1754 - Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence - resubmission

Overview

A further period of consultation is open on application 1754 – Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence, for consideration by the Medical Services Advisory Committee (MSAC) and its Evaluation Subcommittee (ESC). Consultation input helps MSAC and its subcommittees to better understand how a proposed health service or technology fits in the Australian health care environment.

Background

MSAC application 1754 is progressing via a 2-stage process. The first stage - assessment of the clinical evidence - was considered by MSAC in April 2025. At that time, MSAC considered there is a clinical need for gender affirming surgeries for people with gender incongruence. While MSAC considered the proposed surgeries are likely to be effective in the short term for some people, this was highly uncertain due to limitations in the evidence presented in the application.

MSAC advised additional work was required to ensure that MSAC has the necessary evidence and data to make its assessment and provide advice to inform the development of the second stage assessment report (economic and financial analysis).

MSAC requested:

• a more comprehensive assessment of the clinical evidence for gender affirming surgery for adults with gender incongruence
• more work to be done to establish care pathways to meet the needs of people with gender incongruence
• further specific advice from a range of stakeholders to ensure that patients attain the best outcomes from these surgeries.

Previous consultation

Consultation input received prior to April 2025 MSAC meeting

MSAC received and considered consultation input from 2,706 respondents. MSAC noted the significant amount of feedback received and acknowledged the organisations and thousands of people who shared their clinical expertise, knowledge, and lived experience. The information provided in the previous consultation highlighted the benefits in quality‑of‑life of gender‑affirming surgeries, alongside concerns regarding access to specialised care, and potential surgical risks.

More information on the previous consultation can be found in the Public Summary Document for application 1754 on the MSAC website. You can view the PSD as a PDF document (right click on the link and select 'open link in new tab'). If you would prefer to view as a word document, go to the application webpage and scroll to the 'Application Documents' section, locate the PSD and select 'Download Word'. This will download the PSD to your device. 

As noted in the  Public Summary Document, MSAC considered additional consultation input is required from consumer groups and all medical and allied health disciplines involved in the provision of gender affirming care to address the outstanding clinical concerns and provide more certainty to inform the economic and financial analysis.

Stakeholder consultation meetings

Stakeholder consultation meetings were held during May 2026 with consumer and clinical organisations along with state and territory governments to discuss the outstanding issues raised by MSAC including the provision of gender affirming care and care pathways. A summary of the outcomes from these meetings will be published on the  MSAC 1754 application webpage when available.

Purpose of this consultation survey

This survey contains targeted questions which aim to build on the previous consultation input and to address the specific aspects MSAC requested. Responses to the targeted questions in the survey will help MSAC and its subcommittees ensure all relevant issues are identified and fully considered, so that future decisions are accurate, clear and trauma informed.  

Remit of MSAC

MSAC’s role is to assess and advise government on whether changes to the MBS for the surgical procedures identified in the application should be made. The Australian Government (Minister for Health) is responsible for deciding whether to adopt MSACs advice, including deciding whether to list a health service on the MBS.​ 

However, there are limitations to MSAC’s role. MSAC cannot: 

• advise or mandate public hospital funding for surgical procedures relating to gender affirmation  
• advise on funding of PBS medications relating to the gender affirming care 
• mandate that clinicians providing gender affirming care must charge a specified fee and/or provide the service at the MBS rate 
• mandate that MBS items are bulk billed, so the patient won’t incur any out-of-pocket costs  
• mandate that any clinician provide gender affirming care  
• set or develop clinical practice guidelines and/or mandate that clinicians and patients must follow any specific guidelines or pathways, or 
• expand the scope of practice for health professionals or public funding. 

For more information on the role and remit of MSAC please refer to the Medical Services Advisory Committee (MSAC) terms of reference.

How to provide input

You can give input to MSAC on these questions by completing the online survey. MSAC welcomes input from interested individuals and organisations. To help your preparation, you can download a copy of the questions asked in the survey. To do this, click on the ‘Survey Questions’ link below (under 'Related'). If you have trouble using the online survey, you can complete this Microsoft Word version and email to commentsMSAC@health.gov.au.

Previous consultation input received for MSAC application 1754 – Surgical Procedures for Gender Affirmation in Adults with Gender Incongruence, will be carried forward and included in all future considerations by ESC and MSAC. There is no need to give further input unless you want to comment on the specific questions in this survey.