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New guidelines for better healthcare for transgender people

14 December 2018

Dr Jaimie Veale.

Health professionals and transgender advocates  from around the country have created a new set of guidelines:  Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People and Adults in Aotearoa New Zealand. An article outlining these guidelines has been published in the New Zealand Medical Journal today.

The lead author, Dr Jeannie Oliphant has brought together a team from a wide range of disciplines, including Dr Jaimie Veale a Senior Lecturer in psychology at the University of Waikato, who is working on a comprehensive survey of transgender and non-binary people’s health needs.

The guidelines provide an approach to healthcare delivery which is uniquely Aotearoa/New Zealand, by utilising Māori models of health that recognise the importance of holistic care, while also referencing international standards.

Dr Veale says the new guidelines promote healthcare based on informed consent. “This means that healthcare providers’ duty of care is to make sure that people seeking gender affirming care are empowered with all of the information they need to make the best decisions for themselves” she says.

The authors would like District Health Boards to take note of the recommendations in the guidelines. Dr Oliphant says that services for trans people are not consistent around New Zealand. “Access to puberty blockers, hormonal therapy and various surgeries vary greatly in different regions. There is an urgent need for each DHB to develop a clear pathway for provision of gender affirming healthcare locally.”

Dr Oliphant hopes that there will be wide uptake from healthcare providers across the country. “These guidelines have been endorsed by the Australian and New Zealand Professional Association for Transgender Health, the New Zealand Sexual Health Society and the New Zealand Society of Endocrinology and the Ministry of Health links to them on their page for healthcare for transgender New Zealanders” she says.

The guidelines cover areas including supporting families, mental healthcare, access to puberty blocking treatments, hormone therapy, and surgery, as well as fertility preservation.

Some key facts:

  • The Youth’12 survey, estimated approximately 1.2% of adolescents in Aotearoa/New Zealand identify as transgender. As societal acceptance for transgender people grows, it is likely that this level of referrals to health services will continue in the foreseeable future.
  • The survey also highlighted the mental health disparities experienced by transgender youth compared to their cisgender peers with 41% vs 12% experiencing significant depressive symptoms and 20% vs 4% reporting an attempted suicide in a 12 months period. Transgender youth were also nearly five times more likely to experience regular bullying at school.
  • International research has shown that negative mental health outcomes are linked to experiences of discrimination, stigma, and violence and the World Health Organization has proposed removing any reference to gender diversity being a mental illness in its International Classification of Diseases.

The full guidelines and the list of contributors to them are available  here.

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