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OIA response: AVOIA25p. 9-17HR20210124Download
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Officials outline barriers that New Zealanders face when they desire publicly funded medical interventions to modify sex traits. Interventions include surgeries and hormone treatments. In sections 29-31, officials discuss how requiring a diagnosis of gender dysphoria and an assessment by a psychologist before a child begins puberty suppression “can become problematic” . Officials argue that because Māori (supposedly) believe in gender identities, requiring an assessment may lead to “misalignment with indigenous and cross-cultural understandings”. A proposed solution is for national guidelines to clarify those desiring sex trait modifications (presumably including children) should be available without “the agreement of a mental health professional in all cases”.

However, some DHBs require a diagnosis of gender dysphoria to begin hormone treatment, and some require children to get a private assessment by a psychologist before starting puberty blockers or hormone treatment.

This approach can become problematic because requiring a diagnosis of gender dysphoria to transition creates barriers and can pathologise and stigmatise gender diversity. It is also important to consider potential misalignment with indigenous and cross-cultural understandings, for example takatāpui for Māori. Takatāpui embraces all Māori with diverse gender identities, sexualities and sex characteristics.

A potential solution to explore is implementing consistent national guidelines for eligibility to access gender-affirming care. Informed consent means enabling transgender people to take the decision to transition themselves, without requiring the agreement of a mental health professional in all cases.

Authors
Ministry of Health Officials