Francene Jacques fights to include gender confirming surgery on Medicare

At 79-years-old she has taken the final steps to move into the correct address.

Ms Jacques, a transgender woman, has been on hormone replacement therapy for three-and-a-half-years.

In February, the northern Tasmanian woman underwent gender confirming surgery, a labiaplasty, to get rid of parts she "despised".

Ms Jacques met barriers to accessing the procedure, which couldn't be performed in Tasmania.

A Melbourne surgeon had told her she was too old.

Ms Jacques said there was a surgeon in Sydney who would do it.

The procedure meant she spent seven days at The Sydney Private Hospital.

Ms Jacques said she was lucky to have had the surgery when she did.

Gender confirming surgery falls under the umbrella of non-urgent elective surgeries that state's battling COVID-19 outbreaks have paused.

Ms Jacques, of Latrobe, described her surgery as essential.

"It was something I wanted to do and something I had to do. The parts that were involved I despised.

"It was so important for me [to do]."

She said now all her surgeries were done.

"I always thought it would make a difference having it done, but I never realised how much of a difference that would make.

"My pet saying is only those that have been there really understand, others might know but they never understand."

Ms Jacques said Transgender Tasmania had over 200 members.

A petition to the federal parliament to request gender-affirming and gender reassignment services to become eligible for Medicare benefits has gained momentum.

"These surgeries are essential for the mental health and wellbeing of select people in the LGBTQ+ community," the petition read.

It has more than 135,000 signatures.

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A federal Department of Health spokesperson said there was no specific or overarching Medicare Benefits Schedule item for gender affirming surgery.

They said for a procedure to be publicly funded on the MBS it must be independently assessed by the Medical Services Advisory Committee.

"To date, an application has not been submitted to the MSAC to list a MBS item/s for gender affirming surgery," the spokesperson said.

They said MSAC applications were usually sponsored by the sector, suggesting the relevant professional organisation could be the Australian Society of Plastic Surgeons.

The department said there was a range of individual surgical procedures listed on the scheme that could be performed as part of the gender confirmation process.

"The good thing is, I'm a veteran," Ms Jacques said.

Having served for 20 years, she said the Department of Veterans' Affairs paid for the hospital, pathology and transport and accommodation covering two trips to Sydney for her consultation and surgery.

Ms Jacques said some parts that were removed were sent to pathology to do a cancer check.

"If you would've had to pay the hospital on top of that it would've been phenomenal."

To pay for the surgery and anesthetist, Ms Jacques was charged $22,460.05. The total Medicare rebate was a portion of that at $2363.40.

Her surgical procedure was billed under neurovascular island flap, item 45563. The scheduled fee for that procedure was $2184.35.

"If you could find a surgeon who would do it for that, you'd have a queue a mile long," she said.

Ms Jacques said it would make a big difference if the Medicare rebate reflected the value of the procedures.

"That's what we're fighting for.

"I think the people, and they're all cis-men, I think that they imagine we wake up one morning and say, 'I'm going to be a girl' and that's it.

"They don't know the years we spend to get recognised and all the psychologist appointments we have, doctors appointments we have to actually get to that stage.

"And then you start on very low dose HRT and you just gradually wind up from that."

She said the financial cost imposed due to the lack of Medicare support could have disastrous results for many over the longer term.

"Gender confirming surgery is not a luxury, it is something really necessary for many."