12 July 2019
E-mail: [FYI request #10544 email]
Dear Brodie, Official Information Act (1982) Request
I write in response to your Official Information Act request, that we received on 20 June 2019, via
transfer from the Ministry of Health, under Section 14 of the Act. The Ministry of Health will provide
responses to your remaining questions.
You requested the following information:
• Question 4: How many, if any, transgender individuals have been referred to endocrine
services in New Zealand in the past five years, broken down by year?
• Question 5: How many, if any, transgender individuals have been referred to endocrine
services in New Zealand in the past five years, broken down by DHB?
We can provide a response for Counties Manukau Health (CM Health services). We provide services
to the community of South Auckland (approx. 569,400 people).
In the metro-Auckland region, referrals for most gender-affirming services are referred to the care
of the Centre for Youth Health (for young people), and to the Northern Region Transgender Health
Services (NRTHS), rather than other Specialist Medical Services. We note that the prescribing of some
hormonal medications is restricted in New Zealand and requires a Medical Specialist authorisation,
however, this does not require referral to DHB Endocrine Specialist services.
Publicly available information on the Hauroa Tāhine and Northern Region Transgender Health
Services (NRTHS) service can be accessed via the HealthPoint website at the following link, and may
be of interest: • https://www.healthpoint.co.nz/public/sexual-health/northern-region-transgenderhealthservices/
Please refer to these links (above) for information on the available services, including current
information on provision of the procedures you have listed, and availability of a range of other
supportive services and resources. This includes hormone therapy, nursing, medical, psychology and
Counties Manukau District Health Board
Private Bag 93311, Otahuhu, Auckland
T: 09 276 0000 | cmdhb.org.nz
We are not able to provide all of the data you requested, due to the manually intensive nature of
reviewing patient files, and lack of electronic flags available on files to indicate those that should be
reviewed for this level of 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 collation or
However, we can provide data from 2014/15 to 2017/18 on the number of transgender individuals
in Counties Manukau referred
for gender-affirming care First Specialist appointments. Identifying the
number of referrals prior to this date would require substantial manual review and collation from
individual outpatient medical files. 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).
Counties Manukau DHB
• # These numbers, especially from 2014/15 should be treated with caution, as these reflect a
period of changing and increasing service development and provision, data collation capacity,
and the data was initially prepared regionally rather than per DHB.
• These numbers represent First Appointments with a person for the purpose of receiving Gender-
affirming care; which may but does not always include hormone therapy – at either the regional
youth or adult services. Equally, some of those who have been referred for gender-affirming care
will use services to support gender exploration, but not receive hormone therapy.
We further note these numbers may underestimate of the true number of people receiving hormone
therapy, as some referrals can be received by other medical specialty services. We do not hold
information to identify which of those referrals are related to Endocrine Services for transgender
We are working regionally to improve the clinical coding for all referrals, to be clearer in the future
as to those for gender-affirming care.
We regularly respond to Official Information Act requests related to Gender Affirming Services for
our community. These responses are published on our website and best identified by searching
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
Fepulea’i Margie Apa
Chief Executive Officer Counties Manukau Health