Gender reassignment: Informed and calm discussion needed

Media coverage concerning ADF personnel undergoing gender reassignment treatment unfortunately tends to adopt emotive, sensationalist and sometimes prurient themes. Only by noting the facts applying can we have commonsense discussion of the implications for the operational effectiveness of our defence force and the individuals concerned.


Whenever this subject attracts media attention both that coverage and public feedback tends to miss the facts and actual context involved.

Particularly the laws and government policiues applying to all Australians, how modern defence forces actually operate and are funded, and what conditions of service and citizenship rights defence force personnel have long been entitled to.

The position of the Australia Defence Association on this issue is based on the same principles we apply when newspapers ot television programs occasionally purport to be outraged by breast reconstruction surgery for female defence force personnel (at a rate of about three women a year).


Commonwealth has always provided medical & dental care for ADF personnel

First, the basis for any debate needs to begin by noting that all full-time members of our defence force have always received medical and dental treatment for wounds, injuries and illnesses at public expense.

This is both a condition of service for the individual and a prudent investment by the nation in ensuring we have a healthy, fit and usable defence force.

Whether it is a gunshot wound, a physical illness such as measles, or a psychological illness with few or no physical symptoms or effects, the principle is the same.

If the wounds, injury or illness prevents continued service in the defence force then a medical discharge may be necessary in the interests of both the individual and the ADF.

If the reason for a medical discharge was caused by military service, then the person concerned is entitled to continuing treatment and/or compensation at public expense under relevant legislation – as occurs in civilian life through rehabilitation and workers’ compensation arrangements.


Stop trying to second-guess the treating medical specialists

Second, when ADF personnel suffer a recognised medical condition such as gender dysphoria this is diagnosed and treated by an appropriate combination of physicians, psychiatrists and psychologists.

It is simply invalid for others to second-guess such professional diagnoses and treatment. Or query the need for it, when they do not have the professional expertise required and do not know any of the specific diagnoses, facts or circumstances involved.


It is not surgery undertaken for cosmetic reasons

Third, if gender reassignment surgery is involved, we need to note the longstanding precedent of surgery to reconstruct the breasts of female ADF personnel for reasons of injury or illness (both physical and psychological).

This is not "cosmetic surgery" as some media are wont to claim.

Similarly, gender reassignment surgery is also medical treatment for a widely recognised psychological (and at times physical) condition, not merely a procedure supposedly undergone for reasons of personal choice, whim, vanity or purported "perversity".


ADF personnel have the same rights as other Australian citizens

Fourth, defence force personnel do not somehow lose their rights and entitlements as Australian citizens when they put on an ADF uniform.

As with breast reconstruction surgery, gender reassignment surgery for genuine medical reasons is one of the 16 psychological conditions requiring surgery covered wholly or partially for all Australians by Medicare anyway.

Contrived media and associated talkback-radio outrage at the supposed "waste of taxpayers' money involved" is invalid.

In the case of ADF personnel, the defence force is effectively only acting as the taxpayers' agent for Medicare.


Danger of denying the existence of psyhological illnesses

Fifth, the Australia Defence Association is also always wary when some splashy headline, or talkback radio comment, claims or insinuates that psychological conditions are somehow not an illness and "do not deserve" treatment.

This attitude, for example, stopped Post-Traumatic Stress Disorder (PTSD) among war veterans being treated properly for years.

We are also very uncomfortable with how the psychological or physical recovery of the ADF personnel involved is ignored, often contemptuously, when inaccurate and insensitive media beat-ups about psychological conditions are aired.


Defence force operational capability is the priority

Sixth, but not least, is the question of maximising defence force utility in operational and financial terms.

It is generally much cheaper, and certainly much quicker, to retain someone in the Services than it is to discharge them and then have to recruit, train and develop their replacement over many years.

The more experienced and qualified the person retained, the more money and time are saved, and wider operational inconveniences (through teamwork dislocation or capability displacement) avoided.

In the case of possible discharges for medical reasons, if the cost of the medical treatment needed to retain the person is less than the financial, time and foregone operational flexibility costs of replacing them, then it would be a gross waste of the taxpayer’s investment in that person, and in the defence force as a whole, not to at least explore the option.


Continued ADF service depends on operational requirements

Finally, there is the matter of continued defence force service after treatment is completed.

Media and general public acceptance of this is important and, as media coverage and the reaction to it shows, cannot be assumed.

Several other factors more specific or quite particular to our defence force also need to be considered:

  • Does the person wish to remain in the ADF?
  • Is their experience and age an issue, especially if treatment needs to be protracted?
  • Would their continued service fall inside or outside established medical, psychological, physical fitness and deployability parameters?
  • How might their current operational specialisation and employability be affected by a gender change?
  • What might be the effects of the gender change on military teamwork, small-group dynamics, wider unit cohesion and operational effectiveness?
  • What types of unit and deployment would be involved?
  • Would the operational capabilities, conditions and readiness requirements of such units be affected?

Both during and after completion of the treatment consideration of each person and their particular circumstances needs to be undertaken on a case-by-case basis.

Such consideration should not be influenced by ill-informed or prejudiced opinions espoused by some members of the public, particularly when whipped up by some in the media for their own commercial or careerist ends.

"Sunday Night" (Channel 7)
07 November 2010

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