Different gender identities
Transgender and gender diverse are umbrella terms that cover a wide variety of gender identities. We will use the word transgender in this section, although we acknowledge you may identify a different way.
Other words that people might use to describe their gender identity, including Māori and Pacific terms include:
- gender diverse
- tangata ira tāne
- vakasalewalewa; and
Not all transgender people want to conform to binary gender norms. Gender diverse people may identify as binary or non-binary. Each person’s gender expression (how they present to the world) is unique. Individual transition goals may include different aspects of social, medical or surgical care.
Some gender diverse people experience distress as a result of the discrepancy between their gender identity and the sex that they were assigned at birth (often referred to as gender dysphoria). Timely access to gender-affirming health care can relieve distress.
Transgender New Zealanders: Children and young people
All children explore different ways of expressing their gender. Many children do not conform to their culture’s expectations for boys or girls; such as boys who prefer dolls and dressing up in skirts or girls who prefer short hair and refuse to wear dresses. Most of these children are comfortable with the sex they were assigned at birth, although some are not.
Occasionally children persistently assert themselves as a gender different from the sex assigned at birth. Transgender children are usually insistent, consistent and persistent in their gender identity and may exhibit distress or discomfort with their physical body.
Some children are aware of their gender identity from a very early age, while others may take some time to figure it out. Children can be very aware of the disapproval of those around them and may try and hide their feelings about their gender.
For gender-expansive children, including those who may identify as transgender, no medical intervention is needed pre-puberty. However you may want to talk to a paediatrician, mental health professional or parent support group to work out how to best support your child or family member. This is particularly important if there is associated distress related to gender identity.
Supporting your child
Here are some simple tips to help you support your child as they consider their gender identity.
- Assure your child that they have your unconditional love and support.
- Encourage their exploration of how they express themselves and allow them to present in the way they feel most comfortable, (eg clothes, hairstyle, creativity). It is important that your child has a safe space in which to explore their gender.
- Use your child’s preferred gender pronouns (eg he/him, she/her, they/them etc) and preferred names. When your child is ready, support whānau and friends to do the same, providing it is safe to do so.
For young people where these feelings continue into puberty or emerge during puberty, particularly if associated with distress, it is important to see a health professional. Puberty blockers are a medicine that can be used to halt the progress of potentially unwanted puberty-related physical changes.
Blockers are sometimes used from early puberty through to later adolescence to allow time to fully explore gender health options. This is done under the guidance of a clinician who specialises in their use.
Service providers that can help access and provide more information about blockers include:
- paediatric services
- youth health services
- primary care services
Health care for transgender New Zealanders
Services providing gender-affirming health care vary across the country and may be found in primary care, youth one-stop-shop services, sexual health and other hospital services.
Service providers who can help you access hormone therapy include:
- primary health care teams
- sexual health services
- youth health services
The process of starting hormonal therapy includes assessing readiness, from a medical and psychosocial perspective, to begin. More visits may be required for people with complex physical or mental health issues. Information needs to be provided to support an informed consent approach.
Some hormone therapy may produce irreducible changes that you’ll need to consider, such as to your fertility. You may want to investigate fertility preservation (like freezing sperm or eggs) before you start hormones.
Counselling and mental health services
Seeking help with a counsellor or mental health professional is a key part of managing any distress.
The experiences of stigma and discrimination can stop people from reaching out and accessing support. It is important to know that some of the uncomfortable experiences of social and medical transition are temporary – and that health professionals are available to help when you face these barriers.
If you want to know more about mental health providers, you can contact one of the following services, or check with your GP or primary care provider for a referral.
Medical and social transition encompasses many changes in our values, relationships and life choices. Finding an understanding person to share the experience with can help to get through some of the doubts, concerns and worries.
It is common to feel isolated, to feel like you are the only person who has had to face barriers or concerns. But often there are many networks and people in our everyday community who are more than willing to introduce or link others to peer support networks.
If you need urgent help
If there is any concern for the safety of a person or yourself, seek help and guidance from mental health services.
Voice and communication therapy
Voice and communication therapy can help you to make your voice and other aspects of your communication congruent with your gender identity and expression.
Gender affirming surgeries include:
- Feminising breast augmentation
- Masculinising chest reconstruction
- Hysterectomy (removal of the uterus)
- Salpingo-oophorectomy (removal of ovaries and fallopian tubes)
- Orchidectomy (removal of testicles)
- Gender affirming genital surgery.
Availability of these surgeries (except for genital surgery) will depend upon the surgical expertise and capacity within your regional hospital, and the clinical priority given to your surgery.
An assessment of your readiness for surgery may be required before you can be referred for consultation with a surgeon.
Guidance on eligibility for all gender affirming surgery is available 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). The WPATH Standards Version 8 is due to be released in 2022.
Gender affirming genital surgery
From 2020, gender affirming genital surgery has been publicly funded and provided in New Zealand in the private sector. People who have been referred for gender affirming genital surgery are on a waiting list to see a surgeon who can discuss suitability for surgery and surgery options. There is currently a long waiting list.
Referrals for gender affirming genital surgery are generally made by the health care professional who has been providing transgender health care for a person. This is often an endocrinologist or a sexual health physician at a hospital. In some areas, a hospital network may have an agreed process with a general practitioner with special expertise in transgender care to provide referrals.
If you wish to be considered for this surgery, you should discuss this with your transgender care specialist. If you are not currently under the care of a specialist, then you should discuss this with your GP, who can make a referral to an appropriate specialist.
Resources for transgender New Zealanders
New Zealand resources
Mental Health Foundation
Resources on mental health and wellbeing.
Making schools a safer place for all young people of minority sexualities, sexes and genders.
How New Zealand schools support trans and other rainbow students.
The Professional Association for Transgender Health Aotearoa (PATHA) is an interdisciplinary professional organisation working to promote the health, wellbeing and rights of transgender people.
An organisation that supports gender-diverse young people in New Zealand.
- Inside Out – educational videos
- I’m Local – provides information on local trans services by region, with a focus on rural New Zealand
Supporting Aotearoa's Rainbow People
This guide is for anyone who provides mental health support in Aotearoa, including (but not limited to) counsellors, psychologists, psychiatrists, psychotherapists, tohunga (Māori healers), social workers, mental health nurses, and GPs. It will also be helpful for youth workers, group facilitators, and peer supporters.
Counting Ourselves Community Report
This is the first community report from the Counting Ourselves survey about the health and wellbeing of trans and non-binary people in Aotearoa New Zealand.
Gender Minorities Aotearoa
Peer-led organisation. They provide a national services and information database.
Healthinfo Canterbury / Waitaha
Canterbury-specific gender affirming care and support services.
Asia Pacific Transgender Network
Organisation advocating for the rights of trans and gender diverse people across Asia and the Pacific.
A support service for trans children, young people and their families with lots of useful online resources.
US organisation that helps to create gender sensitive and inclusive environment for all children and teens.
Central Toronto Youth Services
Canadian mental health service that provides resources for families of trans youth.
Tasmania’s gender, sexuality and intersex status support and education service.
NHS Livewell: Transgender health
A UK site with a variety of useful resources and information.
Monthly updates on current referrals and the waiting list.
Information and resources on sexual and reproductive health.
This service has been established to help more transgender and non-binary people access publicly-funded gender affirming genital surgery.