Author: MIL OSI Publisher

Source: The Conversation (Au and NZ) – By Karinna Saxby, Senior Research Fellow, Melbourne Institute of Applied Economic and Social Research, The University of Melbourne

Transgender and gender-diverse (“trans”) people have worse mental health compared to the general population. As a result, they’re more likely to use mental health services, such as psychologists and counsellors, and treatments such as antidepressants and anxiety medication.

While there are many contributing factors, including stigma, we know gender dysphoria can play a major role. Gender dysphoria refers to the distress or discomfort some trans people feel about their gender, body, or how others perceive their gender.

Gender-affirming medical care – which may involve hormone therapy or surgery – helps align trans people’s bodies with their gender identity. And evidence shows it can drastically improve trans people’s mental health.

But until now, we haven’t had research that tracks whether this means they actually use mental health services and scripts less.

Our two new studies – one on hormone therapy and one on surgeries – looked at what happens before and after people access gender-affirming medical care.

For the first time, we’ve shown that gender-affirming care dramatically reduces how much people access mental health care – saving Medicare millions.

First, what is gender-affirming medical care?

Trans people may seek out different types and degrees of gender-affirming care.

This can include:

• procedures such as a mastectomy or breast surgery, to masculinise or feminise the appearance of the chest (sometimes known as “top surgery”)

• genital reconstructive surgery (sometimes called “bottom surgery”)

• hormonal treatments, including testosterone and estrogen-based medications.

Not every trans person wants gender-affirming care, but most do.
National survey data suggests around 72% want to access it at some point in their lives.

One 2021 study surveyed 928 trans people, including trans men, trans women and non-binary people. It found 89% of those assigned female at birth had or wanted to have chest surgery, and 82% of those assigned male at birth had or wanted to have genital reconfiguration surgery.

Research consistently finds gender-affirming procedures have very low regret rates (less than 1%) compared to other surgeries, such as knee reconstruction (10%) and cancer procedures (24%).

How do people currently pay for it?

Gender-affirming surgeries aren’t consistently subsidised under Medicare, meaning people who pay for this medical care themselves can incur between $20,000 and $100,000 out-of-pocket.

But the government is considering adding these surgeries to Medicare. This would mean a rebate for certain procedures, although the patient would cover the gap, which could still be many thousands of dollars.

Hormone therapy is listed on the Pharmaceutical Benefits Scheme, meaning patients pay a small co-payment to fill their scripts. Costs vary significantly depending on individuals’ dosages and goals, but the government spends between $79–$278 per person each year.

However, some jurisdictions have recently blocked access to this kind of medical care. Last year, the Northern Territory and Queensland banned hormone therapy for trans people aged under 18, including testosterone, estrogen and puberty blockers.

What we looked at

We know gender-affirming care improves trans people’s quality of life and reduces psychological distress, dysphoria and suicidal thoughts.

So we wanted to see if this would translate to a drop in trans people using mental health care.

We used de-identified Medicare records over a decade (2012–2024) to track how using mental health services and scripts changed for:

• 20,358 trans people (15 years and older) who started estrogen-based hormone therapy
• 11,883 trans people (15 years and older) who started testosterone-based hormone therapy
• 2,872 trans adults who had chest surgery
• 826 trans adults who had genital reconfiguration surgery.

We also adjusted the data for “confounding factors” – differences which could distort results – such as age and socioeconomic background.

What we found

Our data showed that before starting hormone therapy or undergoing surgery, trans people used between 1.6 and 3.6 mental health services (such as psychologist visits or GP mental health plans) each year.

In comparison, the average Australian uses one service every two years. So trans people who sought these types of services used them 3.2–7 times more than average.

But five years after starting hormone therapy, trans people in our data used between 0.3 and 2.6 fewer health services.

If we translate this into reduced psychologist visits using the standard $100 rebate, it means each year, the government spent $30–260 less per person after they started hormones.

In our study on surgery, we were able to look at exact Medicare costs for services and scripts.

