are in this wide country of ours.