EDITOR’S NOTE: MJA InSight and the MJA maintain and uphold a policy of independence from the AMA. Both MJA InSight and the MJA’s independent, official stance is that marriage equality is a health issue, and we support the view that same-sex marriage is a positive step for the health of LGBTI Australians.


IN AN environment in which the federal government has “abrogated its duty of care” to the lesbian, gay, bisexual, transgender and intersex (LGBTI) community, GPs have a vital role to play in helping their LGBTI patients through what is unquestionably a health issue, say mental health experts and equal rights advocates.

Professor Kerryn Phelps, a GP, former national president of the Australian Medical Association (AMA), a marriage equality advocate, and currently the Deputy Lord Mayor of Sydney, told MJA InSight that the prospect of the non-binding, non-compulsory postal vote was already doing damage to the health of LGBTI people.

“Just in my own practice, I’m seeing LGBTI patients who are feeling very anxious and depressed. Within my friendship circle, people are agitated and disturbed by the debate,” she said.

“The government has a duty of care to LGBTI people just as it does to other members of Australian society. By pushing for this postal vote, they are abrogating that duty of care, particularly to the more vulnerable members of the LGBTI community.”

Research shows that LGBT Australians report higher rates of psychological distress than the general population.

“At the moment, many LGBTI people are not even understanding why they are not feeling great,” Professor Phelps told MJA InSight. “GPs can help them recognise what’s going on, listen and recommend strategies for coping. For example, take a break from social media, surround yourself with positive, supportive people, stay positive.

“GPs should audit their own responses to the question of whether same-sex marriage should be legally recognised. If they feel they would vote no, then perhaps it would not be helpful to their LGBTI patients to talk with them about it, and the best thing they could do is refer them to a more sympathetic doctor, perhaps one with LGBTI counselling skills.

“GPs need to be alert and sensitive to the fact that their LGBTI patients might be suffering right now from increased sleeping problems, anxiety and depression.”

“Let your patients know that the majority of Australians do support them, that their relationships are meaningful,” she said.

ACON (the AIDS Council of NSW) has published a Guide for health services to support LGBTI clients during the marriage equality debate, which provides resources, data and conversation pointers for doctors with LGBTI patients.

Australians wishing to vote in the non-compulsory poll must be enrolled with the Australian Electoral Commission by Thursday 24 August, including those turning 18 years old by November 7 – the date voting closes. Ballots will be mailed out on 12 September, and a result is expected to be released by 15 November.

All that is assuming the High Court allows the vote to go ahead after same-sex advocates launched an injunction against the postal vote based on the assertion that, without legislation to establish and fund the poll, the government was acting outside its “executive power”. The High Court is set to rule next month, presumably before the 12 September mail-out date.

Professor Ian Hickie, codirector of the Brain and Mind Centre at the University of Sydney, and a National Mental Health Commissioner, said that the very fact of the postal vote was “very distressing”, particularly to younger members of the LGBTI community.

“The whole notion that the status of one’s relationships is something that everyone gets to decide, rather than it being an individual choice, is very distressing to LGBTI people,” he said.

“Not only is their right to express their gender identity and differences in their own way being challenged, but having to readdress this issue publicly sends them the message that they are seen as fundamentally wrong, and unacceptable.

“The moral discrimination that is going on – the ‘we are the true believers’ advocates who believe that they know more, care more and are just concerned for society and the welfare of children – that is very hard for young people [in the LGBTI community] to get their heads around.”

Professor Hickie told MJA InSight that the evidence was “unequivocal” that the question of marriage equality was a health issue, and Professor Phelps agreed.

“I’ve heard some specious arguments that same-sex marriage is not a health issue, but it unequivocally is, and GPs need to be alert and engaged with their LGBTI patients,” she said.

Both Professors Hickie and Phelps said that the conflation of the same-sex marriage debate with questions about same-sex parenting was “distorted” and “complete nonsense”.

“The concept of ‘family’ and ‘parenthood’ are agreed, common and highly valued concepts in our society,” said Professor Hickie. “The commentary from the ‘No’ lobby, which has framed the same-sex marriage debate into same-sex couples’ capacity to be good parents, is quite distorted.

