Transgender health services for the Northern region

More information

Health Pathways

Health professionals can find more information on the Auckland Regional Health Pathway for gender diversity and transgender health (external link) . Search for transgender.

Healthpoint

Transgender and gender diverse people, families supporting transgender whānau, and health professionals can find information on available services on the Northern Region Transgender Health Services Healthpoint page.

*Transgender – This term is used as a generic word which acknowledges the diversity of terms that people may use to describe themselves. This can include (but is not limited to): Aikāne, Akava’ine, Fa’afafine, Faafatama, Fafafine, Fakaleiti, Māhū, Trans, Transsexual, Genderqueer, Tāhine, Whakawahine, Tangata ira tane, Vakasalewalewa, Palopa and non-binary.

Planning updates

July 2018 Update

 In this update:

  1. Hauora Tāhine – a new name for transgender health services
  2. Counting Ourselves Survey
  3. Pathways for Northland
  4. Transgender Awareness Week 2018
  5. Reminder about feedback on Transgender Health Services

Hauora Tāhine – A new name for Transgender Health Services

Hauora Tāhine – Pathways to Transgender Healthcare Services is the new name for services delivering healthcare to transgender people in the Northern Region. We think the name better describes the patient journey to access gender affirming healthcare.

Following a consultative process the name was gifted to the Northern Region Transgender Clinical and Consumer Advisory Group by Shannon Anahera White, a member of the Northern Region Transgender Clinical and Consumer Advisory Group.

A visual identity for Hauora Tāhine has been developed, this will be used to visually link and signpost the different aspects of transgender healthcare services -  see logo featured on the right.

About Hauora Tāhine

Hauora Tāhine, meaning transgender health contains a new word in the Māori language, Tāhine.

At the Hui Takatāpui, a group of Māori transgender women met to discuss language. Hira Huata noted “the word tāhine came out of my mouth as we were exploring other words that we feel describes us and we feel we have an affinity to…we together decided that the word tāhine empowers us.” The word tāhine, meaning transgender, has received mana through its use by those who live daily as tāhine, those who walk the talk and named that walk.

The use of the word, tāhine, has been endorsed by Te Taura Whiri i te Reo Māori, Māori Language Commission and Dame Naida Glavish ONZM, JP, Chief Advisor Tikanga Māori Health , He Kāmaka Waiora, Waitematā, Auckland and Counties Manukau DHBs.

Counting Ourselves Survey

Counting Ourselves is a survey about the health of transgender and non-binary people living in Aotearoa. The survey asks about mental and physical health; experiences of stigma, discrimination and violence; experiences in the doctors clinics, hospitals and other services; and how help and support from friends and whānau might support those experiences.

The survey is primarily funded by the Health Research Council of New Zealand and can be completed by anyone transgender or identifying as gender diverse identifying who are 14 years or over. To find out more or complete the survey, visit: http://countingourselves.nz/ (external link)

The survey is open until September 2018.

Pathways for Northland

The Transgender Health pathway for Auckland is now available in Northland. While not localised for the services available in Northland, the pathway provides information on providing competent care for transgender and gender diverse people.

This change has been led by Chief Medical Officer for Northland DHB Dr Michael Roberts to imporve pathways for transgender people in Northland.

GPs and otherprimary care providers can access clinical information on blockers, hormone therapy and other information through the Northland Health Pathways (external link) .

Transgender Awareness Week – 12th to 20th November 2018

Transgender Awareness Week, is a focussed opportunity to educate and raise awareness about gender diverse and transgender people, and the issues associated with transition or identity. The week ends with Transgender Day of Remembrance, to remember those who have died as a result of transphobia or prejudice.

This year we will be working alongside community organisations to celebrate Transgender Awareness Week. It will be an opportunity to celebrate five years of the Transgender Health project, as well as promoting healthcare services that are available to transgender people in the Auckland region.

If you, your service or organisation would like to join us in celebrating Transgender Awareness Week, please get in touch! You might like to hold your own event, contribute to one of the above events, or provide other resources. Email the Transgender Health Project Manager on Duncan.matthews@waitematadhb.govt.nz 

Feedback on Transgender Health Services

The Hauora Tāhine teams welcome feedback from your experience of our services. Please tell us what you think here (external link) . Feedback can be anonymous.

