Gender Affirming (Genital) Surgery Service referrals and waitlist

Current status

As of 30 December 2025, there were 381 people on the active wait list for their first specialist assessment (FSA) as part of the Gender Affirming (Genital) Surgery Service (the Service/GAGSS).   

In the last quarter four surgeries were performed in December. The Service continues to review the wait list to ensure patients meet the current service referral criteria for acceptance onto the waitlist and to give us a better and more informed picture of everyone’s overall current health status. 

Patients who do not meet the service’s referral acceptance criteria, do not respond to communication, or who do not provide the GP completed information within required timeframes when requested will not be considered and will be removed from the wait list as part of the review process, with patients and their GPs or referrers being advised of these outcomes. 

This is consistent with the regional hospitals’ current pathways of accessing elective reconstructive surgeries, including top (chest reconstruction/breast removal) surgeries, breast reconstructions and breast reductions. 

Updating contact details

It is important that you contact us immediately if you decide you no longer want to be considered for an FSA, no longer want surgery, or if any of your contact details, including home address, telephone, email or general practitioner (GP) have changed. Please email us at gender.surgery@tewhatuora.govt.nz to let us know about any changes. Please ensure you provide your full name, date of birth and NHI number, along with the change(s) in contact details you are providing.

Patient completed annual updates

We no longer ask for or require that patients on the waiting list complete and submit a Patient Completed Annual Health form to the Service each year. Consequently, the Patient to Complete Annual Review form has been removed from our website.

Patient health, wellbeing and status reviews and updates

When we require an update from any patient or group of patients we will send an email to those we are wanting this information from. These emails will contain a letter to the patient outlining our request, the requirements and will include the form that we wish to be completed by their GP and returned.

The forms will require the patient to book an appointment to be seen in person by their usual GP. An in-person GP – Patient appointment is essential to ensure the GP is able to discuss and provide the updated, current information being requested by the Service.

Please note that any appointments that may require patients to be seen by their GP as part of their ongoing placement within the Gender Affirming (Genital) Surgery Service waiting list are to be self-funded by the patient, with no reimbursement by the Service available.

Belated update

We are delighted to be able to announce publicly that as of late 2023, following the addition of a Urologist and a Gynaecologist to the surgical team that the comprehensive range of surgical procedures (listed on our main page) have been available and are routinely performed including robotic assisted peritoneal flap vaginoplasty.

Sharing some insight

We are often asked who else are the surgical team members?

There is an entire healthcare team behind every surgery that ensures the patient is cared for when they are undergoing surgery within the operating theatre.

Our surgical team includes:

• Plastic and Reconstructive Surgeon(s)
• Anaesthetist
• Anaesthetist Assistant
• Urologist
• Gynaecologist
• Nurses including Scrub Nurse 
• Operating Room or Circulating Nurse,
• Surgical Assistant(s) to the Surgeon(s)
• Registrars and Trainees
• Surgical Technicians (Scrub Techs)

It takes a team, each having an essential role with subspecialist skills in the various surgical procedures provided, and all working in unison in the operating theatre during surgery. 

There are many other people that also make up the team needed for people having surgery. This includes people such as our post operative care unit nurses, post operative care ward nurses, Clinical Psychologist, Clinical Nurse Specialist, Gender Surgery Health Navigator (peer support worker), Pathways Gender Affirming Package of Care support person, theatre support workers including porters who take people to and from the theatre.

Often overlooked are also all the behind-the-scenes people needed including the NTA Team, schedulers, the Hospital theatre manager, and the Health New Zealand Gender Surgery Administration team to name just a few- all working in partnership co-ordinating care for patients.

Wrap around health and wellbeing support for the service

One of the current wrap around/support roles for the GAGS Service is Pathways Health. Pathways is a leading national provider of community based mental health and addiction services operating across Aotearoa New Zealand. Pathways was formed in 1989 and is currently operating in fifteen regions across the country contracted to Health New Zealand and Oranga Tamariki-Ministry for Children. 

Pathways provides via the GAgSS Gender Affirming Package of Care a number of individualised patient centred services to patients receiving surgery to help meet their needs. This includes providing patients with some mental health and wellbeing support during the immediate post operative recovery phase, use of sensory modulation kits specially developed to assist patients, transportation assistance for post-surgical appointments and at times assisting with collection of essential medications and food during the immediate post operative period.

New referrals to the service

We have updated our referral form, and this is included on our webpage.  Any new referrals for gender affirming genital surgery must be made using this form. New referrals should be made by the person’s public hospital transgender health specialist (this is normally an endocrinologist or a sexual health physician) or, for those in Wellington and Christchurch districts only, this may be done by their GP.

People who have been referred for gender affirming genital surgery are on a waiting list for an FSA to see a surgeon and discuss their surgery options. Please note: it is not a waiting list for surgery.

To be considered for an FSA, patients need to meet the Service eligibility criteria as listed on our webpage.

The chart below sets out the number of new referrals received each quarter since January 2013. Of those 78.2 percent of the referrals are for feminising surgery and 21.8 percent are for masculinising surgery.