Advice for health professionals
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Transgender people have both general health needs (eg, cancer, long term conditions, sexual health screening, influenza immunisations) and specific health needs that relate to their transition (eg, hormone therapy and gender affirming surgery). It is important to note that not all transgender people choose to access gender affirming health care.
Transgender people are often overrepresented in poor physical and mental 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.All health providers, both in primary and secondary health care settings, have a duty to deliver services that are respectful of transgender people. Central to this care is respect of the patient’s privacy, gender identity and expression.
- Use the patient’s correct pronouns (he/him, she/her, they/them, ze/hir etc) and 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 and non binary people.
- Remember a person’s gender does not refer to their sexual orientation. Gender is about who we are and how we see ourselves. Transgender people can be heterosexual, lesbian, gay, bisexual, asexual, takatāpui, queer, or another sexual orientation..
- Understand that not everyone who is transgender is binary. Many people are comfortable in a space between masculine and feminine, and this is not a reason to withhold gender-affirming treatments.
- Offer your patients and their whānau as much support as possible, and screen for any distress, which may affect social, spiritual, mental and physical wellbeing.
Guidelines for Gender Affirming Health Care
In 2018, the Professional Association for Transgender Health Aotearoa (PATHA) endorsed the ‘Guidelines for Gender Affirming Health Care for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealand’. PATHA is an interdisciplinary organisation working to promote the health, wellbeing and rights of transgender people.
New Zealand Doctor | Rata Aotearoa article: Gender-affirming healthcare
In 2020, New Zealand Doctor | Rata Aotearoa in partnership with the Royal New Zealand College of General Practitioners (RNZCGP) published an article on the diverse aspects of providing gender affirming healthcare for transgender and non-binary people.
The article has been endorsed by RNZCGP and the ELearning assessment attached to the article has been approved for 1 Continuing Medical Education (CME) credit for the General Practice Educational Programme and continuing professional development purposes.
You need to be a subscriber of New Zealand Doctor and Pharmacy Today to read the article and access the ELearning assessment.
Supporting Transgender People: Online Course
Gender Minorities Aotearoa offers a free online course for people who want to build their confidence in supporting transgender people. This course is designed to increase your knowledge of issues affecting transgender people in Aotearoa. It is a 101 course and suitable for people with any level of knowledge on transgender issues.
The course takes 2-3 hours to complete and is broken into three sessions. You can stop at any time and continue later by logging in again.
Rainbow and takatāpui competence training for the mental health and addiction workforce
In 2021, InsideOUT Kōaro launched a new service to provide free rainbow and takatāpui competency training for the mental health and addiction workforce in Aotearoa. This service will make it easier for rainbow and takatāpui service users to access safe and inclusive care for mental health and addiction challenges.
Rainbow competence training is delivered within three ‘streams’: kaupapa Māori, Pacific, and Tauiwi. The streams draw on their rich bodies of knowledge to help mental health and addiction services meet the needs of their rainbow and takatāpui service users.
Training is free to all mental health and addiction services.
- Auckland Regional Health Pathways: Gender Diverse and Transgender Health pathway (login required)
- AusPATH – the Australian Professional Association for Transgender Health
- Gender Identity Research & Education Society, UK: Gender Variance – For GPs
- Goodfellow Unit: Working with Gender Diverse Clients
- Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in New Zealand
- Healthpoint: Northern Region Transgender Health Services
- Professional Association for Transgender Health Aotearoa (PATHA)
- Royal New Zealand College of GPs
- Thorne Harbour Health (Victoria, Australia): Guide on Initiating Hormone Therapy
- Trans Care British Columbia: Primary Care Toolkit
Gender affirming surgery such as those listed below, are the responsibility of hospital networks (Patients seeking these procedures should be referred to their local hospital provider:
- feminising breast augmentation
- masculinising chest reconstruction
- hysterectomy (removal of the uterus)
- salpingo-oophorectomy (removal of ovaries and fallopian tubes)
- orchidectomy (removal of testicles)
Gender Affirming (genital) Surgery Service
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 for a first specialist assessment (FSA) to see a surgeon and discuss their surgery options. There is currently a long waiting list for an FSA. From 1 July 2022, Health New Zealand (HNZ) is managing the waiting list for an FSA.
Send queries to [email protected]