Statement of Principles concerning gender dysphoria (Reasonable Hypothesis) (No. 113 of 2021)

Administered by Department of Veterans' Affairs

Legislation au F2021L01631 In force Legislative Instrument

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EXPLANATORY STATEMENT

 

STATEMENT OF PRINCIPLES CONCERNING

GENDER DYSPHORIA

(REASONABLE HYPOTHESIS) (NO. 113 OF 2021)

 

VETERANS' ENTITLEMENTS ACT 1986

MILITARY REHABILITATION AND COMPENSATION ACT 2004

 

  1. This is the Explanatory Statement to the Statement of Principles concerning gender dysphoria (Reasonable Hypothesis) (No. 113 of 2021).

Background

2.             The Repatriation Medical Authority (the Authority) has determined, under subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA), Statement of Principles concerning gender dysphoria (Reasonable Hypothesis) (No. 113 of 2021).

3.             The Authority is of the view that there is sound medical-scientific evidence that indicates that gender dysphoria and death from gender dysphoria can be related to particular kinds of service.  The Authority has therefore determined this Statement of Principles concerning gender dysphoria pursuant to subsection 196B(2) of the VEA.

Purpose and Operation

4.             The Statement of Principles will be applied in determining claims under the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).

5.             The Statement of Principles sets out the factors that must as a minimum exist, and which of those factors must be related to the following kinds of service rendered by a person:

 operational service under the VEA;

 peacekeeping service under the VEA;

 hazardous service under the VEA;

 British nuclear test defence service under the VEA;

 warlike service under the MRCA;

 non-warlike service under the MRCA,

before it can be said that a reasonable hypothesis has been raised connecting gender dysphoria or death from gender dysphoria, with the circumstances of that service.  The Statement of Principles has been determined for the purposes of both the VEA and the MRCA.

6.             The Repatriation Commission, Military Rehabilitation and Compensation Commission, Veterans' Review Board or Administrative Appeals Tribunal cannot accept any claim for pension; or a claim for liability or compensation relating to gender dysphoria or death from gender dysphoria that was lodged on or after 1 June 1994 in the case of the VEA, or 1 July 2004 in the case of the MRCA respectively, unless this Statement of Principles upholds that claim (subsection 120A(3) of the VEA or subsection 338(3) of the MRCA).

7.             This new Instrument results from an investigation notified by the Authority in the Government Notices Gazette of 6 July 2021 concerning gender dysphoria in accordance with section 196G of the VEA.  The investigation involved an examination of the sound medical-scientific evidence available to the Authority.

Incorporation

8.             This Instrument incorporates by reference the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), Arlington, VA, American Psychiatric Association, 2013.  A copy of this document is available from the offices of the Repatriation Medical Authority, Level 8, 480 Queen St, Brisbane, Queensland 4000, by contacting the Registrar on telephone (07) 3815 9404.

Consultation

9.             Prior to determining this Instrument, the Authority advertised its intention to undertake an investigation in relation to gender dysphoria in the Government Notices Gazette of 6 July 2021, and circulated a copy of the notice of intention to investigate to a wide range of organisations representing veterans, service personnel and their dependants.  The Authority invited submissions from the Repatriation Commission, the Military Rehabilitation and Compensation Commission, organisations and persons referred to in section 196E of the VEA, and any person having expertise in the field.  No submissions were received for consideration by the Authority in relation to the investigation.

Human Rights

10.         This instrument is compatible with the Human Rights and Freedoms recognised or declared in the International Instruments listed in Section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.  A Statement of Compatibility with Human Rights follows.

Finalisation of Investigation

11.         The determining of this new Instrument finalises the investigation in relation to gender dysphoria as advertised in the Government Notices Gazette of 6 July 2021.

References

12.         A list of references relating to the above condition is available on the Authority's website at: www.rma.gov.au. Any other document referred to in this Statement of Principles is available on request to the Repatriation Medical Authority at the following address:

              

Email:    info@rma.gov.au

Post:      The Registrar

Repatriation Medical Authority

GPO Box 1014

BRISBANE    QLD    4001

 


Statement of Compatibility with Human Rights

(Prepared in accordance with Part 3 of the Human Rights (Parliamentary Scrutiny) Act 2011)

 

Instrument No.:   Statement of Principles No. 113 of 2021

Kind of Injury, Disease or Death: Gender dysphoria

 

This Legislative Instrument is compatible with the human rights and freedoms recognised or declared in the international instruments listed in section 3 of the Human Rights (Parliamentary Scrutiny) Act 2011.

Overview of the Legislative Instrument

1. This Legislative Instrument is determined pursuant to subsection 196B(2) of the Veterans' Entitlements Act 1986 (the VEA) for the purposes of the VEA and the Military Rehabilitation and Compensation Act 2004 (the MRCA).  Part XIA of the VEA requires the determination of these instruments outlining the factors connecting particular kinds of injury, disease or death with service such being determined solely on the available sound medical-scientific evidence.

2. This Legislative Instrument:-

  • facilitates claimants in making, and the Repatriation Commission and the Military Rehabilitation and Compensation Commission in assessing, claims under the VEA and the MRCA respectively, by specifying the circumstances in which medical treatment and compensation can be extended to eligible persons who have gender dysphoria;
  • facilitates the review of such decisions by the Veterans' Review Board and the Administrative Appeals Tribunal; and
  • outlines the factors which the current sound medical-scientific evidence indicates must as a minimum exist, before it can be said that a reasonable hypothesis has been raised, connecting gender dysphoria with the circumstances of eligible service rendered by a person, as set out in clause 5 of the Explanatory Statement.

