Vector Volume 11 Issue 2 - 2017

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15. Leonard W, Pitts M, Mitchell A, Lyons A, Smith A, Patel S, et al. Private Lives 2: The second national survey of the health and wellbeing of gay, lesbian, bisexual and transgender (GLBT) Australians. Melbourne: The Australian Research Centre in Sex, Health & Society, La Trobe University; 2012. 16. Robinson KH, Bansel P, Denson N, Ovenden G, Davies C. Growing Up Queer: Issues Facing Young Australians Who Are Gender Variant and Sexuality Diverse. Melbourne Young and Well, Cooperative Research Centre 2014. 17. Riggs DW, Coleman K, Due C. Healthcare experiences of gender diverse Australians: a mixed-methods, self-report survey. BMC Public Health. 2014;14(1):230. 18. Roberts TK, Fantz CR. Barriers to quality health care for the transgender population. Clinical biochemistry. 2014;47(10- 11):983-7. 19. Safer JD, Coleman E, Feldman J, Garofalo R, Hembree W, Radix A, et al. Barriers to healthcare for transgender individuals. Current opinion in endocrinology, diabetes, and obesity. 2016;23(2):168-71. 20. Snelgrove JW, Jasudavisius AM, Rowe BW, Head EM, Bauer GR. “Completely out-at-sea” with “two-gender medicine”: A qualitative analysis of physician-side barriers to providing healthcare for transgender patients. BMC Health Services Research. 2012;12(1):110. 21. Couch M, Pitts M, Mulcare H, Croy S, Mitchell A, Patel S. TranZnation: A report on the health and wellbeing of transgendered people in Australia and New Zealand Melbourne Australain Research Centre in Sex, Health & Society, La Trobe University 2007. 22. Pitts M, Couch M, Croy S, Mitchell A, Hunter M. Health service use and experiences of transgender people: Australian and New Zealand Perspectives Gay & Lesbian Issues and Psychology. 2009;5(3):167-76. 23. Mogul-Adlin H. Unanticipated: Healthcare Experiences of Gender Nonbinary Patients and Suggestions for Inclusive Care. United States, Connecticu: Yale University; 2015. 24. Transgender and Gender Diverse Health and Wellbeing: Background paper. Victoria Gay, Lesbian, Bisexual, Transgender and Intersex Health and Wellbeing Ministerial Advisory Committee, ; 2014. 25. Bogaert A. Asexuality: What It Is and Why It Matters. The Journal of Sex Research. 2015;52(4):362-79. 26. Gupta K. “And Now I’m Just Different, but There’s Nothing Actually Wrong With Me”: Asexual Marginalization and Resistance. Journal of Homosexuality. 2017;64(8):991-1013. 27. Alencar Albuquerque G, De Lima Garcia C, Da Silva Quirino G, Alves MJH, Belém JM, Dos Santos Figueiredo FW, et al. Access to health services by lesbian, gay, bisexual, and transgender persons: systematic literature review. BMC international health and human rights. 2016;16(2):22. 28. Taylor J. Chief Justice vows change to ‘traumatic’ court process for transgender children. ABC News. 2016. 29. Ryan E. Access to justice for young transgender Australians: Laywers Weekly 2017 [Available from: https://www. lawyersweekly.com.au/opinion/21101-access-to-justice-foryoung-transgender-australians. 30. Bolderston A, Ralph S. Improving the health care experiences of lesbian, gay, bisexual and transgender patients. Radiography. 2016;22:207 — 11. 31. Alliance NLH. Snapshot of mental health and suicide prevention statistics for LGBTI people. National LGBTI Health Alliance; 2016. 32. Lee R. Health care problems of lesbian, gay, bisexual, and transgender patients. The Western Journal of Medicine. 2000;172(6):403 — 8. 33. Curmi C, Peters K, Salamonson Y. Lesbians’ attitudes and practices of cervical cancer screening: a qualitative study. BMC Women’s Health. 2014;14(153). 34. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia. The Kirby Institute; 2016. 35. Amirkhanian YA. Social Networks, Sexual Networks and HIV Risk in Men Who Have Sex with Men. Current HIV/AIDS reports. 2014;11(1):81-92. 36. Richters J, Zou H, Yeung A, Caruana T, O de Visser R, Rissel C, et al. Sexual health and behaviour of men in New South Wales 2013–2014. School of Public Health and Community medicine 2015. 37. The Kirby Institute. HIV, viral hepatitis and sexually transmissible infections in Australia Annual Surveillance Report 2016. Sydney, Sydney NSW 2052: The Kirby Institute 38. Groves A. Transgender women and HIV: A footnote to the epidemic. HIV Australia. 2012;9(4):30-2. 39. Australian Department of Health and Aging. National Lesbian, Gay, Bisexual, Transgender and Intersex (LGBTI): Ageing and Aged Care Strategy. 2012. 40. Ard KL, Makadon HJ. Improving the Health Care of Lesbian, Gay, Bisexual and Transgender People: Understanding and Eliminating Health Disparities Boston, MA: The National LGBT Health Education Center; 2012. 