“The belief that ideal parents are biologically male and female has no basis in a fact. It is just that – an historical belief, sadly peddled as so-called evidence, and it’s complete nonsense,” he said.

Professor Phelps said that the public questioning of same-sex couples’ ability to raise children was “disgraceful”.

“A lot of same-sex couples are very successfully raising their families, and those couples may or may not be married. Their parenting being brought into question as if it’s a given [that they won’t be good parents because they are a same-sex couple] is disgraceful, when all the evidence is to the contrary.”

The AMA has come out strongly in support of marriage equality. A petition has since been sent to the AMA signed by around 1700 doctors from around Australia, with a further 700 signing an online petition in favour of same-sex marriage. To sign the petition, go to “Doctors for marriage equality”.

The Royal Australasian College of Physicians has stated that it “supports initiatives to amend legislation, policies and practices that are unfairly restricting the rights of the LGBTI population. This includes adjustments to marriage laws so that same-sex and transgender individuals can marry, regardless of their gender identity.”

The Royal Australian and New Zealand College of Psychiatrists has also put out a position statement in favour of marriage equality.

The Royal Australian College of General Practitioners does not have a public position on marriage equality. They had not responded to MJA InSight’s inquiries by publication deadline.


If this article has raised issues for you, help is available at:

Doctors’ Health Advisory Service:
NSW and ACT … 02 9437 6552
NT and SA … 08 8366 0250

Queensland … 07 3833 4352
Tasmania and Victoria … 03 9495 6011
WA … 08 9321 3098
New Zealand … 0800 471 2654

Lifeline on 13 11 14

beyondblue on 1300 224 636

LGBTI counselling services:

Out & Online (ages 18-25) – online help for same-gender attracted youth
QLife (counselling and referral service for LGBTI people) – call 1800 184 527 or chat online
headspace (mental health service for ages 12-25) – call 1800 650 890 or chat online
ReachOut.com (youth mental health service) – visit the website for info or use the online forum
Suicide Call Back Service (for anyone thinking about suicide) – call 1300 659 467


To find a doctor, or a job, to use GP Desktop and Doctors Health, book and track your CPD, and buy textbooks and guidelines, visit doctorportal.




Are you in favour of marriage equality?
  • Yes (74%, 789 Votes)
  • No (26%, 277 Votes)

Total Voters: 1,066

Loading ... Loading ...

30 thoughts on “GPs vital to LGBTI mental health during marriage debate

  1. Anonymous says:

    Does the AMA support legislative protection for the Archbishop’s sister, the Rabbi’s wife, or the Imam’s son who owns a function centre, and faces severe psychological stress and social opprobium, if they allow a same-sex wedding on their premises? Australian indigenous culture has accepted only heterosexual relationships for 65,000 years – would an indigenous land council have the right to refuse a same sex wedding on their traditional land, e.g. at Uluru? Or will they be forced to choose between secular prosecution and cultural ostracism?

    While some advocates have proposed protection for clergy or marriage celebrants like Archbishop Porteous of Hobart, who was victimised for stating his religion’s official beliefs on marriage, it seems the devoutly religious person who provides wedding services will have no right to decline to host a same sex marriage ceremony.

    We don’t force an Irish pub to serve meat on a Friday, or a Kosher/Halal restaurant to accede to a customer’s request for pork. Does the AMA believe that our patients who are Catholic caterers, Jewish wedding planners, Muslim limo drivers, or Indigenous musicians should be allowed to refuse a same sex wedding booking, when they believe it to be a sinful act, and their participation would be a personal stressor?

    Otherwise, for these sincerely religious / culturally heteronormative people, “Not only is their right to express their gender identity and differences in their own way being challenged, but having to readdress this issue publicly sends them the message that they are seen as fundamentally wrong, and unacceptable.” As Prof Hickie so eloquently puts it.

  2. Dr David De Leacy says:

    Irrespective of my views on LGBTI, I shall be resigning from this organisation until this bunch of self-righteous polemicists who have unilaterally hijacked the AMA is gotten rid of. I agree wholeheartedly with Dr Rubenstein’s comments. The post-hoc survey is an appalling admission of blatant arrogance. Would the current AMA executive please resign immediately.

