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The federal health department has accepted an expanded definition of infertility that would allow LGBTIQ+ couples and single people to be able to access Medicare rebates for assisted reproductive technology.
After a year-long campaign, advocates and fertility specialists welcomed the move, which they say will provide more equitable access to fertility care across the country — including in vitro fertilisation (IVF) and intrauterine insemination (IUI).
“I’m pleased to announce that the Albanese Labor government has accepted an expanded definition of fertility to ensure single women and women in same-sex relationships can access IVF subsidies under Medicare,” Assistant Minister for Health Ged Kearney said in a post on Instagram on Wednesday.
Ashley Scott, executive officer of Rainbow Families — a not-for-profit organisation for LGBTIQ+ families — described this week’s announcement as a “massive win for our community”.
“We’ve been actively lobbying the federal government to ensure that LGBTQ+ people are treated like any other family,” Scott said on Wednesday.
‘Discrimination when starting a family’
Medicare rebates for fertility treatment are generally available once a medical cause of infertility is diagnosed.
This has been defined as the inability to conceive after 12 months or more of regular, unprotected intercourse. However, advocates and some specialists said this was delaying or blocking some LGBTIQ+ couples and single people from receiving rebates.
Rainbow Families conducted a survey last year which found that around half of LGBTIQ+ parents had not received any Medicare rebates when trying to conceive at Australian clinics.
Around one in three received a rebate once they had been deemed medically infertile following at least three rounds of failed treatments.
“We’ve heard from community for a long time now about the discrimination they face when starting a family using an IVF clinic,” Scott said on Wednesday.
“Some people were able to access the Medicare rebate on their first attempt, while others had to prove they were medically infertile — sometimes after three failed rounds of IVF or IUI. Even within the same clinics, there was a lack of consistency.”
A sweeping review of Australia’s fertility sector, conducted by the Fertility Society of Australia and New Zealand (FSANZ) last year, also called for more equitable access to treatments like IVF, irrespective of a person’s relationship status, sexual orientation or gender identity.
This included changing the definition of infertility, which was recently revised by the Australian and New Zealand Society for Reproductive Endocrinology and Infertility (ANZSREI) “as the basis for expanded and non-discriminatory access to IVF and ART (assisted reproductive technology)”.
The definition broadens the sector’s definition of infertility to include “the inability to achieve a successful pregnancy based on a patient’s medical, sexual, and reproductive history, age, physical findings, diagnostic testing, or any combinations of these factors, and the need for medical intervention to achieve a successful pregnancy.”
SBS News understands the health department has written to peak bodies in the fertility sector, confirming it acknowledges the updated version of infertility.
This means services which a health practitioner considers meet the updated definition and are delivered in line with relevant Medicare Benefits Schedule (MBS) items can attract a rebate.
A ‘really important policy change’
Kearney said the move was a “really important policy change for so many women”.
“For too long, single women and lesbians faced barriers when it came to accessing IVF. It was expensive, it was unfair, and it was just plain wrong,” she said.
“There’s been so many women and community organisations who have fought for this change for so long. I’m happy to share this win with them.”
FSANZ president Dr Petra Wale said the society welcomed the health department’s recognition of the revised definition of infertility as a “clinically relevant” service under Medicare and the Health Insurance Act.
“This acknowledgement is a significant step toward improving equitable access to fertility care and aligns with ANZSREI’s expanded definition of infertility, which has been endorsed by FSANZ and RANZCOG (Royal Australian and New Zealand College of Obstetricians and Gynaecologists).”
Wale said the acknowledgement “paves the way for more inclusive access to reproductive care”.
“This expanded definition reinforces the principle that fertility care should not be restricted by relationship status, sexual orientation, or gender identity.”
Wale said the revised definition “affirms the critical role of clinicians” in determining patient eligibility.
She said further efforts are underway to seek recognition under the expanded definition of Australian Defence Force personnel, who are not currently covered by Medicare.
Fight for equal reproductive ‘not over’
For Rainbow Families, the fight for equality in reproductive care “is not over”, with surrogacy “still excluded” from the Medicare rebate, Scott said.
Sarah Jefford, a surrogacy lawyer, explained to SBS News last September that under Medicare’s rules, fertility treatment can be provided for the purpose of surrogacy, but there are no available rebates.
“We will continue to advocate for this to change so that all LGBTQ+ people — including gay dads and people using surrogacy — have equal access to family-building support,” Scott said.
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