3. The Instrument is assessed as being a technical instrument which improves the medico-scientific quality of outcomes under the VEA and the MRCA. 

Human Rights Implications

4. This Legislative Instrument does not derogate from any human rights. It promotes the human rights of veterans, current and former Defence Force members as well as other persons such as their dependents, including:

  • the right to social security (Art 9, International Covenant on Economic, Social and Cultural Rights; Art 26, Convention on the Rights of the Child and Art 28, Convention on the Rights of Persons with Disabilities) by helping to ensure that the qualifying conditions for the benefit are 'reasonable, proportionate and transparent'[1];
  • the right to an adequate standard of living (Art 11, ICESCR; Art 27, CRC and Art 28, CRPD) by facilitating the assessment and determination of social security benefits;
  • the right to the enjoyment of the highest attainable standard of physical and mental health (Art 12, ICESCR and Art 25, CRPD), by facilitating the assessment and determination of compensation and benefits in relation to the treatment and rehabilitation of veterans and Defence Force members;
  • the rights of persons with disabilities by facilitating the determination of claims relating to treatment and rehabilitation (Art 26, CRPD); and
  • ensuring that those rights "will be exercised without discrimination of any kind as to race, colour, sex, language, religion, political or other opinion, national or social origin, property, birth or other status" (Art 2, ICESCR).

Conclusion

This Legislative Instrument is compatible with human rights as it does not derogate from and promotes a number of human rights.

 

Repatriation Medical Authority

 

 

 

 

 

 

[1] In General Comment No. 19 (The right to social security), the Committee on Economic, Social and Cultural Rights said (at paragraph 24) this to be one of the elements of ensuring accessibility to social security.

Overview

The Statement of Principles concerning Gender Dysphoria (Reasonable Hypothesis) (No. 113 of 2021), enacted under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA), addresses the need to establish a clear link between gender dysphoria and specific types of military service for the purposes of claims under these Acts. The Repatriation Medical Authority determined this Statement of Principles based on sound medical-scientific evidence, aiming to facilitate the assessment and determination of claims for compensation and benefits related to gender dysphoria. This instrument outlines the minimum factors that must be present and connected to eligible service to raise a reasonable hypothesis about the service's relation to gender dysphoria. It ensures that claims lodged after the specified dates under the VEA and MRCA must be upheld by this Statement of Principles, thereby formalising the process and criteria for such claims. The Authority's determination process involved an examination of available evidence and compatibility with human rights, ensuring that the rights of veterans and other eligible persons are upheld and exercised without discrimination.

Scope and Application

The Statement of Principles concerning gender dysphoria (Reasonable Hypothesis) (No. 113 of 2021) applies to claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA) and is intended to facilitate the assessment and determination of claims related to gender dysphoria for veterans and Defence Force members. It applies to those who have rendered specific kinds of service, such as operational, peacekeeping, hazardous, or British nuclear test defence service under the VEA, or warlike and non-warlike service under the MRCA. Claims for pension or liability or compensation relating to gender dysphoria or death from gender dysphoria must adhere to this Statement of Principles if lodged on or after the specified dates of 1 June 1994 for the VEA and 1 July 2004 for the MRCA. The Statement of Principles outlines the minimum factors that must exist to establish a reasonable hypothesis connecting gender dysphoria with service circumstances. This Instrument is compatible with human rights, promoting the rights of veterans, current and former Defence Force members, and their dependents by ensuring the qualifying conditions for benefits are reasonable, proportionate, and transparent. It facilitates the assessment and determination of social security benefits, ensuring an adequate standard of living, and facilitates the assessment and determination of compensation and benefits for the treatment and rehabilitation of veterans and Defence Force members, thereby promoting their right to the highest attainable standard of physical and mental health.

Key Provisions

The main operative sections of this legislation are sections 2 to 12, which outline the Statement of Principles concerning gender dysphoria, the investigation process, and the compatibility with human rights. Section 2 provides background on the determination of the Statement of Principles by the Repatriation Medical Authority (the Authority), while section 3 explains the purpose and operation of the Statement of Principles in relation to claims under the Veterans' Entitlements Act 1986 (VEA) and the Military Rehabilitation and Compensation Act 2004 (MRCA). Section 4 sets out the kinds of service that must be related to gender dysphoria or death from gender dysphoria for a reasonable hypothesis to be raised. Section 5 explains the incorporation of the Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5) by reference. Section 6 outlines the consultation process and the lack of submissions received by the Authority. Section 7 states the compatibility of this instrument with human rights, and section 8 finalises the investigation. The obligations and requirements imposed by this legislation primarily concern the Repatriation Medical Authority and the relevant Commissions, Boards, and Tribunals in assessing claims related to gender dysphoria. The Authority is required to determine Statements of Principles based on sound medical-scientific evidence, and the Commissions, Boards, and Tribunals must uphold the Statement of Principles in assessing claims. The Statement of Principles sets out the factors that must exist, and which of those factors must be related to the specified kinds of service, before a reasonable hypothesis can be raised connecting gender dysphoria or death from gender dysphoria with the circumstances of that service. The legislation also requires the Authority to consult with relevant organisations and individuals and ensure compatibility with human rights. The legislation does not explicitly outline offences, penalties, or civil/criminal consequences for breach. However, failure to comply with the requirements of the Statement of Principles or the legislation could result in the rejection of claims for pension or compensation related to gender dysphoria or death from gender dysphoria. This could potentially lead to legal challenges, appeals, or other consequences for the parties involved.

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