  3. Dr. Elliot Rubinstein says:

    The AMA does not represent me on this issue, nor does my college and I resent professional associations taking stands on behalf of their members on these matters.
    I believe issues around ‘marriage equality’ have profound implications in regard to the way our society is organized far beyond the immediate question. As such I am pleased that there will be an open debate. To me this is clearly a political issue. As for offending people that is unavoidable in a democratic society. I am offended daily by various opinions in the media. Too bad, that’s what you get in a free society.

  4. Anonymous says:

    @24: “…logic and evidence against discrimination towards any group”. Logic? Evidence??
    More like: “..roll over and give me what I want, or else I’ll hurt myself.”

    It used to be called a tantrum.
    Or Borderline.

  5. Anonymous says:

    I have been continuously surprised by this debate amongst medical circles and Facebook groups where any thread mentioning this debate is shut down to ensure a safe space and the need to virtue signal what seems to be the only acceptable Yes viewpoint. This debate is important and the AMA took it upon itself to engage in this political issue. Then any debate following this has been stifled and No voters are basically told we need to refer LGBQTZS patients on to other doctors??? The same rights as a married of defacto relationship are already afforded regardless is sexual orientation. Do I have the right to marry my cousin? A child?? Multiple partners?? If love is love and marriage is a right for every human being then how can society put any restrictions on any union which will then be legalised? And that union forms the basis of the family unit into which children are raised so this is a matter that all of society cares about. So many concerning statements in the above article but ” The belief that ideal parents are biologically male and female has no basis in a fact” takes the cake….. it may not be the popular or loudest viewpoint but as professionals we should be able to review and discuss the evidence.

  6. Ray says:

    Professor Hickie’s comment that there is no basis for believing that it is best for a child to have a mother and father and that such a belief is nonsense I find rather disappointing coming from a person of his stature. For centuries this reproductive relationship has been the norm and worked very well. There is evidence that while same sex parents or single parents can raise a child quite adequately it is not ideal.
    Having spent 43 years in purely clinical practice observing several generations, married couples consistently produced a better human being than those coming from broken homes or multiple “fathers”.
    Perhaps the day may come when Penny and those like her will learn the correct meaning of phobia. We who have reservations about same sex marriage do not have an irrational fear of homosexuals in fact I enjoy their company immensely.
    Finally, could this publication cease butchering the English language by using that recent abomination “authored”?

  7. Anonymous says:

    It is incredibly disappointing to read the vitriolic comments made by the above No voters.
    It is amazing to think that the majority of you are doctors who have vowed to do the best for ALL your patients including minorities.
    Your opinions should be evidence based just as as your medical practice should be.
    The weight of evidence is stated in the above article and elsewhere that the LGBTIQ community should not be discriminated against in this way. Their health is irrefutably adversely affected.
    Jack the LGBTIQ community is not treated equally under the law in many different ways as a consequence of not allowing its members to marry. I think you have reversed who is being bullied here. And what an inappropriate comment – who is not being allowed to live and let live? – the LGTBIQ community.
    Do not let your negative feelings towards the AMA for taking a position in the debate confuse your appraisal of the logic and evidence against discrimination towards any group.

  8. Anonymous says:

    The number of doctor who poll on “No” has not been changed since I polled 2hours ago, but absolutely I can see there are few doctors made a “No” comments. This is not the way to make it as “yes”

  9. Anonymous says:

    The AMA and doctors in general have no more ‘expertise’ in the matter of SSM than any other person in the community, and it’s deceptive and manipulative of a group to misuse their authority and training in medical matters to promote their social and political agendas and to claim authority for their views in what is a societal issue. There’s no evidence whatsoever that there’s a higher rate of ‘mental illness’ in the LGBT group due to the SSM debate.

  10. Anonymous says:

    Is there a petition for “Marriage Inequality ” ? Can the AMA get off their Hobby horse and deal with real issues ??

  11. Anonymous says:

    From my clinical work, this issue is causing causing considerable distress to the non-homosexual community.
    It’s a shame the pro-campaigners are able to degrade their opposition with complete PC immunity.

