SPECIAL INVESTIGATION: Extreme methods to obtain drug
ROBERT BURTON-BRADLEY & BENN DORRINGTON
Transgender and intersex people are being listed as 鈥榮exual deviants鈥� with the help of GPs to obtain a hormone suppressing drug used to block testosterone.
Patients undergoing male-to-female transitioning and intersex people take the drug Cyproterone Acetate, also known as Androcur, to suppress male hormones during gender reassignment.
However, the drug is only approved for use by the Australian Therapeutic Goods Administration (TGA) under the Pharmaceutical Benefits Scheme (PBS) for prostate cancer sufferers, hormone treatments for non-pregnant women and people who declare themselves to Medicare as sexual deviants in order to obtain a subsidised medicare-approved authority prescription.
In recent years, online discussion within Australia鈥檚 transgender and intersex communities has raised serious claims about the allegedly controversial measures to accessing Androcur and where information on sexual deviants was being stored, but Australian medical authorities have denied these claims.
President of Australia鈥檚 peak intersex organisation, Organisation Intersex International (Oii) Australia, Gina Wilson, said thousands of transgender and intersex people had used the drug for testosterone suppression during the past 30 years by listing themselves as sexual deviants.
鈥淚t鈥檚 important for trans and intersex people to be, at least, included on the PBS just as a matter of equality,鈥� Wilson told the Star Observer.
鈥淲e shouldn鈥檛 be discriminated against on the basis of a drug that we need.鈥�
Wilson said she believed the only way transgender and intersex people could gain access to Androcur was to tell doctors and medical practitioners that they were sexual deviants.
However, the Australian Department of Health and the Australian Medical Association told the Star Observer that people could access the testosterone suppressant privately and off the PBS.
The drug can be obtained on a private script if a doctor willing to write a prescription can be found. However, it remains expensive, costing up to $178 for a month鈥檚 supply off the public health system, with the nearest substitute generic still costing at least $130.
On the PBS, Androcur can cost under $40.
The Department of Health said that private scripts were available for the drug and that it was up to the prescribing doctor to inform patients of this option as well as the availability of the drug on the PBS if a patient listed themselves as a sexual deviant.
鈥淒ecisions on prescribing are made by doctors and other authorised medical practitioners in accordance with the clinical needs of their patients,鈥� the Health Department spokeswoman said.
鈥淚n doing so, it is the medical practitioner鈥檚 responsibility to determine whether his/her patient qualifies to receive medicines through the Pharmaceutical Benefits Scheme (PBS) in line with its listed indication/s.
鈥淚t is a legal requirement when prescribing PBS medicines that medical practitioners prescribe in accordance with the applicable PBS restrictions.鈥�
Wilson said she was not aware Androcur could be privately prescribed.
While she remained skeptical that Androcur could be prescribed off the public system and without the rigid circumstances, she said more information was needed about this option.
Just last year, Wilson called on the Health Department to commission trials to investigate hormone treatments like Androcur for transgender and intersex people so there was more research available.
Wilson has campaigned extensively on the issue and said a fourth use for Androcur should be listed on the PBS to make the subsidised medication available to transgender and intersex Australians.
Wilson found it was ridiculous that two minority groups would be relegated to paying full price for important medications even though research showed these groups were more likely to face financial hardship.
The latest research into gender-diverse Australians found that both trans men and women earned significantly less than same-sex attracted people.
This year, the Private Lives 2 report revealed only one in three transgender people were working full-time and up to 78 percent of transgender people earned less than $1,000 a week compared to just 50 percent of gay men or 57 percent of lesbians.
Wilson claimed transgender and intersex people would have bought Androcur with a private script had they known about the option and added that the process needs to be simplified.
A spokeswoman for the Department of Human Services, which runs Medicare and the PBS, dismissed online speculation of a sexual deviant list.
She said when transsexuals declared themselves as sexual deviants, the information was not stored or kept by Medicare or the Department of Human Services.
鈥淭he Department of Human Services (DHS) does not have a patient register or a list of PBS prescription records for drugs prescribed for male patients to reduce drive in sexual deviations,鈥� the spokeswoman said.
A spokeswoman for the TGA, which is run by the Health Department, also said the information was not stored.
鈥淭he Australian Government Department of Health and Ageing does not hold any records of patient details,鈥� the spokeswoman said.
Police did not have access to the information either, as Wilson said she had contacted all of Australia鈥檚 police agencies who said they did not have access.
Neither department had any figures available on the number of people applying through the PBS for the drug as sexual deviants, however, the Department of Human Services spokeswoman said the PBS had strict rule about fraudulent applications.
鈥淒HS has a robust compliance program and treats all allegations of incorrect claiming and fraud seriously,鈥� she said.
The TGA said that it did not have the authority to make transsexual transitioning an available use of the drug under the PBS as only the company which owned the drug, Bayer, could make such an application which the TGA would then consider.
Bayer Australia indicated that it would not be leading that change anytime soon.
鈥淎ndrocur does not have a registered indication for us in male-to-female gender transition as there is insufficient scientific evidence to support a submission to the TGA,鈥� a Bayer Australia spokeswoman said.
鈥淎 company cannot apply for PBS reimbursement without an indication.鈥�
Following Bayer Australia鈥檚 reluctance to tackle the issue, Wilson called on the federal government and Australian universities to initiate a study into gender diverse people and the use of Cyproterone Acetate.
鈥淭he experiment has been done over 30 years and thousands of people have taken it, the side effects are well known and its action is well known,鈥� Wilson said.
鈥淚t鈥檚 ludicrous to say that because no test has been funded, I guess what they are saying is, there鈥檚 nothing in the list to support it.
鈥淏ut then, if no one is going to put it in the literature that will always be the case.鈥�
The Star Observer contacted the Gender Centre for comment but did not receive a response in time for publication.
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