Southern District Health Board
Dunedin Hospital
201 Great King Street
Private Bag 1921
DUNEDIN 9054
Chief Executive Officer
Phone 03-476 9456 Fax 03-476 9450
10 May 2019
Gloria Fraser
By Email:
[FYI request #10084 email] Dear Ms Fraser
Official Information Act Request
I refer to your Official Information Act request received on 16 April 2019 in which you specifically
requested the following:
Could you please advise whether the following gender-affirming healthcare services are funded
by the Southern District Health Board for transgender patients, and whether the services are
currently available:
Puberty blockers
Puberty blockers are funded by the Southern DHB and currently available.
Hormone therapy
Hormone therapy is funded by the Southern DHB and currently available.
Mastectomy, Hysterectomy, Orchidectomy, Breast augmentation, Facial feminization surgery
Patients wanting Gender Reassignment Surgery (GRS) are generally referred to the GRS
surgeon in Auckland.
Facial hair removal
Facial hair removal is currently not available at Southern DHB.
Voice training
Voice training is currently not available at Southern DHB.
Could you please also advise:
Are transgender healthcare providers under the Southern 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?
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These guidelines have recently been published, and one of the authors works in the Adult
Southern DHB Endocrinology Department. We are moving towards integrating these
guidelines into our practice. The Child Health Service utilises New Zealand guidelines as well
as reference to international resources such as the Endocrine Society Clinical Practice
Guideline.
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’).
All patients seen in the Adult Endocrine Clinic must have been assessed by a psychologist or
psychiatrist prior to being seen in the clinic.
If a readiness assessment is required to access gender-affirming healthcare services, who
carries out this assessment?
Individuals are usually seen by a psychiatrist within the Southern DHB or Otago region.
Is this assessment funded by the Southern District Health Board? Does the assessment use an
informed consent model?
If this is done by a Southern DHB psychiatrist, it is a funded assessment. The patient is fully
informed about the process and provided with a copy of the assessment report that is sent
to the endocrinology service. In Child Health the assessment uses an informed consent
model and is funded by the Southern DHB.
What steps is the Southern District Health Board taking to improve healthcare provision for
transgender New Zealanders?
The Southern DHB is committed to continue to provide publically funded gender-affirming
healthcare services.
You have the right to seek an investigation and review of our decision by the Ombudsman. The
Ombudsman's Office can be contacted on 0800 802 602 or on-line at
http://www.ombudsman.parliament.nz/. Yours sincerely
Chris Fleming
Chief Executive Officer
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