When someone had chest surgery, we found the government spent $1,769 less on their mental health care (on average) over the following five years.

For genital surgery, the average mental health care saving per person was $3,416 over the following five years.

What this means

If gender-affirming surgeries are added to Medicare, the average proposed rebates would be $1,328 for chest surgery and $1,195 for genital reconfiguration surgery.

Our findings suggest these one-off costs would be be eclipsed by the reduced government spending on mental health care within 4–5 years.

It’s difficult to know how many Australians are actually trans, as we don’t yet have census data on this.

And we don’t know exactly how many people would access surgeries if they were added to Medicare. But the research mentioned above from 2021 suggests between eight and nine in every ten trans people want or have already had top or bottom surgery.

So we applied those rates to estimate demand for surgery in the sample we observed who were currently on hormone therapy, given people usually take hormones before surgery. Still, this is a conservative estimate.

Our calculations show, if the government paid $1,328 each for 89% of 11,883 trans people to receive top surgery, the total cost would be $14 million. Once we subtract the mental health savings over five years for this group ($18.7 million) this means Medicare would spend $4.6 million less over five years.

The cost for 82% of 20,358 trans people to get bottom surgery (with a $1,195 rebate per person) would be $19.9 million. Once we subtract the mental health savings over five years for this group ($57 million) Medicare would save about $37 million over five years.

This would lead to a total of almost $42 million in savings within five years.

However given the significant unmet need for gender-affirming care this number is likely to be much higher.

Hormone therapy is similarly cost effective. In some cases it offsets the money spent in mental health care and in others it leads to savings.

When trans people have access to gender-affirming medical care, it reduces their distress and vastly improves their quality of life. Now, our findings show there are economic benefits too.

Karinna Saxby has previously received funding from the Department of Health and Aged Care and currently receives funding from the University of Melbourne McKenzie Fellowship. Karinna is a co-founder and committee member of LGBTQ Economists and Allies in the Asia Pacific (LEAP).

Brendan Nolan has received research funding from NHMRC, University of Melbourne, Endocrine Society of Australia, Royal Australasian College of Physicians Foundation and Viertel Charitable Foundation. He is currently a member of the Endocrine Society (US), Endocrine Society of Australia, World Professional Association for Transgender Health and Australian Professional Association for Trans Health.

Clue Coman receives Research Training Program (RTP) scholarship funding through the University of New South Wales.

Dennis Petrie receives funding from Australian Research Council (ARC), National Health and Medical Research Council (NHMRC), Department of Health, Disability and Ageing, VicHealth, Medical Research Future Fund and the National Disability Insurance Agency.

– ref. Funding surgery and hormones for trans people can save Medicare millions: new research – https://theconversation.com/funding-surgery-and-hormones-for-trans-people-can-save-medicare-millions-new-research-274125

Evening Report: https://eveningreport.nz/2026/02/11/funding-surgery-and-hormones-for-trans-people-can-save-medicare-millions-new-research-274125/

Source: The Conversation (Au and NZ) – By Margaret Murray, Senior Lecturer, Nutrition, Swinburne University of Technology

School is back and, with it, the daily task of packing a lunchbox.

If your child is coming home with uneaten sandwiches, you’re not alone. They’re easy to make and transport, but sometimes the last thing kids (or adults) want to eat.

The food kids eat at school typically provides at least one-third of their daily energy intake. So a nutritious lunchbox is an important way to support their overall health, as well as their focus and performance at school.

While sandwiches may be an obvious lunchbox choice, there are loads of other options.

What can you pack instead?

If you don’t want to stray too far from the sandwich, but want to change things up, try out sandwich sushi, or a sandwich roll. It uses similar ingredients to a sandwich but in the shape of a sushi roll.

To make sandwich sushi, cut the crusts off, flatten the bread using a rolling pin or your hand. Spread the bread with a dip or other ingredient such as avocado or tuna, fill with ingredients such as sliced cucumber or carrot, then roll and cut it like sushi.

