8. Gender and Sexual Health

The DRS notes that differences between genders in culture, roles in society, economic status and biology create differences in health status between women and men.

8.1  Women’s Health: General
8.1.1  The DRS realises there is a need to improve the health and well-being of all Australian women, and recognises their specific health needs arising out of their many roles in our society.  Issues which impact upon women’s health in particular are access to political, economic and social power, cultural expectations of women (including a “carer” role), geographic and age-related factors.

8.1.2  The DRS believes all women in Australia must have access to appropriate information and education about health.  This encompasses effective participation in decisions about their health within all services.  A choice in the gender of their practitioner should be available and family planning wherever possible.

8.1.3  The DRS supports the role of women’s health centres, and urges that they be adequately and securely funded to maintain a viable service.  These centres should be seen as complementing mainstream services, rather than competing with them.  Channels of communication between these centres and mainstream services need to be improved.

8.1.4  The DRS believes that a number of important women’s health issues are often not adequately covered in the training of health workers and calls for greater emphasis on women’s health in the education of health care workers, and in research.  (see also Medical Workforce 5.3.3 and Ethical Medical Practice 3.5.5)

8.1.5  The DRS is concerned that violence, including emotional, physical and sexual violence, continues to damage many women.  To reduce the effect of this, the DRS supports the provision of appropriate support services, with 24-hour availability of well-trained counsellors and female medical practitioners.  There is also the need to provide accessible and appropriate long term counselling services. (see also 15.3 Domestic Violence and 15.4 Sexual Assault)

8.1.6  The DRS calls for the special needs of HIV positive women to be recognised by health service providers, government and research bodies.  (see also HIV/PLWAIDS 11.2.6)

8.2  Women’s Reproductive Health
8.2.1  The DRS acknowledges that all people should have the right to determine the number and spacing of their children and the necessary information and services to enable this; and that the withholding of abortion services does not prevent abortion but rather increases morbidity and mortality due to unsafe or illegal abortion.  Therefore the DRS:
i. supports the availability of free, safe termination of pregnancy, and believes that all women should have a right to this under law.  Abortion should be governed by laws relating to good medical practice.
ii. deplores attempts to restrict access to safe abortion or removal of abortion from the Medicare schedule.

8.2.2  The DRS believes all women should have access to new approved scientific developments and methods of birth control and abortion.

8.2.3  The DRS affirms the right of women to choose to have home births where there are no serious or overriding contraindications.  The DRS also recommends that health departments take appropriate measures to facilitate the availability of doctor and/or midwife assisted home births.  This would include the provision of effective ambulance and hospital back-up where continuation of home birth becomes inappropriate.  (see also Role of Non-medical Health Professionals 4.8.3)

8.2.4  The DRS supports the concept of birthing centres in hospitals and supports their expansion.  Administration of the centres should involve community participation.

8.3  Men’s Health
8.3.1  The DRS recognises that there are particular issues for men which affect their health.  These issues can arise from the process of socialisation to compete and dominate in social and political spheres which can foster violence.  As a result of this, many men experience a number of psychological difficulties, a reluctance to acknowledge and address their own health issues and diffidence in approaching health services.  (see also 15. Violence and Aggression)

8.3.2  The DRS recognises that despite the fact that the majority of health research has been conducted on men and that there are biases towards men in health care teaching (due to the dominance of men in teaching and research positions), men still have poorer health in a number of areas and a lower life expectancy than women.

8.3.3  The DRS believes that increased attention to lifestyle changes (such as exercise, reduction of alcohol consumption, and strategies to reduce violence) are more important in improving the health of men than technological improvements in health care.

8.3.4  The DRS believes all men in Australia must have access to appropriate information and education about health.  In particular, men need to be encouraged to make earlier, more appropriate use of primary health services.

8.3.5  The DRS encourages the development of accessible, appropriate services for those who are victims of violence.  It is also important to develop preventive and treatment services for those who are at risk of, or have, perpetrated violence. (see also Violence and Aggression 15.1.3 General, 15.3 Domestic Violence and 15.4 Sexual Assault)

8.3.6  The DRS believes in order to improve men’s health, the men’s health movement needs to focus on the above issues, rather than competing with the women’s health movement.

8.4  Reproductive Technology
8.4.1  The DRS believes that access to reproductive technology should be available when appropriate, irrespective of financial means, marital status or sexual orientation.  Counselling regarding all options should be available at an early stage, and throughout treatment and should include the possible dangers of treatments as well as the benefits.

8.4.2  The DRS believes the development and use of technology must be closely monitored to ensure that the primary aim is to benefit infertile and subfertile persons (rather than for financial, scientific or other reasons).  An ethical committee with a legal base should be established to enforce this.  (see also Ethical Medical Practice, Research 3.5.4)

8.5 Gender and sexual diversity

The DRS believes that:

8.5.1 No discrimination should occur on the basis of gender identity, sexual orientation and/or intersex status.

8.5.2 Health care professionals should provide inclusive, respectful, culturally sensitive and appropriate care for lesbian, gay, bisexual, transgender, intersex and queer (LGBTIQ) people.

8.5.3 All health care relating to gender and sexual diversity should be available within the public health care system.

8.5.4 Health professional training institutions have a responsibility to provide appropriate and effective curricula in LGBTIQ healthcare and cultural competence.

8.5.5 Individuals should have access to gender affirmation processes, should they wish to seek them and do so with full consent.

8.5.6 Management of transgender and intersex issues should be carried out by multidisciplinary teams and should occur within a human rights framework that respects individuals’ autonomy.

8.5.7 Health care services must respect the diversity within LGBTIQ communities. This requires consultation with a range of LGBTIQ organisations and representatives to ensure the needs of their community are being met.