26 January 2021
OIA Reference #: OIA2020112601
Aly
Email:
[FYI request #14177 email]
Tēnā koe Aly
Official Information Act 1982 (OIA) – Response – OIA2020112601
Thank you for your official information request regarding gender-affirming health services, which was
received by Capital & Coast District Health Board (CCDHB) on 26 November 2020. You requested the
following information:
1. Whether hormone therapy services are funded by the Capital & Coast District
Health Board for transgender patients, whether hormone therapy services are
currently available, and the process of accessing those services that are available.
2. Is care available on an Informed Consent basis?
3. Specifically, is an assessment by a mental health professional required in order to
access gender-affirming healthcare services? If so, which services?
4. In the case of hormone therapy, can primary health providers prescribe
hormones, or does this have to be initially approved by an endocrinologist?
5. Is any period of real life experience required to access hormone therapy?
On 23 December 2020, we notified you that you could expect a response from us on or by 26 January
2021.
Our response to your request is outlined below.
Response
1. Whether hormone therapy services are funded by the Capital & Coast District Health Board for
transgender patients, whether hormone therapy services are currently available, and the process
of accessing those services that are available.
Gender-affirming hormonal therapy in clients over 18 years of age is commenced by the Endocrine
service at CCDHB following referral from a General Practitioner. Gender-affirming hormonal therapy can
also commence at several selected primary care sites throughout the region, including youth one-stop-
shop practices and tertiary education student health practices. Patients under 16 years of age are seen
by CCDHB’s paediatric endocrinology service, while clients between the ages of 16-18 may be seen by
any of the above services.
Capital & Coast DHB | Private Bag 7902, Newtown, Wellington 6242
Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021
www.ccdhb.org.nz | Phone: 04 385 5999
| Fax: 04 385 5856
2. Is care available on an Informed Consent basis?
Yes, care is available on an informed consent basis.
3. Specifically, is an assessment by a mental health professional required in order to access gender-
affirming healthcare services? If so, which services?
Hormone therapy
For patients over 18 years old, a readiness for hormonal therapy assessment is required prior to a
meeting with an endocrinologist or prescribing general practitioner. The assessment comprises a
number of specified aspects and is typically conducted by a mental health professional, although this
assessment could potentially be conducted by any health professional with adequate skills and
experience. In Wellington, this assessment is provided for young adults and adults (over 16 years old)
by a clinical psychologist working within the Endocrinology department. A clinical psychologist
employed by Wairarapa District Health Board is due to complete these for adults (over 18 years old) in
the Wairarapa region, or by one of a number of clinical psychologists working in the private sector.
For children under 16 years of age, a paediatric endocrinologist will assess children entering puberty for
discussion on puberty blocking hormones. They may be referred on to the adult service after this
assessment, if that appears best for the young person – especially in a developmental sense.
For 16-18 year olds, the paediatric endocrinology team ascertains from the primary care referrer which
pathway will best suit the young person’s needs (which often depends on what else is going on in their
life, including co-morbidities). After that step, they could either be seen by the adult service or by the
paediatric service, with involvement of the Child and Adolescent Mental Health Service / paediatric
endocrine service.
Hysterectomy and Orchidectomy
Readiness assessments are required for these services.
4. In the case of hormone therapy, can primary health providers prescribe hormones, or does this
have to be initially approved by an endocrinologist?
As stated in our answer to Question 1 above, gender-affirming hormonal therapy can also commence at
several selected primary care sites throughout the region, including youth one-stop-shop practices and
tertiary education student health practices.
5. Is any period of real life experience required to access hormone therapy?
No there is no period of ‘real life’ experience required to access hormone therapy.
Capital & Coast DHB | Private Bag 7902, Newtown, Wellington 6242
Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021
www.ccdhb.org.nz | Phone: 04 385 5999
| Fax: 04 385 5856
I trust this information fulfils your request. You have the right, under section 28 of the OIA, to seek an
investigation and review by the Ombudsman of this decision. Information about how to make a
complaint is available at
www.ombudsman.parliament.nz or you can free phone 0800 802 602.
Ngā mihi
Fionnagh Dougan
Āpiha Whakahaere Mātāmua | Chief Executive
Capital & Coast DHB | Private Bag 7902, Newtown, Wellington 6242
Wellington Regional Hospital, Riddiford Street, Newtown, Wellington 6021
www.ccdhb.org.nz | Phone: 04 385 5999
| Fax: 04 385 5856