You may also be inspired to try making some sushi rolls. These take a little more preparation, including cooking the sushi rice in advance, but are a great sandwich alternative.

If you want to stick with bread, a roll, wrap or pita pocket may be enough change to keep the lunchbox feeling fresh. You could try out recipes like this chicken and avocado wrap or ham and salad pita pocket.

A frittata is another good option for replacing the sandwich as the main lunchbox meal. Frittatas need to be prepared in advance but can be easily adapted based on ingredients you’ve got in the fridge or cupboard such as cherry tomatoes, mushrooms, baby spinach, roasted pumpkin or frozen corn.

Likewise, a savoury muffin (like these cheesy corn muffins) takes a bit or preparation but can be bulk cooked and portioned in advance to make mornings quick and easy. There are lots of different recipes for savoury muffins, so find one that suits your tastes. This recipe uses zucchini, carrot, peas and corn.

Dinner leftovers can also make great lunchbox meals. Stir fry with noodles, or a hearty salad like this Mexican-style one with beans, can be packed into containers to make a nutritious lunch.

Other salad options include pasta salad or this balsamic bean salad.

To make a salad that’s going to be filling for lunch, try to include some wholegrain carbohydrates (such as brown rice, wholemeal pasta, barley, lentils or quionoa) and a source of protein (such as egg, cheese, tofu, kidney beans or chicken).

Having an insulated lunch box or thermos can help to keep foods hot or cold until lunch time.

What else should a lunchbox include?

A lunchbox is more than just the main meal: a balanced lunchbox should include a main meal, a fruit or vegetable snack, another snack and a drink.

Snack options might include plain popcorn, hard boiled eggs, yoghurt, cheese sticks, crackers and fresh fruit and vegetables (which can be cut into pieces for easier munching).

For a balanced lunchbox, try to include at least one item from each of these food groups:

1. fruit (such as banana, grapes, apple, berries, pear, stone fruit, melon)

2. vegetables (carrots, celery, pumpkin, spinach, tomatoes, cucumber)

3. grain and cereal foods (rice, wholegrain crackers, noodles, bread, wraps)

4. meat or meat alternatives (eggs, nuts, chicken, tuna, lentils, tofu)

5. milk, yoghurt or cheese (or non-dairy alternatives like soy milk)

6. water.

Including foods from each of these groups will help to ensure the right balance of carbohydrates, fats, protein, vitamins and minerals.

Using a lunchbox with multiple compartments can help with packing a small portion of each different food. For example, rice crackers in one compartment, cheese cubes in another, and some cherry tomatoes and mini cucumbers in a third.

Offering variety and keeping portions small can also help to manage fussy eating.

Making it easier for parents

Parents juggle food preferences, logistics, societal expectations, time, nutrition and other pressures.

As a society, we need to better support families to create healthy and sustainable lunchboxes. Research suggests suggests this could include:

• giving students a longer time to eat lunch at school
• teaching students about the value of food
• supporting healthy canteen policies
• restricting marketing to children
• improving the clarity of food labelling.

Some experts also argue we should move to a school-provided lunch program.

These changes can’t be implemented by schools or parents alone but require action across multiple industries and government departments.

In the meantime, it’s important to acknowledge the challenges and value the effort associated with putting together the daily lunchbox.

Margaret Murray does not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and has disclosed no relevant affiliations beyond their academic appointment.

– ref. My kids (and I) hate sandwiches, what can I pack for lunch instead? – https://theconversation.com/my-kids-and-i-hate-sandwiches-what-can-i-pack-for-lunch-instead-275207

Evening Report: https://eveningreport.nz/2026/02/11/my-kids-and-i-hate-sandwiches-what-can-i-pack-for-lunch-instead-275207/

Source: The Conversation (Au and NZ) – By Barbara Jacquelyn Sahakian, Professor of Clinical Neuropsychology, University of Cambridge

Menopause is a key period in a woman’s life. This transition is often accompanied by wide-ranging physical and psychological symptoms — some of which can be debilitating and affect daily life. Menopause has also been linked to cognitive problems — such as memory, attention and language deficits.

