Reforms may ease ‘crisis’ in trans healthcare
Experts hope massive reforms will ease a ‘‘crisis’’ in trans healthcare, which sees many without access to treatments and forced to move cities in search of services.
On Tuesday, the Government announced all DHBs would be abolished, creating one national organisation, Health New Zealand, with four regional divisions.
Health Minister Andrew Little said the shakeup was necessary to end the ‘‘postcode lottery’’ of care, calling for the system to ‘‘listen’’ to the rainbow community.
Senior researcher at Waikato University Jack Byrne said the reforms presented a ‘‘real opportunity’’ for gender affirming healthcare.
Access to services including hormone treatments, counselling and surgeries was in ‘‘crisis’’, differing dramatically between regions.
‘‘In many places there’s literally no trans health pathway, and in a few places there’s a limited amount of services.’’
About two-thirds of trans men can’t access chest reconstruction where they live, no DHBs provide laser hair removal and few provide voice training for trans women, Byrne said.
Even inexpensive hormone treatments could be difficult to find, people on the West Coast, for example, have to drive to Christchurch to get them.
The reforms opened the door for a national strategy on gender affirming healthcare.
It created the possibility for more development of trans health services at a primary level, such as through GPs, Byrne said.
‘‘There’s some real opportunities here for community targeted services.’’
Cost of services was another major barrier, and more funding needed to be addressed through the national strategy.
‘‘For young people, at a time in your life when you should be completing your education, or doing your job, and having fun, instead you’re spending all of your time trying to fund your healthcare.
‘‘Most people I know plead with KiwiSaver to fund services, they are more likely to be successful doing that if they’re older.’’
He was pleased Little had mentioned rainbow voices, but called on the Government to actively consult with trans organisations in designing the new system.
Rainbow advocate Moira Clunie said they hoped the reforms would bring more consistent guidelines for health professionals.
In some parts of the country, GPs can prescribe hormones with informed consent – where a patient discusses possible impacts and signs a form for the treatment.
‘‘In other parts of the country [DHBs] still require a specialist mental health assessment to see whether someone might be ready to take hormones.
‘‘It sort of puts a barrier in place for that person to access what they need,’’ Clunie said.
In some cases it was more education and understanding that was needed in the health system, rather than just more money.
People shouldn’t have to uproot their lives or launch an online funding campaign to access essential services, Clunie said.