Advice for health professionals
On this page
- General advice
- Referring for gender affirming surgery
- Referring for masculinising or feminising gender affirming genital surgery
- Service forms for gender affirming (genital) surgery
Transgender people have both general health needs (eg, oncology, chronic conditions, sexual health screening, influenza immunisations) and specific health needs that relate to transition (eg, endocrine, surgical).
All health providers, both in community and hospital settings, have a duty to deliver services that are respectful of our transgender community.
- Use the patient’s correct pronouns (he/him, she/her, they/them, etc) and preferred name. If you are not sure how your patient wishes to be addressed, politely ask.
- Being aware of local support services, groups, resources and relevant referral pathways for transgender people.
- Don’t confuse being transgender with sexual orientation. Gender is about who we are and how we fit in the world. Transgender people can be heterosexual, lesbian, gay, bisexual, asexual, takatāpui, queer or one of many other words available.
- Understand that there is a growing recognition of gender as fluid, or as a spectrum. Not all transgender people want to ‘achieve’ or ‘pass’ as the opposite gender to what they were assigned at birth. Many people are comfortable in a space between masculine and feminine, and this is not a reason to withhold gender-affirming treatments.
Transgender people are often over represented in poor health outcomes. Few of these poor outcomes are caused by a transgender identity itself, but rather by discrimination from whānau, health services and those in wider society.
The distress caused by the mismatch of sex assigned at birth and gender identity (often termed gender dysphoria) can be effectively reduced when access to timely, gender-affirming health care is available.
Gender affirming health care, including surgical procedures such as those listed below, are the responsibility of DHBs. Patients seeking these procedures should be referred to their local DHB provider:
- feminising breast augmentation for trans women
- masculinising chest reconstruction for trans men
- hysterectomy (removal of the uterus)
- salpingo-oophorectomy (removal of ovaries and fallopian tubes)
- orchidectomy (removal of testicles)
- facial feminisation
- laryngeal shave (reducing the size of the Adam’s apple).
The Ministry of Health has funded a limited number of these surgeries through its High Cost Treatment Pool. From 2019 gender affirming genital surgery can be publicly funded and provided in New Zealand in the private sector.
People who have been referred for gender affirming genital surgery are on a waiting list to see a surgeon who can discuss surgery options. There is currently a long waiting list.
New referrals for gender affirming genital surgery should be made by the DHB specialist who has been providing transgender health care for a person. This is normally an endocrinologist or a sexual health physician. In some cases a referral from a general practitioner with special expertise in transgender care can be accepted.
To be considered for surgical assessment, patients need to:
- meet the eligibility criteria set out in the Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People, published by The World Professional Association for Transgender Health
- be eligible for publicly funded surgery in New Zealand
- be fit to undertake a complex surgical procedure.
Referrals should be made on the Gender Affirming (Genital) Surgery Service referral form (available below), with relevant clinical reports attached.
Referrals can be sent to email: email@example.com.
People on the waiting list will be contacted every six months to update their contact details and health status.
Referrals for gender affirming genital surgery should be from a DHB specialist on this referral form.
People on the waiting list will be contacted every six months and asked to complete this form.
People who are on the waiting list and who are getting close to the 'top of the list' will be sent this form to complete.
Queries can be sent to email: firstname.lastname@example.org.