To mitigate the effects of menopause — including hot flashes, depressive symptoms and sleep problems — many women turn to hormone replacement therapy (HRT). In England, an estimated 15% of women are prescribed HRT for menopause symptoms. In Europe, this number is even higher – varying between 18% in Spain to 55% in France.

But there’s limited understanding of the effects of menopause and subsequent HRT use on the brain, cognition and mental health. To address this, we analysed data from nearly 125,000 women from the UK Biobank (a large database containing genetic and health data from about 500,000 people).

We placed participants into three groups: pre-menopausal, post-menopausal and post-menopausal with HRT. The average age of menopause was around 49 years old. Women who used HRT typically began treatment around the same age.

In short, we found that menopause was associated with poorer sleep, increased mental health problems and even changes within the brain itself.

Post-menopausal women were more likely than pre-menopausal women to report symptoms of anxiety and depression. They were also more likely to seek help from a GP or psychiatrist and to be prescribed antidepressants.

Sleep disturbances were more common after menopause, as well. Post-menopausal women reported higher rates of insomnia, shorter sleep duration and increased fatigue.

Brain imaging analyses also revealed significant reductions in grey matter volume following menopause. Grey matter is an important component of the central nervous system which is composed mainly of brain cells. These reductions were most pronounced in regions critical for learning and memory (namely the hippocampus and entorhinal cortex) and areas key in emotional regulation and attention (termed the anterior cingulate cortex).

Notably, the hippocampus and entorhinal cortex are among the earliest affected in Alzheimer’s disease, the most common form of dementia.

The changes we observed in our study could suggest that menopause-related brain changes may contribute to increased vulnerability to Alzheimer’s disease later in life. This could help explain why there’s a higher prevalence of dementia observed in women.

We also investigated whether taking HRT post-menopause had any effect on health outcomes. Notably, HRT did not improve the reduction in brain grey matter.

In addition, we found that women using HRT showed higher levels of anxiety and depression compared to post-menopausal women who had never used HRT. However, further analyses indicated that these differences were already present. This suggested that pre-existing mental health problems may have influenced the decision to begin using HRT rather than these symptoms being caused by the medication itself.

One potential benefit of HRT use was noted in cognitive performance – particularly for psychomotor speed. Psychomotor slowing is a hallmark feature of ageing.

Post-menopausal women who had never used HRT showed slower reaction times compared with both pre-menopausal women and post-menopausal women who had used HRT. This indicates that HRT helps to slow the menopause-related declines in psychomotor speed.

HRT and menopause

There’s still much we don’t know about HRT – and more evidence on its benefits and risks are still needed.

Some studies report that those taking HRT have an increased dementia risk, while others suggest a decreased risk of dementia.

More research is also needed to understand the effects of HRT and how the different routes and dosages affect menopause symptoms. But according to one UK Biobank study of 538 women, the effects don’t appear to differ – regardless of factors such as the formulation, route of administration and duration of use.

Importantly, however, it’s difficult to establish whether women are actually receiving an effective dose. One in four women using the highest licensed dose of HRT still had low levels of estradiol (oestrogen) – around 200 picomoles per litre. Older women and HRT patch users were more likely to have lower levels.

Optimal plasma levels to relieve menopause symptoms are between 220-550 picomoles per litre. This means that for 25% of the women in the study, HRT would not have had optimal benefit for menopause symptoms.

Considering that most women go through the menopause, it’s important to resolve the question of whether HRT is beneficial – including preventing brain grey matter volume reductions and reducing the risk of dementia. It will also be important to know what the best dose and route of administration are.

There is evidence to suggest healthy lifestyle habits may mitigate these menopause-related changes in brain health.

