''How Do You Tell Someone You Don't Have A Vagina?''

''How Do You Tell Someone You Don't Have A Vagina?'' - Michaela * has dated a handful of men, but whenever the relationships began to get serious, she would end them.

''How do you tell someone you don't have a vagina?'' she asks.

The 18-year-old, who was also born with two uteruses and a deformed kidney, hopes she never has to - but her future is hanging in a bureaucratic balance, which has infuriated doctors who want to help.

As an apprentice chef, Michaela cannot afford the cost of a surgically created vagina but desperately wants a chance at a normal marriage and sex life.

Her doctor, Michael Bennett - one of only two people in Australia trained to do such procedures - has offered to operate for free, but NSW Health will not allow it. The nation's only other paediatric/adolescent gynaecologist, Sonia Grover, works in Melbourne but spent most of the year on leave in Switzerland.

''This is despicable. It's not like [Michaela] can go to anyone else,'' Professor Bennett said.

The problem began in January when Professor Bennett retired as the head of obstetrics and gynaecology at the University of NSW. That role was linked to his contract at the Royal Women's Hospital, in Randwick, where he has been seeing patients for 27 years.

Concerned that women who could not afford private health cover would be marooned, he requested permission to work at the hospital one day a week until Associate Professor Grover returned from Switzerland or a colleague, undertaking training in Britain, returns next year.

South Eastern Sydney Illawarra Area Health Service refused the request on the grounds the hospital could not afford it. Professor Bennett then offered to do the surgery free but was told the hospital had no money and was asked to provide a ''business case'' to support his request.

''I presented the 130 cases I had dealt with in the past five years. All but five of them had been day surgery patients, so the costs are very little. … This is a stupid bureaucratic argument.''

About one in 5000 women were born with reproductive abnormalities and almost all were profoundly troubled, feeling alone and lacking self-esteem, he said. ''But with very little money or time, someone with the expertise and training that I have can get them back on track to being normal.''

Michaela is not the only case Professor Bennett is fighting for. He has another patient, 18, sitting her Higher School Certificate, who needs a vaginal construction and cannot afford the surgery. She wanted the operation before she attended schoolies next week, so she could ''do whatever every other girl does at schoolies'', he said.

A spokeswoman for NSW Health said women such as Michaela could be treated as public patients at the Sydney Children's Hospital, the Children's Hospital at Westmead or Prince of Wales, a statement that infuriates Professor Bennett.

He has presented evidence that unless these women are treated by specialists, such as himself, they often ended up with botched surgery. One girl, who could have had a vagina surgically created, will now have to go without because her gynaecologist accidentally cut the tissues between her rectum and bladder.

The opposition health spokeswoman, Jillian Skinner, said there was no excuse to deny these young women. ''When a highly specialised surgeon is offering his services for free, it makes no sense for the government to act as a roadblock. Health administrators should be looking at ways to make this work, not coming up with excuses as to why it can't be done.''

Michaela is saving her minimal wage in the hope she can afford the surgery in a few years, but Professor Bennett has refused to reveal the full cost for fear of dashing her hopes. ''This is the last thing I need to do and then I'll be just like everyone else,'' she said. ( sydney morning herald )