News

  • 6 Dec 2019 5:25 PM | Anonymous member (Administrator)

    PATHA asserts that the provision of gender affirming healthcare for transgender and gender diverse people is a medical necessity and that the lack of equitable access to this healthcare in Aotearoa is causing harm.[1]

    PATHA notes that in He Ara Oranga (The Report of the Government Inquiry into Mental Health and Addiction) rainbow populations are recognised as being negatively impacted by “the cumulative effects of discrimination, bullying, prejudice and exclusion,” and that in addition limited access to gender affirming healthcare “has a negative effect on the mental health and wellbeing of people seeking to access them (p72).[2] 

    It is the opinion of PATHA that limited and inconsistent access to essential healthcare (such as puberty blockers, fertility preservation, hormonal therapies, mental health support and gender affirming surgeries including chest reconstruction, hysterectomy and orchiectomy) is itself an aspect of discrimination. 

    PATHA recognises the right of transgender and gender diverse people to be able to make informed choices for themselves regarding gender affirming healthcare and that as a minimum, District Health Boards (DHBs) should provide timely access to the following services: puberty blockers, fertility preservation, hormonal therapies, mental health support and gender affirming surgeries including chest reconstruction, hysterectomy and orchiectomy.

    Currently, there are large variations in the provision of gender affirming healthcare services across the 20 DHBs in Aotearoa, New Zealand.[3] PATHA strongly recommends that all DHBs provide clear information about pathways to access gender affirming healthcare services delivered by DHBs and primary health care. PATHA recognises that these healthcare services should involve transgender people, including Māori transgender people, in the development and provision of services.[4] 

    PATHA affirms that all health services in New Zealand must provide equitable and accessible gender affirming healthcare services that are evidence based and align with international standards and community feedback. To that end, PATHA recommends that DHBs enable flexible and responsive pathways that are based on informed consent and self-determination.[4]

    References

    [1] For a list of medication organisations who affirm the medical necessity of gender affirming care see: https://transcendlegal.org/medical-organization-statements. For more information about the health of transgender people in New Zealand and the negative impact of inconsistent access to gender affirming healthcare see Veale J, Byrne J, Tan K, Guy S, Yee A, Nopera T & Bentham R (2019) Counting Ourselves: The health and wellbeing of trans and non-binary people in Aotearoa New Zealand. Transgender Health Research Lab, University of Waikato: Hamilton NZ. https://countingourselves.nz/index.php/community-report/.

    [2] See the full report here: https://www.mentalhealth.inquiry.govt.nz/inquiry-report/he-ara-oranga/

    [3] For more details on the lack of consistent gender affirming services across New Zealand see: https://patha.nz/news/is-the-provision-of-gender-affirming-health-care-equitable-across-the-district-health-boards-in-aotearoa-new-zealand

    [4] Oliphant J, Veale J, Macdonald J, Carroll R, Johnson R, Harte M, Stephenson C, Bullock J. Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato, 2018, p8-9. https://researchcommons.waikato.ac.nz/handle/10289/12160


  • 8 Oct 2019 4:17 PM | Anonymous member (Administrator)

    The Professional Association for Transgender Health Aotearoa (PATHA) committee would like to express collegial and professional support for those working professionally for transgender health in Australia during a time where there are media attacks against the provision of gender-affirming care in that country.

    PATHA supports the increasing focus in both countries on informed consent models of gender-affirming care in position statements, standards, and guidelines developed and endorsed by both the Australian Professional Association for Trans Health (AusPATH) and PATHA. These are based on local and international research, and user feedback in this rapidly-developing area of medical care.

    PATHA supports AusPATH in their work to improve the quality of and access to gender-affirming care, for those who need it. Leading medical organisations have stated the medical necessity of gender-affirming care, including the American Academy of Pediatrics, American Medical Association, World Medical Association, and the World Professional Association for Transgender Health. Lack of services, withholding care, and so-called reparative therapies are harmful and contravene international human rights standards that apply to both Australia and Aotearoa New Zealand.

    There is a very close working relationship between those working professionally for trans health in Australia and Aotearoa New Zealand, whether through formal bodies (such as ANZPATH until recently and various Australasian Colleges) or through online and face-to-face collaborations. This level of collaboration was always envisaged when PATHA was established and we intend for continuing and strengthening collaboration between PATHA and AusPATH.

  • 21 Sep 2019 4:16 PM | Anonymous member (Administrator)

    The inaugural Aotearoa Trans Health Symposium was held in Hamilton in May 2019. The symposium attracted almost 200 delegates, including health professionals and community members. As part of the event, a panel discussion was held to outline what gender affirming health care was being provided by District Health Boards (DHBs) around the country. Panelists involved in the provision of trans health from 13 DHBs spoke about the services available in their DHB.