Our work and that of other research groups shows that a number of lifestyle habits can improve brain health, cognition and wellbeing, thereby reducing the risk of cognitive decline associated with ageing and dementia. This includes regular exercise, engaging in cognitively challenging activities (such as learning a new language or playing chess), having a nutritious and balanced diet, getting the right amount of good-quality sleep and having strong social connections.

Research also shows regular physical activity can increase the size of the hippocampus, which may help mitigate some of the menopause-related reductions observed in this region.

Sleep is also critically important as it supports the consolidation of memories and helps clear toxic waste byproducts from the brain – processes that are essential for memory, brain health and immune function.

Having a healthy lifestyle may offer an accessible and effective strategy to promote brain health, cognitive reserve and resilience to stress during and after the menopause transition.

Barbara Jacquelyn Sahakian receives funding from the Wellcome Trust and the Lundbeck Foundation. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes. She receives Royalties from Cambridge University Press for Brain Boost: Healthy Habits for a Happier Life.

Christelle Langley receives funding from the Wellcome Trust. Her research work is conducted within the NIHR Cambridge Biomedical Research Centre (BRC) Mental Health and Neurodegeneration Themes. She receives royalties from Cambridge University Press for Brain Boost: Healthy Habits for a Happier Life.

– ref. Menopause: our study revealed how it affects the brain, cognition and mental health – https://theconversation.com/menopause-our-study-revealed-how-it-affects-the-brain-cognition-and-mental-health-275329

Evening Report: https://eveningreport.nz/2026/02/11/menopause-our-study-revealed-how-it-affects-the-brain-cognition-and-mental-health-275329/

Source: The Conversation (Au and NZ) – By Rebecca J Evans, Lecturer and Researcher in Music Psychology, Auckland University of Technology

Looking back over 2025, one of the most powerful events for New Zealanders was the reclaiming of the Guinness World Record for the world’s largest haka at Eden Park.

The crowd was diverse. Some were deeply committed, while others were simply excited to dance. Either way, footage from the day clearly signals a growing engagement with te reo Māori (the Māori language) within mainstream Aotearoa New Zealand.

The mass haka was championed by Hinewehi Mohi, who famously sang the national anthem in te reo and led the Waiata Anthems project) – and was supported by New Zealand’s most-streamed band Six60, whose song Pepeha is often sung in school assemblies.

The event also reflected a broader trend identified in the 2023 census, wherein the number of people who speak te reo Māori grew 15% since 2018. This trend is changing the music landscape of Aotearoa.

Sounds that reshape the nation

Music offers us a window into societal thoughts about politics, identity and power. Sounds, lyrics and genres can reflect public tensions, hopes and debates that might not always surface in more formal settings.

In recent years, a number of Aotearoa’s musical artists have used language to build on and reshape our national identity. At the forefront of this cultural shift are two well-loved acts: genre-bending singer-songwriter Marlon Williams and heavy metal export Alien Weaponry.

Both have been reconnecting with te reo in a big way, with documentaries charting their journeys (see Ngā Ao E Rua – Two Worlds and Kua Tupu Te Ara).

But there are many other exceptional artists also playing their part. And since Spotify Wrapped didn’t quite do our local acts justice, we thought we’d provide our personal pick of five musicians doing remarkable mahi (work).

Mokotron

Hailing from Ngati Hine “down North”, Mokotron is the musical project of long-time Tāmaki Makaurau-based producer and University of Auckland academic Tiopira McDowell.

His Taite Music Prize-winning album Waerea (2024) brings reo Māori and taonga pūoro (Māori musical instruments) into what he describes as “dark, problematic, trauma-driven Māori electro bass”.

The track Ko Wai Koe?, which grew out of McDowell’s involvement in Treaty settlement negotiations, is built around the repeated questioning of authority and the legitimacy of colonial power.

The visuals for the track combine hulking Māori carvings with colonial-themed Space Invaders imagery, reflecting what McDowell describes as his approach to “ancient futurism”. It goes off live too – such as at Glastonbury and in this Boiler Room set with TeKuraHuia.