  12. Anonymous says:

    Very disappointed AMA put the political issue into medical discussion. Personally I never thought same sex marriage is going to sort out the mental health issues. Just the politician want to orient doctors” professional practices

  13. Anonymous says:

    From the Editor: Peter, nobody’s bullying or villifying anyone as far as I can see. And, MJA InSight is not the MJA, or the AMA. Those with a differing view are welcome to express themselves here in the comments section, or in the Letters section of the MJA or in a letter of complaint to the AMA. All views are respected, and published here, as long as they remain civil. Thank you for your feedback.

  14. Peter says:

    Why is this an article in the MJA? So much virtue-signalling and bullying of anyone who still persists in holding an understanding of marriage and sexuality which has existed since humans have been recording their history, or who dares depart from the current fetish for sexual/gender redefinitions. So the MJA is OK with bullying peers and vilifying members of the population who think (let alone dare speak out against) such a potentially damaging social experiment should be avoided?

    I find it extraordinary that only a decade after a National Apology, the AMA and some professional colleges are aligning themselves with and endorsing the modern equivalent of a stolen generation (children can only be born following heterosexual reproduction, so the SSM movement is essentially demanding children be forcebly removed from at least one natural parent – contrary to Article 7 of the UN Convention on the Rights of the Child).

  15. John Graham says:

    I do not think this is a health issue and take exception to health bodies pressuring members to vote .
    The wider community can have a democratic vote and reflect true democracy at work and not preached to about how we should vote. We are individuals and should enjoy freedom to vote how we like.
    Just for the record I have many close friends who do not share my sexual preference and I think about it in my contact with them about as much as whether they eat potatoes like me or not.
    It is a non event and people should be judged on merit and kindness not race, sex or any other divisive component dreamed up by people who dont have a life.
    We all have equal rights and I trust the Australian people to make an appropriate choice. The only danger is that pressure groups distort the facts and the media are not blameless. It takes a little time to see what we are voting for and the long term implications something lacking in politics.
    If you are still reading this may I say one more thing. It does not matter a dam what other people think and people should be encouraged to not seek the approval of others and they need to compassionately and intelligently weigh the facts before making a decision which is theirs.

  16. Anonymous says:

    Why do the LGBTIQetc., have to call it “marriage”, which is an english word for the legal union of a man and a woman.
    Why must they usurp someone else’s “word”.
    They already have a legal union if they so desire, they can still worship in church if they so desire, in fact they can do most things they desire, except use the word marriage.
    How about they make up their own word, like “legal union” or whatever, have a ceremony if they so desire , and get on with life, instead of involving the rest of us, who are no more interested in their living state , than that of others who are married.

  17. Anonymous says:

    Apparently there are over 100,000 medical practitioners in Australia. A petition signed by 1700 people is meaningless and not representative of Australian doctors as a whole.

  18. Jack says:

    What on earth has right to vote got to do with marriage (Penny)? Most of us, 98% of the populace who are none of the LGBTIQRSUVXYZ community, are sick and tired of bullying and dodgy research (for want if a better name). You or they already have full rights under the law – learn when to shut up and live and let live.

  19. Anonymous says:

    One of the problems in this contemporary society is the belief that people’s self-esteem must continually be upheld, their feelings considered on every occasion, and to challenge bad ideas (such as SSM) is somehow detrimental to their mental health? Has the human race really come this far, through famine, wars, triumph and perseverance, to the point we cannot even disagree with a patient in case it hurts their feelings?

    this comment “” GPs should audit their own responses to the question of whether same-sex marriage should be legally recognised. If they feel they would vote no, then perhaps it would not be helpful to their LGBTI patients to talk with them about it, and the best thing they could do is refer them to a more sympathetic doctor, perhaps one with LGBTI counselling skills.”” is extremely lame, buying into the liberal left wing belief that only they are compassionate enough to deal with the issues in our culture. This is so far from the truth and is censorship. It also does not treat the homosexual as a very wise or resilient person surely?

    I will be voting NO because I have heard no convincing argument to do otherwise – and saying someone has the “right” to get married is not an argument. No one can judge someone for the relationship they choose at this stage – of course with some exceptions – no one is saying homosexuals cannot live together, love one another, or have civil unions. What we are saying is that marriage is between a man and a woman

  20. Anonymous says:

    My concern is that the main argument I hear for the Yes case is that it is not ‘politically correct’ to make a No case. Political correctness is widely used by people to the left of centre to gag debate. This seems a classical example.
    This anonymous poll currently shows 2/3 (granted small number: 45) say No. It would be politically incorrect to admit to this, so publicly, apart from outspoken No voters, few declare their intention to vote No. It will be really interesting to see what the numbers come out to on the day!

