Quarter 3 (Jan-Mar) update

Current status

As at 30 March 2024, there were 337 people on the active wait list for their first specialist assessment (FSA) as part of the Gender Affirming (Genital) Surgery Service (the Service). Of those 337 people, 94 have had an FSA.

Three surgeries have been performed so far in 2024 with two surgeries planned for April.  

The Service is currently reviewing those groups of patients who were referred between October 2018 to December 2021, as part of the waitlist review and validation process, to ensure they meet 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.

As part of our ongoing waitlist review and validation process, patients referred during 2021 have been contacted to provide updated health and wellbeing questionnaires. Each patient’s General Practitioner (GP) needs to complete the health and wellbeing questionnaire so the service has an understanding of their current health status and if they meet the current waitlist referral acceptance criteria. This information also gives us a more informed and current picture of everyone’s overall health status which helps us better to look after people in partnership with their GPs where possible while they are waiting.

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 will not be considered and will be removed from the wait list as part of the review process, with patients and their GP's or referrers are being advised of these requirements.

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.

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 your contact details, home address, or GP has changed. Email us at gender.surgery@tewhatuora.govt.nz to let us know about any changes.

Wrap around health and wellbeing support for the Service

Health New Zealand – Te Whatu Ora is working to improve and increase wrap around services. 

The wrap around services will include the establishment of several new roles to provide more intensive health and wellbeing support for patients on the waiting list for an FSA and/or preparing for surgery. 

One of these support roles 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 Te Whatu Ora and Oranga Tamariki-Ministry for Children. 

Pathways provides a number of services centred around transportation to/from accommodation, initial post-surgical appointments  in the immediate post operative recovery period collecting food/medications as well as providing patients with some emotional health and wellbeing support during their immediate post operative recovery. 

New referrals to the service

New referrals for gender affirming genital surgery can be made by the person’s transgender health professional. This is normally an endocrinologist or a sexual health physician. In Wellington and Christchurch , a referral from a general practitioner with special expertise in transgender care may be accepted. 

For referral acceptance to be considered patients need to:

  • meet the eligibility criteria set out in the Standards of Care for the Health of Transsexual, Transgender and Gender Nonconforming People, published by The World Professional Association for Transgender Health (WPATH) version seven. The Service is not currently accepting new referrals for patients being assessed under version eight. 
  • be eligible for publicly funded surgery and residing in New Zealand 
  • be physically and mentally fit to undertake a complex surgical procedure. This includes being a non-smoker (including nicotine based vapes and recreational drugs) having a BMI under 35 and social support. People being referred for the first time should note that a BMI of between 30-34 is currently acceptable for an initial referral however BMI must be under 30 to proceed to surgery. 
  • There may be FSA delays for those whose BMI is between 30-34 to ensure that those who are more ready to proceed can be seen.

The chart below sets out the number of new referrals received by quarter between January 2013 and  March 2024. Overall, 77 percent of the referrals are for feminising surgery and 23 percent are for masculinising surgery.

New referrals to the Service

A bar chart showing number of new referrals received by quarter A bar chart showing number of new referrals received by quarter A bar chart showing number of new referrals received by quarter