Theia/Te Kaahu

Theia, and her folk leaning alter-ego Te Kaahu, are the stage names of Em-Haley Walker, from the iwi (tribes) Waikato-Tainui and Ngaati Tiipaa.

Theia is a fierce proponent of Māori language revitalisation – and was number five on politician and iwi leader Debbie Ngarewa-Packer’s end-of-year Spotify Wrapped.

Signed back in 2016 to Warner Music, Theia’s breakout pop track Roam (2016) feels worlds away from her sharp, confrontational 2025 single BALDH3AD!, which addresses colonial violence and culminates in the refrain “Ka whawahi to, tonu mātou, ake ake” (“we will fight on forever and ever”, referencing Ngāti Maniapoto leader Rewi Maniapoto).

Theia’s strong visual aesthetic is highlighted through the Edwardian-esque visuals of her new album Girl, In A Savage World (2025) – a subversive approach that takes colonial era garb and artfully reclaims it, akin to Dam Native’s 1997 track Behold My Kool Style.

GreatSouth

GreatSouth (from the iwi of Ngāti Kahungunu ki Wairarapa and Te Rarawa), formerly Fable, is a grounded and humble emerging indie-rock artist blending sharp musicality with strong urban foundations.

Driven by today’s social and political climate, he speaks openly about Māori inequities both in his music and on social media.

This tāne (man) crafts his guitar music with taonga puoro, weaving te reo where it feels natural, and “sharing his slice of Māori being” one indie-rock waiata at a time.

Geneva AM

Geneva AM (from the iwi of Ngāti Ruapani mai Waikaremoana, Ngāti Kahungunu ki Wairoa, Aitutaki, and from Palmerston) is multi-talented.

She is a producer, former indie-electronica band SoccerPractice vocalist, former radio DJ and visual artist. In 2025, she released her debut album Pikipiki – a joyful bilingual project about rising up and moving forward.

Original tracks sit alongside reimagined Aotearoa favourites such as Tūtira Mai Ngā Iwi and Pūrea Nei, and blend a ton of unexpected genres including classical, drum and bass, and emo rock.

The track Toitū Te Tiriti champions the 1840 treaty, with strings so emotive they could stir the hearts of anyone – even if they didn’t attend the nation’s largest march in support of the treaty.

Mokomokai

Mokomokai – a playful hip-hop collective featuring Dirty (aka Manu Walters), Dusty and Ghos – is a great microcosm of the changing way te reo Māori sits within music.

On their 2023 album Whakarehu, the track Kupe (featuring Melodownz) name-checks legendary Polynesian explorer Kupe and well-loved singer-songwriter Che Fu – situating the act within an expanding New Zealand hip-hop genealogy.

At the back-end of Melodownz’ verse, his pepeha (tribal saying used to introduce oneself) slots in comfortably. He speaks to his journey as an artist embracing his Māori identity (as shown in the Waiata Anthems documentary series, in which everything is linked back to Hinewehi Mohi).

Tātou tātou e (all of us, all of us)

There are many more extraordinary musicians championing te reo, including MĀ, Anna Coddington, Rei with his Māori language degree, and L.A.B. (who recorded their first song Maumahara Noa Ahau in te reo).

As a nation, we’re getting there, and we can count on our musicians to lead the way. Let’s not forget, tōku reo tōku ohooho (“our language is our awakening”).

The authors do not work for, consult, own shares in or receive funding from any company or organisation that would benefit from this article, and have disclosed no relevant affiliations beyond their academic appointment.

– ref. 5 New Zealand music acts keeping te reo Māori alive and rocking – https://theconversation.com/5-new-zealand-music-acts-keeping-te-reo-maori-alive-and-rocking-271189

Evening Report: https://eveningreport.nz/2026/02/11/5-new-zealand-music-acts-keeping-te-reo-maori-alive-and-rocking-271189/