Corporate Services
15 May 2019
Gloria Fraser
Ema
il: [FYI request #10076 email] Dear Gloria
YOUR OFFICIAL INFORMATION ACT (1982) REQUEST HBDHB REF: OIA2019054
I refer to your Official Information Act request dated 12 April 2019 where you requested information from
Hawke’s Bay District Health Board (HBDHB). Your questions and HBDHB’s response is provided below:
1. Could you please advise whether the following gender-affirming healthcare services are funded by
the Hawke’s Bay District Health Board for transgender patients, and whether the services are
currently available:
- Puberty blockers
- Hormone therapy
- Mastectomy
- Hysterectomy
- Orchidectomy
- Facial hair removal
- Breast augmentation
- Voice training
- Facial feminization surgery
HBDHB provides both puberty blocking therapy and cross gender steroids (‘hormone therapy”).
Puberty blockade (which is largely reversible) is utilised primarily by HBDHB paediatricians, with
back up advice/support from HBDHB and Starship endocrinology staff.
Cross gender steroids (which are irreversible) are provided through HBDHB’s adult endocrinology.
There is also a general practice –based GPSI service (General Practitioner with Special Interest) run
by a Hawke’s Bay GP, in collaboration with hospital-based services. All the other services listed
above are tertiary level and not provided by HBDHB.
2. Are transgender healthcare providers under the Hawke’s Bay 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?
Yes, HBDHB bases its services on the Oliphant Guidelines.
3. 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’).
Readiness/psychological assessments are completed before embarking on any puberty blockade or
hormonal treatment, always using an informed consent model. HBDHB’s paediatric team also see
C H I E F E X E C U T I V E ’ S O F F I C E
Hawke’s Bay District Health Board
Telephone 06 878 8109 Fax 06 878 1648 Email:
[email address]; www.hawkesbay.health.nz
Corporate Office, Cnr Omahu Road and McLeod Street, Private Bag 9014, Hastings 4156, New Zealand
some children with gender dysphoria, who are followed for some years without intervention. In
these cases, psychological assessments are not completed as they do not progress to treatment.
4.
If a readiness assessment is required to access gender-affirming healthcare services, who carries out
this assessment? Is this assessment funded by the Hawke’s Bay District Health Board? Does the
assessment use an informed consent model?
Refer response provided to question 3 above; services provided at Hawke’s Bay Hospital are funded
by HBDHB for patients eligible for publicly-funded healthcare.
5.
What steps is the Hawke’s Bay District Health Board taking to improve healthcare provision for
transgender New Zealanders?
HBDHB has taken a number of steps to improve its transgender services over the past few years
including:
Multidisciplinary group established to map current services and provide guidance for referrers
(Map of Medicine approach).
Development of GPSI service with increasing amount support from Primary Care.
Establishment of Transgender Multi-Discipline Team (MDT) which meets monthly to discuss
active cases and agree on best management. Members include adult endocrinologist,
paediatric endocrinologist, GP with Special Interest, clinical psychologists, endocrine clinic
nurse, clinical nurse manager, psychiatrists, registered social worker and planning and
commissioning manager.
Supporting staff members to attend national and international meetings as part of their
professional development to improve knowledge and skills.
I trust this information meets your needs. If you would like any further information or clarification please
phone me. If you are not satisfied with this response you may contact the Office of the Ombudsmen,
phone 0800 802 602.
Please note that this response, or an edited version of this response, may be published on the Hawke’s Bay
DHB website after your receipt of this response.
Yours sincerely
Kevin Snee
CHIEF EXECUTIVE OFFICER
cc:
Ministry of Health via email: [email address]
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