Gender Care – Info + FAQ

WHO: Gender Care Whanganui is driven by Pride Whanganui and funded by Te Whatu Ora, Health New Zealand. 

WHAT: Gender Care Whanganui aims to support a person’s gender affirming healthcare goals which may include exploration of gender expression, support around social transition, hormone therapy as well as other requirements. Patients will have access to a wide range of services depending on need and personal preference. These services include but are not limited to; a Gender Affirming GP, Peer Support Workers, Clinical Psychologist, Support Groups, Resources/Information, Gender Affirming Products.

WHEN: Initially, this clinic will run monthly with reassessment of this timeframe after six months. This clinic is solely for gender affirming healthcare – patients do not need to change practices and are encouraged to stay with their current GP to access all other medical needs.

HOW: In 2021 a Rainbow Healthcare Reference Group was set-up in Whanganui to ensure that the health needs of LGBTTQI+ people were being met. As of today, this group consists of 24 medical professionals from Manawatu and Whanganui and several representatives from Pride Whanganui. The biggest need identified from this group and the patients/clients they see is a space for gender affirming healthcare. This informed our decision to apply for funding to create our own clinic. Once the initial Expression of Interest (EOI) was approved by Te Whatu Ora, we (Gender Care Whanganui as we would later become) spent four weeks collecting data officially – via a region wide survey, and anecdotally, by means of kōrero within the current LGBTTQI+ community and patients already accessing Gender Affirming Healthcare. This data collection allowed us to see that a Gender Affirming Healthcare Clinic was not only needed and wanted, but what it could look like as well. With this data together with clinical information and societal knowledge we submitted our application, and after its acceptance presented to a panel to articulate our vision. Within a few weeks we were confirmed as successful and awarded $100,000 over three years to run our clinic. $50,000 for the first year and $25,000 for year two and year three equally.

WHY: The Professional Association for Transgender Health Aotearoa (PATHA) has stated that more than a third of transgender people in Aotearoa have avoided seeing a doctor because they were worried about being disrespected or mistreated. That is just the tip of the iceberg however. In this article from 2023, it clearly breaks down the full story behind why specific Gender Affirming Healthcare Clinics are needed. Read more HERE. 

In research completed recently from Whanganui Company HARC, they delved further into the needs of Whanganui Transgender & Gender Diverse Adults, Youth, & Parents of Transgender Children within Primary Healthcare Services. The research highlighted that locally, the issues as previously discussed are still forefront. Transgender and gender diverse (TGD) people of all ages face significant barriers to healthcare, with those who are indigenous experiencing even greater disparities. Consequently, TGD people have higher levels of mental health issues and distress, with elevated risks of self-harm and suicide. Read the full research paper HERE.

 

FAQ – PATIENTS:

How do I know if this clinic is for me?
Whether you have questions around your gender identity, what transitioning entails, or how to transition, you might consider making an appointment. This clinic offers a supportive environment that respects and understands your gender identity and expression. Our clinic GP/Doctor has expertise in gender-affirming care and can offer additional resources like peer support or community support.

Is there an appointment cost?
No. Thanks to the funding we have received from Te Whatu Ora – Health New Zealand, there is no appointment cost for the individual.

How do I make an appointment?

            Your doctor can refer you by completing the referral form on your behalf via the link below
            You can self-refer using the form on the Pride Whanganui website here: www.pridewhanganui.co.nz/gender-care-whanganui or by completing a paper version which can be obtained via the Pride Whanganui office.

 

Will I get GAHT (Hormones) at my first appointment?
Not usually. In most cases, there are several steps to complete before Gender Affirming Hormone Therapy (GAHT) can be administered. These steps can vary depending on a person’s medical history, or other circumstances.

Do I have to get GAHT/Hormones?
No. Being transgender/gender diverse is about your gender identity, which is how you feel and identify yourself, regardless of whether you choose to undergo hormone therapy or any other medical treatments. Some transgender individuals choose to take hormones as part of their transition, while others may not. Each person’s journey is unique, and what’s most important is finding what feels right for you.

Can you refer me for Gender Affirming Surgery?
Yes. However please note that there is a lengthy process after this point. Read more about the publicly funded process HERE and more information on the privately funded process can be found HERE.

What can I expect at my first appointment?
Once a referral is received, it will be sent to our clinic team. The clinic team will then decide if your needs are medical or non-medical. If they are medical, then an appointment will be set up with our Gender Affirming GP; if non-medical then the appointment will be made with one of our Peer Support workers. If the appointment is with our GP and a detailed referral has not been filled out, then your first appointment will be mainly information gathering. Understanding your needs, your journey and what your expectations of gender affirming care are. If your referral form has been filled out in detail, then less information gathering will be needed and a course of action can be looked at.

 

FAQ – GENERAL:

What Gender Affirming Healthcare guidelines does this clinic follow?
We follow the PATHA – Professional Association for Transgender Health Aotearoa – Guidelines for gender affirming care – both for prescribing in primary care (2023) and gender affirming care guidelines (2018). Updated guidelines for gender affirming care are being written currently and will be adhered to once they are published. We also follow the WPATH Standards of Care, Version 8.

How do we know that this practice is safe?
We have a monthly Multidisciplinary Team (MDT) meeting between various health professionals working in the space, which is in line with the WPATH Standards of Care, Version 8 and international standards and a monthly referral triage meeting. As well as this, everyone in the team and those who are connected to the clinic undertakes regular upskilling and training. Gender affirming care has been widely shown to be safe and to improve both mental and physical health outcomes for trans and gender diverse people.

Can someone under 18 come to the clinic without the parent knowing?
Yes, but we will always encourage the involvement of parents/guardians wherever possible and would only continue to care for the young person after careful deliberation, multidisciplinary team discussion, and if we believe that refusing to treat would negatively impact on the young person’s health. Under s36 of the Care of Children Act 2004, a child of/or over the age of 16 can consent to any medical or surgical treatment, or procedure. At common law, a child under the age of 16 may be able to give consent to medical procedures and treatment, decided on a case by case basis. This is referred to as “Gillick competence”. Making a decision about whether an individual has the capacity to consent can be difficult and require, in addition to considering intellectual maturity, careful professional judgement about whether the young person’s mental state interferes with their capacity to consent to assessment or treatment. Where we judge that a child/young person does not have capacity to give consent, a guardian (usually a parent) can consent on the child/young person’s behalf if the child or young person is under 18 years. Children who are judged not to have the capacity to consent still have a right to information about themselves and their treatment. If there is no guardian in New Zealand or no guardian of that kind can be found with reasonable diligence or is capable of giving consent, by a person in New Zealand who has been acting in the place of a parent.

Will you talk to patients about de-transitioning?
Each patient will get an information booklet which includes information on de-transitioning. If the client indicates they need further information than is provided, then the GP will supply them with the appropriate resources.

 

Further Queries/Questions – email: health@pridewhanganui.co.nz