    Prior to the symposium, Dr Jeannie Oliphant conducted a survey of clinicians from around New Zealand. Information was sought from clinicians providing gender affirming healthcare in all of the 20 DHBs in New Zealand with the exception of West Coast DHB for which no appropriate clinician could be identified. No response, unfortunately, could be elicited from the clinicians approached in the Southern DHB but survey responses were received from clinicians representing the 18 remaining DHBs. In some regions, multiple DHBs share services and resources, such as the Auckland region which is made up of three DHBs; Waitemata, Auckland and Counties Manukau and the Wellington region which also has three DHBs; Capital and Coast, Hutt and Wairarapa.

    The 2018 Guidelines for Gender Affirming Healthcare for Gender Diverse Children, Young People and Adults in Aotearoa, New Zealand has made a series of recommendations for the provision of gender affirming healthcare in this country.1 One of the key recommendations in the guidelines is that DHBs provide clear information on pathways to access gender affirming healthcare services and that DHBs have clear and timely referral pathways for young people and their whānau to access information and trans health care.

    There is good evidence that provision of puberty blockers and gender affirming healthcare for trans young people significantly improves mental health and wellbeing outcomes.2,3 It is well recognised that young people who are trans and gender diverse report high rates of distress, with a national survey of secondary students showing that significant depressive symptoms and suicide attempts in the past 12 months were reported by 41% and 20% of trans students, respectively, compared to 12% and 4% of their non-trans peers.4

    Of the 18 DHBs, 9 (50%) have some information available to clinicians regarding referral pathways for gender affirming healthcare in their region but only the three Auckland region DHBs (17%) provide information to the public on the healthcare available and how to access this. The simple act of providing publically-available information would relieve a huge amount of distress and frustration for those people trying to access support for themselves or their whānau.

    Another key recommendation in the guidelines is that DHBs provide equitable and accessible gender affirming healthcare services that align with international standards, evidence-based literature and community feedback. While detailed information about the health services were not obtained, it was reassuring that puberty blockers and hormonal therapies could be accessed through all 18 of the DHBs, although some smaller DHBs reported difficulty in providing this care.

    The guidelines recommend that health services enable the involvement of trans and gender diverse people, including Māori trans and gender diverse people, in decisions that affect them with regard to the development and provision of services.1 The importance of involving consumers in the development and oversight of clinical services is well understood in the health sector. However only nine DHBs (Auckland region x 3, Waikato, Wellington region x 3 and Canterbury region x 2) have some form of clinical and consumer advisory group providing input into service development. The guidelines also recommend that DHBs provide clear pathways for timely access to gender affirming healthcare, including puberty blockers, hormonal therapies, fertility preservation, voice therapy, counselling and mental health support, and gender affirming surgeries. Not all trans and gender diverse people will want to access all of these interventions, but for some this is immensely important.

    Counselling support was available in seven of the DHBs, with nine DHBs only having limited access and two DHBs not providing any counseling support. The table below highlights the postcode lottery nature of obtaining gender affirming healthcare in New Zealand at present.

    District Health Board

    Fertility (sperm freezing)

    Voice therapy

    Chest surgery

    Hysterectomy

    Orchiectomy

    Northland

    Yes

    Yes

    No

    Yes

    Yes

    Waitematā

    Auckland

    Counties Manukau

    Yes

    Yes

    Yes

    No

    No

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Waikato

    Yes

    Yes

    No

    Limited access

    Limited access

    Lakes

    No

    No

    No

    Unclear

    Unclear

    Bay of Plenty

    Yes

    Yes

    Some access

    No

    No

    Tairāwhiti

    No

    No

    Yes

    Yes

    Yes

    Hawkes Bay

    No

    No

    No

    No

    No

    Taranaki

    Yes

    Yes

    No

    No

    No

    Whanganui

    Yes

    No

    No

    Unclear

    Unclear

    MidCentral

    Yes

    No

    No

    Yes

    Unclear

    Capital & Coast

    Hutt

    Wairarapa

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    No

    No

    No

    Yes

    Yes

    Yes

    Yes

    Yes

    Yes

    Nelson/Marlborough

    No

    Yes

    No

    Limited access

    No

    West Coast

    Not contacted

    Canterbury/Sth Canterbury

    Yes

    Yes

    In progress

    In progress

    In progress

    Southern

    No response

    It is clear from the above table that there is a need for a conversation between the Ministry of Health and DHBs regarding the minimum standard of gender affirming healthcare that should be provided. This would be beneficial for trans and gender diverse people in all regions of New Zealand. In addition, there are some very simple and low-cost initiatives that would make a huge difference for trans and gender diverse people and their whānau around New Zealand, such as DHBs providing publicly-available information on the pathways to access services.

    References:

    1.      Oliphant J, Veale J, Macdonald J, Carroll R, Johnson R, Harte M, Stephenson C, Bullock J. Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato, 2018.

