Paper short abstract:

The controversy and contestations facing trans health over the years have shaped the treatment protocol and continue to impact the day to day experiences of clinicians and clients. In this complex context of diversely opinionated stakeholders, what might good care look like?

Paper long abstract:

While any field of healthcare has arguably changed and developed drastically since 1990, transgender-specific healthcare (the provision of gender-affirming treatments like hormones and surgery), in some respects has experienced an especially profound shift. This shift is not only within the medical care provided, but also in the processes that precede access to that medical care.

Trans health is a branch of medicine that has faced rampant contestation since its inception. A great deal of this contestation is about the path to accessing treatment, where gender clinics often mandate a mental health assessment that has been criticised for being pathologising and creating unnecessary barriers to care. Additionally, it is a field of healthcare that disrupts expected regulations and categorisations of western healthcare. This paper will thus explore how these contestations have shaped trans health over the years including how it impacts the day-to-day encounters between clinicians and their clients.

While the research for this paper took place at Monash Health Gender Clinic in Melbourne Australia, gender clinics in Europe as much as Australia, grapple with the same dilemma of providing care that abides by a heavily criticised system. A polarisation exists between the healthcare system and trans activists/advocates on what constitutes good care. As an underrepresented topic in medical anthropology, this paper seeks to explore the important question of "What is good care?" in the above described context, plus the risks of providing treatment, clinician liability and non-maleficence, and the drive, on all fronts, to improve the care provided.