MINISTER OF HEALTH
Mr Tim Barnett
ORIGINAL SUBMITTED FOR YOUR
SIGNATURE
MP for Christchurch Central
Electorate Office
PO Box 13295
...............................................................
for Director-General of Health
CHRISTCHURCH
Date:
18/3/03
Ministerial Number: 03000916
H Number:
H200300794
Attention: Lynne Lulham
Name of Section:
CMS
Contact Person:
Tanith Robb
Phone:
2676
Peer Reviewer:
Christine Andrews
Dear Tim
File Number:
HC01-52-0-2
Thank you for your letter of 11 March 2003 (REF: LL637) enclosing correspondence
from 9(2)(a)
regarding funding of gender reassignment surgery.
I appreciate that gender reassignment surgery is a very emotional issue for some
people. However, gender reassignment surgery is a small part in the process of
gender reassignment and should only be considered when it is clinica ly appropriate.
Policy development relating to gender reassignment services is complex and it is
important to make sure that we get it right. Important progress has been made on
policy surrounding this issue. In particular, I am informed the Ministry of Health has
initiated work on gender dysphoria services including gender reassignment services.
This work will review access to, and the availability of, gender dysphoria services
throughout New Zealand within current resources.
The Ministry of Health is currently surveying all district health boards (DHBs), asking
for details of their gender dysphoria services. It is also convening a national meeting
of clinicians with expertise in managing gender dysphoria. This workshop will take
place in April 2003 and is intended to be the first step in the development of clinician
support material aimed at general practitioners (GPs). I expect this material will
include:
• a register of clinicians with an interest and expertise in management of
gender dysphoria
• clinical guidelines to support consistency of approach to clinical issues
RELEASED UNDER THE
arising from gender dysphoria. These may be newly developed guidelines
or they may be an endorsement of guidelines already in existence overseas.
Consumers will be involved in the development of this material. The material will aim
to:
OFFICIAL INFORMATION ACT
• improve knowledge around gender dysphoria issues amongst GPs
• improve consistency of advice and clinical care to consumers
• facilitate referral of consumers to appropriate specialists.
The initial focus of this initiative will be to improve services other than formal gender
reassignment surgery. This includes hormonal treatment, psychological and
psychiatric services and non-gender reassignment surgery (mastectomy,
orchidectomy, hysterectomy). DHBs will be reminded of their obligation to provide
these services. Formal gender reassignment surgery will then be considered as part
of the continuum of care provided. Issues such as funding, international best
practice and availability of appropriately trained surgeons will need to be considered.
This initiative replaces earlier plans to establish a national committee to review
individual applications for gender reassignment services under the Special High Cost
Treatment Pool. It represents an important step forward because it will allow for a
fuller consideration of the complex clinical and definitional issues involved, and the
most effective way services can be provided to New Zealanders needing such
services. It will also allow for clear decisions about which services at which stages in
the process of reassigning gender should be publicly funded.
As I previously stated, a letter has already been sent to relevant specialists at each
DHB and there will also be a meeting of experts as soon as the responses to the
letters to DHBs have been collated. The Principal Medical Advisor will also be
reporting to me directly on progress.
Thank you for writing.
Yours sincerely
Hon Annette King
MINISTER OF HEALTH
RELEASED UNDER THE
OFFICIAL INFORMATION ACT
