Withheld Guidelines For Gender Affirming Healthcare In Aotearoa New Zealand (2025) Released

The Professional Association for Transgender Health Aotearoa (PATHA) is an interdisciplinary professional organisation working to promote the health, wellbeing and rights of transgender people. Our members work professionally for transgender health in clinical, academic, community, legal, and other settings. Our vision is that all transgender people have full access to appropriate healthcare, and that all healthcare providers have access to information and resources which enable them to provide appropriate healthcare.

On 28 November 2025 PATHA released the Guidelines for Gender Affirming Healthcare in Aotearoa New Zealand (2025 edition), after receiving a copy in an OIA release, entering them into the public domain. The Guidelines can be found on PATHA's website.

The updated national guidelines have been developed through a robust interdisciplinary process by health professionals experienced in providing gender affirming healthcare and people with lived experience. Forty-nine people contributed to the writing and review of the guidelines, both nationally and internationally and from a range of disciplines, approximately one-third of whom are transgender.

The guidelines utilise Te Whare Takatāpui, a conceptual model of wellbeing for takatāpui and rainbow people that was developed by Professor Elizabeth Kerekere. The guidelines reflect the strength of an evidence-based, and lived experience-informed process. They also reflect the cultural needs of communities accessing gender affirming healthcare in Aotearoa New Zealand.

Dr Rona Carroll, clinical lead and an author of the guidelines says "I regularly hear from health professionals around the country who are seeking information to support them in their care of transgender and non-binary patients. These guidelines provide up to date, Aotearoa specific information to support improved healthcare for transgender and non-binary people."

The updated guidelines take into account the evolving evidence base on transgender health and wellbeing, as well as the Ministry of Health’s position statement on the use of puberty blockers in gender affirming care. They also align with the World Professional Association for Transgender Health Standards of Care, Version 8.

“Recent Counting Ourselves data continues to show that transgender and non-binary people in Aotearoa experience inequitable health and wellbeing outcomes, and difficulty accessing healthcare. We hope that these guidelines can be used by health professionals around Aotearoa to help address these inequities,” says PATHA President, Jennifer Shields. “As well as clinical guidance, these updated guidelines also include information on making healthcare environments inclusive of transgender patients, alongside information on social support and non-medical gender affirmation. They are evidence based, as well as patient and family-centred. They can be used to support clinical best practice”

The guidelines were planned to be published in March 2025, but were prevented from publication by the Minister of Health, until a decision was made by Cabinet about the use of reversible pubertal suppression for transgender children and young people with gender incongruence or gender dysphoria. After the Minister of Health prevented the guidelines from being published, PATHA made an Official Information Act (OIA) Request for the guidelines. Our request was initially declined. Then on 28 November 2025, the Minister of Health released the complete guidelines under the OIA.

After the regulations to ban new prescriptions of GnRH agonists were announced, Te Whatu Ora advised that all information about initiating reversible pubertal suppression would be required to be deleted from the guidelines. We were asked if we would like to make these deletions ourselves. Te Whatu Ora also asked us whether PATHA and the guideline authors would like to still be credited and named in the document that has the information about initiating GnRH analogues removed. In consultation with the guideline authors, PATHA’s Executive Committee declined these offers. We feel deeply uncomfortable putting our names and PATHA’s name to anything that does not align with best practice supported by the best available research. We have no intention of compromising on our patients’ safety and wellbeing, our ethics, or our professional reputation.

The PATHA Executive Committee has decided to independently release the version of the guidelines that was approved by Te Whatu Ora’s Clinical Governance Group and Executive Leadership Team. This is the version of the guidelines submitted to Te Whatu Ora for publication, and the version that earlier this year the Minister of Health withheld from publication.

The 2025 Guidelines for Gender Affirming Healthcare in Aotearoa New Zealand are available here: https://patha.nz/assets/Gender-Affirming-Healthcare_GAHC_2025_February-final.pdf

© Scoop Media