The Australian Professional Association for Trans Health (AusPATH) was established in 2009 (previously as the Australian and New Zealand Professional Association for Transgender Health) and is Australia’s peak body for professionals involved in the health, rights and well-being of trans, including gender diverse and non-binary (TGDNB), people. The AusPATH membership comprises approximately 250 experienced professionals working across Australia.
AusPATH supports the addition of meaningfully inclusive questions on gender identity within the 2021 Census.
Population estimates from cross-sectional studies, such as the National Survey of Australian Secondary Students and Sexual Health 2019, indicate that 2.3% of young people are trans, including gender diverse or non-binary (TGDNB). However, despite the relatively large size of this population, no national population data exists.
It is well established that TGDNB Australians experience a range of health and wellbeing challenges at higher rates than the general population, but in order to establish the true extent of the issues and respond at an appropriate level, the number of TGDNB people living in Australia must be known.
It is also well documented that the TGDNB population has a higher prevalence of mental health conditions such as depression, anxiety disorders, violence (including domestic violence), abuse, self-harm and suicide attempts compared to the general population. Knowing the population size and characteristics will allow the design and distribution of necessary health services to areas of need, and appropriate allocation of resources.
TGDNB people are included as a national priority in the 5th National Mental Health and Suicide Prevention Plan, and addressing the above issues is a necessity if this is to be a success. Additionally, while a paucity of data exists at a national level of the prevalence of TGDNB people living with HIV/AIDS, they are also considered a priority population in the 8th National HIV Strategy. Furthermore, for healthy ageing and aged care, TGDNB people are included in the 2012 National Lesbian, Bisexual, Transgender and Intersex (LGBTI) Ageing and Aged Care Strategy.
In light of the Federal Government’s commitment in these important policy areas, it becomes imperative that accurate and relevant data be collected at the national level to help address the diverse needs of TGDNB people. Without comprehensive, inclusive national data, essential planning of resources at a population level cannot be undertaken in these key areas. The 2021 Australian Census of Population and Housing offers the ideal opportunity to obtain accurate data to reflect the reality of the Australian population.
Collecting data on gender using options variables such as ‘male, female or trangender’ is contrary to best practice and is likely to confound analysis given that most TGDNB people are simply male or female. We recommend a two-step methodology, as per well-established and tested guidelines applicable to an Australian and global context. This approach involves a question about the marker used to register an individual’s birth (male or female) alongside a second question about an individual’s gender identity (male, female or non-binary). These simple questions are easy to understand and would be acceptable to the broader general population.
This approach was not followed in the 2016 Census survey instrument resulting in an inadequate and inaccurate representation of Australia’s TGDNB population. The ABS confirmed this with a statement, ‘This count is not considered to be an accurate count, due to limitations around the special procedures and willingness or opportunity to report as sex and/or gender diverse’.
In summary, AusPATH believes that it is both important and possible to collect data on gender identity in a national census. This is of national importance, and such data will satisfy a vital need in enabling better health service delivery for the TGDNB population. The collection of such data will be acceptable to census respondents, and it can be collected accurately and efficiently. There is likely to be a continuing need for such data in future censuses.
Furthermore, AusPATH endorses previous statements made by the National LGBTI Health Alliance, Equality Australia, and Intersex Human Rights Australia (IHRA) in support of the meaningful inclusion of questions related to sexual orientation, gender identity and intersex status.
AusPATH supports the inclusion of a two-question format related to gender identity in the 2021 Australian Census.