02 November 2018
Ruth Hil
Reporter
Radio New Zealand
P O Box 123,
Wel ington 6140
E-ma
il: Ruth.Hil @rnz.co.nz
Dear Ms Hill,
Official Information Act (1982) Request
I write in response to your Official Information Act request, received 04 October 2018. You requested
the following information:
1.
How many people were referred to the DHB for gender reassignment hormone therapy
each year since 2006 until the present time?
2.
How many were treated within the DHB and how many were referred to another DHB? If
so, where?
3.
What was the breakdown of ages in each of those years (youngest/ oldest/ median age)?
4.
How many were transitioning male to female and how many female to male in each of
those years?
Our response uses information from the Centre for Youth Health and Auckland Regional Sexual
Health outpatient services. There are limitations in the patient medical files coding systems, which
would necessitate a significant manual audit of patient files to answer some of your queries. We are
providing information that is reasonably accessible either from electronic coding, service reporting,
or information prepared in response to other Official Information Act requests, covering provision
since 2014/15.
Consequently, the information provided below has some limitations, which are noted alongside the
relevant data. Some of the data may be available for one service or DHB, where it not is available for
another. Where applicable, this has also been noted below each question.
We also note that your query is specific to referrals for Hormone Therapy. However, the data
available is for the total number of patients referred for Gender Affirming Care. Therefore, in each
data table provided there may be included a cohort who have been referred for Gender Affirming
Care, but are not receiving Hormone Therapy. This is most notable for the Centre for Youth Health
service, where it is common for patients to be solely on hormone blockers but not receiving gender
reassignment hormone therapy.
We are not able to provide all of the data you requested, due to the manual y intensive nature of
reviewing patient files, and lack of electronic flags to indicate which files should be reviewed for this
Counties Manukau District Health Board
19 Lambie Drive, Manukau, Auckland 2104 | Private Bag 94052, Manukau, Auckland 2241
T: 09 276 0000 | cmdhb.org.nz
treatment detail. We therefore refuse your request for data on this topic prior to 2014, under Section
18(f) of the Official Information Act, due to substantial col ation or research.
If you are dissatisfied with this decision, you have the right to seek an independent review from the
Office of the Ombudsman, whose contact details are available vi
a www.ombudsman.parliament.nz
We note that with the development of regional Gender Affirming Healthcare Services for Waitemata,
Auckland and Counties Manukau DHB, the recording and reporting of patient information is
improving.
General information about the services available to transgender people presenting for services at
Waitemata, Auckland and Counties Manukau DHB is available at:
https://www.healthpoint.co.nz/public/sexual-health/hauora-tahine-pathways-to-transgender-
healthcare/
1. How many people were referred to the DHB for gender reassignment hormone therapy each
year since 2006 until the present time?
The number of people
referred to the DHB for any Gender Affirming care is extracted from DHB
databases across Metro Auckland DHBs, from 1 July 2014 (
Table 1). Reporting the number of
referrals prior to this date would require substantial manual review and col ation from individual
outpatient medical files.
Year
DHB
2014/15
2015/16
2016/17
2017/18
Counties Manukau DHB
18
56
36
79
Table 1
These numbers represent First Appointments with a person for the purpose of receiving Gender
Affirming Care that may, but does not always include hormone therapy – at either the youth or adult
service. We note these numbers may underestimate of the true number of people receiving
hormone therapy, as some referrals are received by other specialty services. These other referrals
are not coded electronically as specifically related to Gender-Affirming care.
2. How many were treated within the DHB, and how many were referred to another DHB? If so,
where?
Gender Affirming care across Metro Auckland is delivered by two services: Sexual Health delivers an
Adult service, via Auckland DHB; Centre for Youth Health deliver a Youth service, via Counties
Manukau DHB. Both services offer outpatient clinics across Metro-Auckland to the populations of
Waitemata, Auckland and Counties Manukau DHBs. No referrals to other DHBs outside of
Waitemata, Auckland or Counties Manukau DHBs are made for Hormone Therapy.
3. What was the breakdown of ages in each of those years (youngest/ oldest/ median age)?
The ages detailed below (
Table 2) are inclusive of al people referred to and seen by either the youth
or adult service. It includes those who have been referred for gender exploration, but have not
received hormone therapy.
Page 2
Year
2015/16
2016/17
2017/18
Counties Manukau DHB
Min age
Not available1
Not available1
Not available1
Max age
50
61
63
Median age
302
232
292
Table 2 1 Data on ages is not available for those in Counties Manukau DHB who attend the youth service.
2 Median ages for Counties Manukau DHB are calculated using age data for the Adult service only, as
age data for the Youth service for Counties Manukau is not available at this time.
4. How many were transitioning male to female and how many female to male in each of those
years?
This service is run on an outpatient basis, and this clinical treatment information is not coded
electronically. The available information (
Table 3) is based on the current caseload of the Centre for
Youth Health for Counties Manukau cases only.
Year
2015/16
2016/17
2017/18
Counties Manukau DHB
Male to female
163
Female to male
Not Available
143
Non binary
03
Table 3 3 Data complete up to 1 May 2018. Not complete for the ful 2017/18 year.
Further col ation of this data is not possible without extensive manual review of outpatient medical
files.
I trust this information satisfactorily answers your query. If you are not satisfied with this response
you are entitled to seek a review of the response by the Ombudsman under section 28(3) of the
Official Information Act.
Please note that this response or an edited version of this may be published on the Counties
Manukau DHB website.
Yours sincerely,
Fepulea’i Margie Apa
Chief Executive
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