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October 2023 update

Current status

As at 31 October 2023, there were 449 referrals on the active wait list for a first specialist assessment. 94 out of the 449 referrals have had their first specialist assessment.

The Service is currently reviewing groups of patients who were referred between October 2018 and May 2019, June 2019 to December 2019 and January 2020 to December 2020, before a first specialist assessment (FSA) can be offered. The service has updated its process as now patients must have their General Practitioner (GP) complete the updated health and wellbeing questionnaire form to enable the service to have an accurate account of their current health status before a First Specialist Appointment (FSA) can be offered.

The Service sent updated health requests to:

  • 29 of the 50 patients referred between October 2018 and May 2019 with 18 patients in total responding and providing health updates from their GPs since the initial request from 6 March 2023. Of the 18 responses, six patients have a BMI over 35, two patients with a BMI between 30-35, 10 patients had a BMI of below 30, two patients requested to be removed and eight patients requiring further information to be supplied. 
  • 60 patients who were referred between June 2019 and December 2019, only 33 patients responded. Of the 33 responses received, nine patients had a BMI over 35, six patients with a BMI between 30-35, 16 patients had a BMI below 30, two patients requested to be removed and 17 patients required further information to be supplied. 
  • 73 patients who were referred between January 2020 and December 2020, only 29 patients responded. Of the 29 responses received, four patients have a BMI over 35, three patients have a BMI between 30-35 and 22 patients have a BMI under 30. Four patients circumstances have changed which has led to them being removed from this tranche / group of patients being reviewed. 

The Service will now be declining patients from the wait list if they do not meet the gender affirming genital surgery service FSA criteria or they do not respond to either our attempts at contacting them or provide the GP Completed information we request as part of the new review process, with affected patients and their GP's being advised of this outcome. The Service will continue to provide updates each month on any changes or progress made.

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 email, home address, phone number or GP has changed. Email us at gender.surgery@health.govt.nz to let us know about any changes.

So far seven surgeries have been performed in 2023, and an additional two surgeries were cancelled due to patient’s personal circumstances preventing surgery being undertaken. Several other additional patients declined surgery dates that had been scheduled, due to their personal circumstances. Two surgeries are scheduled in November 2023. 

GAgS Service BMI expectation for patients to access the wait list for an FSA and to progress to surgery 

The Service is currently accepting new patients on to the wait list for a first specialist assessment (FSA) with a BMI less than 35, with the expectation that patients with a BMI between 30 and 35 will be working with their general practitioners (GP) on a healthy weight management programme while they are waiting to be offered an FSA with the surgeon. 

This gives patients the opportunity to reduce their weight to a BMI of 30 or less, in a managed and safe way over time, while they wait for their FSA with the surgeon.

Doing so minimises delays such as additional resources or appointments required for monitoring weight loss, the effects these have on service surgery preparations and patient’s  potentially proceeding to surgery, and leads to an overall decrease in delays for others still waiting to be seen.

Please note: Patients on the waiting list will not be offered surgery unless their BMI is below 30.

Wrap around health and wellbeing support for the Service

Te Whatu Ora - Health New Zealand is working closely with the service provider to improve service delivery, with increased provision of 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. 

 

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 some cases, a referral from a general practitioner with special expertise in transgender care can be accepted. 

For referral acceptance to be considered patients need to:

The Service is currently accepting new patients with a BMI less than 35, with the expectation that people with a BMI of between 30-35 will be working with their General Practitioner (GP) on a healthy weight management programme to reduce their BMI to below 30, with the goal of achieving a stable BMI of between 18.5-30 during the time they are waiting for an FSA with the surgeon.

The chart below sets out the number of new referrals received by quarter between January 2013 and 31 March 2023. Overall, 77 percent of the referrals are for feminising surgery and 23 percent are for masculinising surgery. The number of people referred to the waitlist increased by over 160 percent between October 2018 and 30 September 2020.

New referrals to the Service

A bar chart showing number of new referrals received by quarter between January 2013 and 30 September 2022 A bar chart showing number of new referrals received by quarter between January 2013 and 30 September 2022 A bar chart showing number of new referrals received by quarter between January 2013 and 30 September 2022

Prioritisation of referrals

We are currently giving priority for a first specialist assessment (FSA) to referrals of the longest wait patients. There may be some delays in providing an FSA to people whose BMI is currently between 30-35. 

Previous updates from the last year