41. Arora M, Walker K, Duvivier RJ, Wynne K. Transgender health delivery and education in the Hunter New England local health district. ANZPATH 2017 Biennial Conference; Sydney, Australia2017. 42. Canty J, Gray L. The last taboo? Teaching skills for clinical consultations with sex/gender diverse people in medical education. . ANZPATH 2017 Biennial Conference; Sydney, Australia2017. 43. Grosz AM, Gutierrez D, Lui AA, Chang JJ, Cole-Kelly K, Ng H. A Student-Led Introduction to Lesbian, Gay, Bisexual, and Transgender Health for First-Year Medical Students. Family Medicine. 2017;49(1):52-6. 44. Safer JD, Pearce E. A simple curriculum content change increased medical student comfort with transgender medicine. Endocrine Practice. 2013;19(4):633-7. 45. Sizemore LA, Rebeiro PF, Mcgoy SL. Improving HIV Surveillance Among Transgender Populations in Tennessee. LGBT Health. 2016;3(3):208-13. 9
Commercial surrogacy in Australia: the benefits of harm minimization through legalisation [Feature Article] Emily Feng-Gu and Keyur Doolabh Emily is an enthusiastic fourth year medical student at Monash University. She is completing a Diploma of Liberal Arts (Philosophy), and hopes to complete a Bachelor of Medical Science next year in her area of interest: bioethics. In her spare moments, she can be found with a coffee in one hand and a book in the other. Keyur is a medical student with an interest in philosophy. He enjoys writing, and is particularly interested in poverty, climate change and animal welfare. Surrogate /sʌrəɡət/ A substitute, or someone or something that represents another person or thing in their stead.[1] The status quo There is much controversy around surrogacy in Australia. We have what is known as ‘altruistic surrogacy,’ whereby a woman cannot be compensated beyond reasonable expenses for gestating a baby intended for someone else. Even the name puts our moral intuitions at ease. Altruistic. Contrast this with the term ‘commercial surrogacy’, which makes many of us instinctively recoil. So what is it about commercial surrogacy, where a woman is paid to gestate a baby, that we take issue with? The most common type of surrogacy is gestational surrogacy, wherein the commissioning parent(s) uses IVF to create an embryo from their own or donor gametes and transfer it into the uterus of the gestational surrogate. With this method, the surrogate mother does not provide any genetic material. People that seek out surrogacy commonly include infertile heterosexual couples and homosexual couples desiring children of their own. The demand for surrogacy has heightened in recent years following changes to child protection policy, which lead to drastic falls in the number of children for adoption and stricter criteria implemented by overseas countries regarding the age and family types who can adopt. For example, none of Australia’s current international adoption agreements allow same-sex couples to adopt.[2] The status quo in Australia (except the Northern Territory) only allows altruistic surrogacy, where one must not compensate the surrogate mother beyond out-of-pocket expenses like medical cost, travel, and time off work. The options are further limited by the fact that surrogacy is illegal for single people and samesex couples in certain states like Western Australia and South Australia. The increasing number of roadblocks to accessing surrogacy has left many desperate couples resorting to offshore commercial surrogacy. But even this option is becoming more restricted now that Thailand, Cambodia, India, and Nepal have banned foreigners from commercial surrogacy following the notorious “Gammy scandal” in 2014.[3] Objections to commercial surrogacy Commercial surrogacy commonly encounters several types of objections. Some think it is inescapably a form of exploitation of women, reducing the surrogate to her base reproductive capability, and effectively turning her into a walking incubator. Certainly, the idea of a class of ‘breeders’ is eerily reminiscent of Margaret Atwood’s classic novel The Handmaid’s Tale, which could be interpreted as a cautionary tale warning against the harms of surrogacy. In a similar vein, some argue that pregnancy belongs in a special moral realm, and that by bringing market forces into the arena we degrade the intrinsic value of creating life. Maybe there are some things in life which simply should not come with a price tag. Certainly, the idea of a class of ‘breeders’ is eerily reminiscent of Margaret Atwood’s classic novel The Handmaid’s Tale 10
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Page 29 and 30: Paddling upstream: Experiences from
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