Queer Endurance/Defiance, a queer activist group based in Te Whanganui-a-Tara, is uniting with trans activists from across New Zealand to better define healthcare goals and improve healthcare outcomes for transgender people. The united group will be submitting their recommendations to Government via an open letter, with the possibility of more vocal action in the future to ensure these recommendations are heard.

With the Pae Ora (Healthy Futures) Bill, having passed its third reading in parliament on 7 June 2022, the Government will now disestablish the nation’s twenty District Health Boards and replace them with a single entity, Te Whatu Ora - Health NZ. This reform is intended to “give people access to consistent quality care” since “where you live should not determine the range and quality of services you receive.” (See https://www.futureofhealth.govt.nz/health-nz/) The reform is of huge significance for the transgender community, as some DHBs currently have abysmal policies and care records for gender transition health. Replacing the inconsistencies of the current model with a unified national policy could therefore be of immense benefit.

Unfortunately, although the reform is intended to take place in 2022, and an interim Health NZ was set up in September 2021 to begin making policies in preparation for the change, no work appears to have been done to come up with a unified policy for transgender health. This leaves open the possibility that the new organization will hastily adopt a policy for our treatment without carefully considering which DHBs are currently providing the best care. As a result, there is a risk the worst practices might be adopted rather than the best.

Queer Endurance / Defiance have therefore come up with a list of recommendations for policies that the new national health authority should adopt for transgender health, to ensure it meets the needs of the nation’s transgender population. These recommendations are as follows:

i) Hormone Replace Therapy (HRT) prescriptions for gender transition should be available in all primary care practices for patients aged 18 and over.

ii) These HRT prescriptions should be provided on a basis of informed consent alone (i.e. no therapist's letter should be required, no appointment with an endocrinologist should be required).

iii) Comprehensive advisory HRT prescription guidelines should be developed, and made available to both doctors and patients, to help doctors and patients without prior experience in this area judge medication options, dosages, risk factors etcetera.

iv) Funded HRT prescription options should include all reputable HRT medications in use internationally.

v) Hormone blocker prescriptions should be available in all primary care practices.

vi) Hormone blockers should be prescribed to all trans youth on the basis of informed consent and a therapist's evaluation.

vii) Comprehensive advisory hormone blocker prescription guidelines should be developed and made available to doctors and patients.

viii) Gender affirming surgery referral should be available in all primary care practices.

ix) Gender affirming surgery referral should be provided on the sole basis of an informed consent process over an appropriate duration (i.e. no HRT requirements, no unnecessary BMI requirements, etcetera, but a relationship of some duration between patient and referrer would be required to judge informed consent).

x) Funding for gender affirming surgeries, including for genitals, chest, and face and extending to all safe gender-affirming surgical procedures, should be widely available.

xi) Gender affirming surgery funding should match demand.

xii) Training for gender affirming surgery practitioners should be planned to match modelled future demand.

xiii) Where demand for gender affirming surgery exceeds national capacity, funding should include international travel fees and pricings of reputable overseas surgeons.

xiv) Comprehensive advisory gender affirming surgery guidelines should be developed and made available to referring doctors and patients.

xv) Voice therapy and hair removal services should be available and funded throughout New Zealand, with providers for both available in all urban centres.

xvi) Voice therapy and hair removal referrals should be on the basis of informed consent solely.

xvii) Principles should be developed at a national level for respectful and non-discriminatory treatment of trans patients, to be implemented in all sections of the health system.

xviii) These reforms should be carried out under the responsibility of a national trans health leadership body formed for this purpose, and in consultation with trans communities around the country.

- Queer Endurance / Defiance, Wellington

https://www.facebook.com/QueerEndurance

© Scoop Media