Trans healthcare in NZ hit by under-resourcing

Under-resourcing in New Zealand’s health system is hitting trans healthcare, warn experts.

Nearly one year on from health experts calling for change in the system, resourcing remains the stand-out issue affecting gender-affirming healthcare outcomes.

And Charlie Blount (they/them), who made the decision to undergo surgery three years ago, found a complete lack of awareness of it at their initial GP consultation.

The experts outlined what was required to create a healthcare system that would successfully serve the needs of trans communities, through a report by the Professional Association for Transgender Health Aotearoa (PATHA).

PATHA President Jennifer Shields says the primary care system is one of the biggest strengths in trans healthcare currently, however under-resourcing is still setting it back.

“I think a lot of what we are facing is pretty similar to what a lot of people are facing at the moment with the state the healthcare system is in. But our trans community obviously face some additional barriers.

“Our primary care system works so well but it does mean we put a lot of pressure on GPs to do a lot of things. So it’s really tricky to ask them to do more without additional resourcing.”

According to Counting Ourselves 2018 around half of trans and non-binary people felt their main healthcare provider was mostly competent in addressing their specific needs.

Shields says that one of the biggest successes following last year's report was a boost in funding for these primary care models.

“We have seen some targeted funding that came out of the budget two years ago including funding for workforce development for our primary care workforce.”

However, competency from GPs when it comes to trans and gender-diverse issues still isn’t something that all patients are receiving.

Blount, 20, made the decision to get 'top surgery', or a mastectomy, three years ago.

They say when seeing their GP to begin the process last year, they were met with a lack of awareness.

“She told me herself this is the first time I've referred someone for surgery. And she didn't understand why I wanted it done. She had nothing to offer me in terms of support or advice in this big decision I was making.”

Blount said it left them feeling as though they had to know exactly what they wanted from the system, when they had a lot of questions.

“I want to see more education of GPs, I think with handling sensitive issues. They should not be specialists, but they should be able to ask you the right questions.”

Shields agrees that more education in medical schools around trans and gender-affirming care is something that needs to be implemented.

“Their [medical schools] curriculum around that is pretty limited, so we’re still churning out a generation of doctors with pretty limited understanding of this care.”

Associate Minister for Health and the Rainbow Portfolio Matt Doocey says that this Government is committed to improving the health outcomes for all New Zealanders, especially those in our most vulnerable groups.

“It’s widely recognised that people in the Rainbow and Transgender community are some of our most vulnerable, and often suffer poorer health outcomes than the general population.”

Shields says the problems that trans healthcare faces are largely “structural and systemic”.

The coalition government has currently made no announcements or policies specifically relating to transgender communities or improving healthcare outcomes for those communities.

Counting Ourselves (2018) is an independent survey set up to fill the gap in transgender statistics in Aotearoa, the updated 2023 survey results are set to be released mid 2024. Watch a quick breakdown of those stats here.