  21. Dave Sinclair says:

    Do I care if heterophobic people say you are homophobic? NO, I like certain phobias as they keep me safe in this weird society.

  22. Mark says:

    The wording of the poll is disingenuous. The real question is do you agree with same sex marriage? This in turn means do you agree with changing the definition of marriage which has hitherto meant a union between a man and a woman.
    Most agree that same sex couples should have equal rights to form partnerships with all the obligations and benefits of marriage before the law; many however disagree that this should be called marriage…get a new word, after all the feminists came up with Ms which is ubiquitously accepted.
    Same sex couples do not qualify for marriage any more than I qualify to run in the Olympics in the women’s 100metres.
    As to the alleged psychological damage being done to LBGT people where is the evidence? All I’ve seen is aggression by the supporters of the yes case who, until very recent times viewed marriage as a male heterosexual construct to subjugate women..

  23. Randal Williams says:

    I was disappointed that the AMA did not run a members’ poll on this before going public with its pro stance. I am personally in favour of legalising same sex unions but recognise that many of our colleagues, particularly of more senior years, have deeply held religious and cultural objections, and must have felt annoyed and disregarded by the leaders of the AMA.. There is no problem with the AMA pointing out the psychological and medical aspects of this issue, but its public advocacy of what is a complex legal, social and ethical issue was inappropriate in my view.

  24. Anonymous says:

    I am utterly appalled that there are doctors commenting here who don’t seem to think the same-sex marriage debate presents a mental health issue for LGBTI people. Have you not read the story?? Or are you just so determined to vote no that you can’t brook an alternative view? Doctors who don’t want to acknowledge the mental health issues of their LGBTI — that’s no doctor I want to go to.

  25. Anonymous says:

    Why should the RACGP have a position ? This merely reflects the power broker’s opinion on the matter and not a general consensus! We need proportional representation on this matter and not merely a bunch of people around a table trying to be politically correct. Let’s take a vote and then represent the majority

  26. sociologist says:

    Penny – people attend doctors because they have a medical problem to be sorted- people attend lawyers because they have legal problem to sorted. So it is not treating anyone superior or inferior as you imply.
    The issue to be decided by society is a legal one and that is why doctors are annoyed that their medical association has suddenly expanded their role as to be legal problem advocates – rather than continuing their elected role to of medical representation they seem to have become advocates for non medical problems – in other words pushing their own barrow.

  27. Anonymous says:

    GPs should indeed be available to counsel any LGBT patients who are distressed by this debate.
    That is totally different to saying the debate should not be had.
    Why is there an assumption that LGBT people are so fragile as to need to be infantilised and cossetted from this discussion? What ever happened to ‘Gay and Proud’?
    I have not so far seen articles in MJA Insight calling for GPs to be available to deal with distressed One Nation voters, who are a minority group and who are routinely subjected to at least as much vitriol and abuse in every national debate.

  28. sociologist says:

    The real story is that this is really a sideshow and do not form an integral part of a GPs practice – so the RACGP’s position is the proper and accurate position of the professionals they represent.
    Unlike some other doctors associations who do not seem to give voice to their mainstream constituents and try to be relevant by commenting on the nooks & crannies of medicine ignoring the main picture. perhaps to get publicity??

  29. Penny says:

    As a member of the LGBT community, what annoys me most about the ‘No’ voters is the ones that think they can vote no but “That’s not homophobia”. It absolutely is, it’s treating people inferior based on their sexual preferences.

    It would absolutely be misogyny to believe women do not have the right to vote. It would be racism to believe that Aboriginal children have worse outcomes, therefore Aboriginal people should not be allowed to marry to dissuade them from having children. If you’re gonna vote no, then you need to be comfortable with the fact that you’re treating people badly because of their sexual identity.

  30. Anonymous says:

    The real story here is that the RACGP doesn’t have a official position on same-sex marriage. Unfathomable.

Comments are closed.