CORPORATE OFFICE
Level 1
32 Oxford Terrace
Telephone: 0064 3 364 4160
Christchurch Central
Fax: 0064 3 364 4165
CHRISTCHURCH 8011
[email address]
15 May 2019
Gloria Fraser
Email: [FYI request #10073 email]
Dear Gloria
RE Official Information Act request CDHB 10079
I refer to your email dated 12 April 2019 requesting the following information under the Official
Information Act from Canterbury DHB regarding gender affirming healthcare availability. Specifically:
1. Are transgender healthcare providers under the Canterbury District Health Board encouraged to
follow Oliphant et al’s (2018) Guidelines for gender affirming healthcare for gender diverse and
transgender children, young people and adults in Aotearoa New Zealand? If not, which guidelines
do they follow, if any?
The Oliphant (2018) Guidelines for gender affirming healthcare have been used to inform the
Canterbury DHB Clinical HealthPathway relating to transgender healthcare. These guidelines are
endorsed and used as a reference point by those clinicians working in the provision of transgender
healthcare.
The World Professional Association for Transgender Health (WPATH) guidelines are also taken into
account.
https://www.wpath.org/about/ethics-and-standards
2. Is a readiness assessment required to access gender-affirming healthcare services? (This is an
assessment of readiness for treatment from a medical and psychosocial perspective, as well as
whether the client understands the risks and benefits of treatment, and is sometimes referred to
as a ‘mental health assessment’).
Yes an assessment by an appropriate psychologist or psychiatrist (with experience in gender dysphoria)
is required before referral can be made to Secondary care (Canterbury DHB) services. These
assessments can be obtained via the public system (CAF or adult mental health) or via private clinicians
(listed on HP) with expertise. Only ONE assessment for endocrinology or surgical services is required.
Patients only require a second assessment for Genital reassignment surgery. Previously this assessment
was required to go on the waitlist but currently the original assessment (for hormones or other gender
affirming surgeries) is enough. This acknowledges the long waitlist for genital reassignment surgery and
an assessment will be arranged closer to the surgery date.
3. If a readiness assessment is required to access gender-affirming healthcare services, who carries
out this assessment? Is this assessment funded by the Canterbury District Health Board? Does the
assessment use an informed consent model?
As above. Yes an "informed consent model" is used.
4. What steps is the Canterbury District Health Board taking to improve healthcare provision for
transgender New Zealanders?
The Canterbury DHB has been working through Canterbury Clinical Network over the past two years to
improve services for gender diverse people.
Actions to date include:
Setting up a new Community Advisory Group for gender diverse peoples in Canterbury, which will
have appropriate consumer, whānau, Maori, PHO and clinician membership;
Clarifying and streamlining referral pathways from general practice to secondary care (and the
corresponding clinical guidelines, Hospital and Community HealthPathways for general practice, have
been updated);
Organising the appointment of a CDHB clinical champion for the organisation (one of our surgeons)
Gender Diversity/ transgender health has become part of the Canterbury Child & Youth Health
Workstream‘s annual work plan.
Ongoing lobbying for increased trans-friendly mental health services for those that need them to
improve mental health equity.
I trust that this satisfies your interest in this matter.
Please note that this response, or an edited version of this response, may be published on the
Canterbury DHB website after your receipt of this response.
Yours sincerely
Carolyn Gullery
Executive Director
Planning, Funding & Decision Support