    2.      de Vries AL, McGuire JK, Steensma TD, Wagenaar EC, Doreleijers TA, Cohen-Kettenis PT. Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics. 2014;134:696- 704.

    3.      Olson KR, Durwood L, DeMeules M, McLaughlin KA. Mental health of transgender children who are supported in their identities. Pediatrics. 2016;137(3):e20153223.

    4.      Clark TC, Lucassen MF, Bullen P, Denny SJ, Fleming TM, Robinson EM, et al. The health and well-being of transgender high school students: results from the New Zealand adolescent health survey (Youth ’12). J Adolesc Health 2014 Jul;55:93-99.

  • 25 Jun 2019 4:15 PM | Anonymous member (Administrator)

    The Professional Association for Transgender Health (PATHA) welcomes the news this week that Statistics New Zealand will move beyond a binary (male or female only) gender question in the Household Economic Survey. The organisation also supports Statistics New Zealand’s decision to include a question about sex assigned at birth, to be able to count the transgender population.

    “This is long overdue”, said Dr Jaimie Veale, PATHA President and Senior Lecturer in Psychology at the University of Waikato. “Transgender people have been telling Statistics New Zealand for a long time that they need to see themselves represented in our population data. These questions reflect international standards for best practice, and the data we collect using these questions will be crucial for us to understand the size of the transgender population, demand for services, as well as the health social inequities that transgender people face. Accurate data is necessary for us to inform policy and law changes”, she said.

    “My understanding is Stats NZ is still working out what might be the best and most effective ways of collecting information about rainbow populations, including population measures for intersex and transgender people, and we welcome their progress towards robust data about and for our communities”, said Joey Macdonald, PATHA Secretary.

    PATHA was formed at a meeting of over 70 health professionals and people working to promote transgender people’s health at the Aotearoa New Zealand Trans Health Symposium on May 4th 2019, to provide networking, education, and advocacy for this group.

  • 2 Jun 2019 4:13 PM | Anonymous member (Administrator)

    On the 9th May 2019, the New Zealand Companies Office accepted our application to register the Professional Association for Transgender Health Aotearoa Incorporated.

    The societies number is 2735252.

    As per the rules of the society, the first AGM of the organisation will be held between the 1st April and 30th June 2020. In the interim, the inaugural Executive Committee, selected at the 4th May 2019 meeting, will govern the organisation. The inaugural Executive Committee includes:

    • Dr Jaimie Veale (President)

    • Dr Jeannie Oliphant (Vice President)

    • Joey Macdonald (Secretary)

    • Duncan Matthews (Treasurer)

    • Jesse Porter

    • Dr Rachel Johnson

    • Jemima Bullock

    CSPdoc_3199901_3.pdf


  • 31 May 2019 4:11 PM | Anonymous member (Administrator)

    Delegates at the country’s first ever Trans Health Symposium voted unanimously to create the Professional Association for Transgender Health Aotearoa.

    The inaugural President of PATHA is Dr Jaimie Veale, who is a Senior Lecturer in Psychology at the University of Waikato.

    Over 200 hundred health professionals and members of transgender communities attended the event at the University of Waikato. The level of interest in the Symposium went far beyond organisers’ expectations, requiring them to move it to a larger venue in the weeks before registrations closed.

    The event included overviews of two large University of Waikato research projects: the Honour Project Aotearoa and the Counting Ourselves survey. Other presentations focused on ways to address barriers to gender affirming care and mental health support around the Aotearoa, including through Māori and Pasifika community-led health initiatives (FINE and Gender Minorities Aotearoa), and by working with children, youth and their whānau.

    Invited speakers included Dr Ruth Pearce from the UK, who presented research on pregnancy among transgender people and Dr Rita Yang who discussed surgical pathways in New Zealand.

    Publication of a new transgender health guideline for New Zealand was celebrated. “This guideline provides clear recommendations to District Health Boards about the gender affirming healthcare services that should be provided locally for transgender people”, said lead author, Dr Jeannie Oliphant.

    A panel discussion involving clinicians representing 13 different District Health Boards  revealed a concerning lack of equity in the healthcare services available across New Zealand. “Currently only the Auckland DHBs provide publicly available information regarding local service provision”, noted Dr Oliphant, “there is an urgent need for other DHBs to provide clear pathways for consumers wanting to access gender affirming healthcare regionally”.

    Over 70 delegates voting to establish the new Professional Association for Transgender Health Aotearoa (PATHA). “This organisation was formed to provide education, networking, and collaboration for everyone working professionally to advance the health of transgender people in Aotearoa”, said inaugural PATHA President, Dr Jaimie Veale.

About PATHA

The Professional Association for Transgender Health Aotearoa (PATHA) is an interdisciplinary professional organisation working to promote the health, wellbeing, and rights of transgender people. We are a group of people working professionally on transgender health, whether in clinical, academic, community, legal and/or other settings.

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