Reasons for sex surgery at odds

02 December 2004

By OSKAR ALLEY

The specialist who approved Joanne Martin's
first-stage sex change operation
says the procedure is done to reduce the cost of
taxpayer-funded drug
therapy contradicting prison bosses' evidence to
Parliament.

Endocrinologist Robyn Toomath said an orchidectomy,
the surgical removal of
testicles, was granted because it helped a
transgender patient and ended
expensive and continuing drug treatment.

But the explanation is at odds with that provided by
public prisons general
manager Phil McCarthy to Parliament's law and order
select committee.

Mr McCarthy confirmed to MPs yesterday that The
Dominion Post's reports that
Martin who has 157 criminal convictions had
undergone the procedure
during a one-night stay in Wellington Hospital were
correct.

But the surgery was done for "health" reasons, not
for "gender reassignment"
reasons, which prison guidelines forbade, Mr
McCarthy said. He could not
remember what those health reasons were, despite
being briefed on Martin's
case.

"My understanding is that the operation that Joanne
underwent can be done on
a number of occasions for a number of different
reasons and not necessarily
as part of a series of operations that represent
gender reassignment," Mr
McCarthy said.

"So I'm assured that, despite the fact that the
public indications as to
what happened (are) true, our policy was not
breached."

It was not for prison officials to "second-guess" a
specialist's medical
judgment, he said.

But Dr Toomath, who treated Martin, said that
explanation was "wrong".

She was surprised to learn that Martin's case was
being discussed at
Parliament and noted that no one from the
Corrections Department had
contacted her to discuss the reason for the surgery.
She would not comment
on Martin's case specifically, but said
orchidectomies were ideal for
treating transgender patients and produced a
"desirable" outcome for
recipients.

The alternative to surgery was the constant
prescription of "moderately
expensive" anti-androgen drugs, which suppressed
testosterone and required
regular specialist assessments and outpatient clinic
visits.

"If you can do exactly the same in a very quick
procedure, the patient is
very happy, it saves the hospital and the taxpayer
money, it's just a
no-brainer."

The fact that a surgery candidate had criminal
convictions would "play no
part whatsoever" in a specialist's approval of the
procedure, she said.

"We do not discriminate between the care we offer
people, whether or not
they're in prison."

Mr McCarthy said in response last night: "It is
clear that this surgery
wouldn't have been performed if the inmate was not
seeking gender
reassignment."

He had been advised that "medical reasons drove the
need for the operation"
and the prison would not have facilitated the
surgery if those medical
circumstances did not exist.

© Fairfax New Zealand Limited 2004.