Yesterday, Labour MPs were questioned by the media about a policy remit put forward by Young Labour to ensure access and public funding to hormone replacement therapy and gender reassignment surgery. The proposal passed through two Young Labour regional party conferences, but still has a long way to go before even becoming part of the Labour Party’s policy platform. However, it does bring to the foreground issues as to the current state of access to gender reassignment surgery in New Zealand currently.
The current policy in place for those wanting gender reassignment surgery is not only incredibly expensive, but also extremely onerous. The Ministry of Heath has implemented four phases of gender transition after a diagnosis of Gender Identity Disorder:
- Real life experience in the desired role
- Hormones of the desired gender
- Surgery to change genitalia and other sexual characteristics
The first stage requires assessment by both a psychiatrist and psychologist, proving that a person has lived and worked full time as their gender for two years. The second stage requires demonstrating knowledge of the consequences of taking hormones and proving they you can take those hormones in a responsible manner, after documenting real-life experience and/or counselling for more than 3 months. The third stage involves multidisciplinary evaluation to ensure that all consequences of the surgery are carefully considered. This requires more than a year of continuous hormonal treatment, more than 2 years continuous real life experience as the applicant’s preferred gender and evaluation in the form of two psychiatric reports by senior psychiatrists with experience in the field, of one which must be a non-treating doctor, and 1 psychologists report from a senior psychologist or social worker with experience in that field. The fourth stage is follow up monitoring and check-ins. On top of all of this, the person must fly to Australia to have the surgery, as the only surgeon in New Zealand able to perform such surgery has retired.
Minister of Health Jonathan Coleman says he is happy with the current funding and that the government has dismissed the policy proposal on expanding it, describing it as “nutty”. The current funding only allows for four people to receive this surgery every two years. With a current 73 people on the waiting list, it will be over 36 years before all of them receive surgery. That will be in addition to the people that join the list as time goes on. The current funding situation means that people have to wait years before treatment is available, or pay the estimated $120,000 themselves to get the surgery done. Even waiting for the time itself may not be enough, as eligibility to for the surgery is based on Ministry of Health criteria.
The lack of government funding for most seeking gender reassignment surgery means that they have to foot the bill themselves. The process is thus inherently unequal. Paying for the surgery is not easily done, as most New Zealanders do not have $120,000 to spare. The lack of access to gender reassignment surgery can have detrimental consequences on a transperson’s mental health, emotional well being and ability to live comfortably in social situations. Their inability to access the surgery is based upon wealth and having to pass extensive and rigorous criteria, yet has severe consequences on the individual. The policies in place to allow access to the surgery should be looked at to allow a more equitable outcome.
Public funding for gender reassignment surgery is still a long way off from becoming a Labour Party policy, even further from becoming law. But it does highlight the concerns that surround the inability for many transpeople to access what some would perceive as a surgery vital to their well being. Given the lack of support from MPs, complete public funding seems an unlikely policy outcome for Labour’s policy platform, but hopefully it is addressed in some way, and gender reassignment surgery is made more readily available for New Zealanders who need it.
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