February 2018

In this update:

  1. Pride Festival 2018
  2. Posters and brochures for Transgender Health Services
  3. Melanie Adriaansen, Waitemata Laboratories recognised for academic article
  4. Looking forward to Transgender Week of Awareness 2018
  5. Reminder about Transgender Health Services feedback

Pride Festival 2018

photo of transgender health services team at the pride parade

Around 15 people joined the recent Auckland DHB Rainbow Network entry in the recent 2018 Auckland Pride Parade to raise awareness of the Transgender Health Services available in Auckland. Dressed in the colours of the transgender flag and holding placards, the group represented people from the Centre for Youth Health, Funding and Planning, Northern Region Transgender Clinical and Consumer Advisory Group and community.

The presence and visibility was well received, with a number of positive comments from marchers in other floats and spectators of the parade.

Transgender Health Services also planned a presence at the Big Gay Out held in Coyle Park on the 11th February. Unfortunately, due to the weather and health and safety requirements, the Big Gay Out event was cancelled soon after setup.

Posters and brochures for Transgender Health Services

The Transgender Health Services have a new poster and brochure available covering what is available in Auckland.

Download copies of the poster [PDF, 259 KB] and brochure here or email the Project Manager to order printed copies: duncan.matthews@waitematadhb.govt.nz

Melanie Adriaansen, Waitemata Laboratories recognised for academic article

Melanie Adriaansen has been selected as the winner of the New Zealand Institute of Medical Laboratory Sciences (NZIMLS) Journal prize for 2017 for her article “Binary male-female laboratory reference ranges do not reflect reality for transgender individuals on sex-hormone therapy”. A special thanks to Melanie for her work in this area, contributing to the New Zealand base of knowledge and research about healthcare for transgender and gender diverse people.

Read the full article here. (external link)

Looking forward to Transgender Week of Awareness 2018

Transgender Week of Awareness (TWoA) is celebrated internationally, with the purpose to educate about transgender and gender diverse people, transition and identity. It is celebrated in the week before Transgender Day of Remembrance (TDoR), which memorialises victims of transphobic violence.

In 2018, TWoA will be celebrated from the 12th to 18th November. The Transgender Health Services team is planning to use this week of international celebration to raise awareness of the resources available to transgender people at the DHB, both internally to our staff and externally to the public.

To learn more about TWoA, visit the Wikipedia entry (external link) .

Feedback on Transgender Health Services

A reminder that the Northern Region Transgender Health team welcome feedback from those with experience of our services. Feedback, anonymous or otherwise, can be submitted online (external link) .

October 2017

In this update:

  1. Auckland Regional Health Pathways for Gender Diverse and Transgender Health live
  2. Healthpoint page for Transgender Health Services live
  3. Two new Advisory Group members
  4. Reminder about Transgender Health Services feedback

Auckland Regional Health Pathways for Gender Diverse and Transgender Health live

 We’re happy to advise that the new Transgender and Gender Diverse Health pathway is now live on Auckland Regional Health Pathways (external link) .

The pathway is primarily designed to support GPs and Primary Care teams, but contains a wealth of information that is relevant to anyone working with transgender people across the health system. Just some of the areas covered are:

  • Referral to Northern Region Transgender Health Services
  • Monitoring ongoing hormonal treatments
  • Information about screening
  • Supporting holistic wellbeing
  • Basic competency working with transgender patients.

Access to the live pathways requires a login to Auckland Regional Health Pathways (external link) .  As noted, HealthPathways is aimed at general practitioners and practice nurses, but can also be used by hospital specialists and managers, community and allied health providers.

Healthpoint page for Transgender Health Services live

Healthpoint provides up-to-date information about healthcare providers, referral expectations, services offered and common treatments. While transgender health was previously covered as a subset of other services, Northern Region Transgender Health Services now have a dedicated page, providing more information to the public on services, and high level information about medical treatments.

The new Healthpoint page is live now.

Two new Advisory Group members

With the resignation of two members from the Northern Region Transgender Clinical and Consumer Advisory Group (NRTCCAG), Paul Vroegop and Jackie Hilton, two new members have been appointed. The remaining members of the NRTCCAG thank Paul and Jackie for their work and contribution since April, and are sorry to be losing their skills and passion from the advisory group.

The two new advisory members are Val Yeung and Lyndon Moore.

Val is a Mental Health clinician at Auckland DHB, new to Aotearoa. Most recently she worked alongside young people working through their gender identity, and their families, in the UK child and adolescent mental health services.

Lyndon is a counsellor at Auckland Sexual Health. He is experienced in working with transgender and gender diverse people on a range of areas, including identity and transition.

Feedback on Transgender Health Services

A reminder that the Northern Region Transgender Health team welcome feedback from those with experience of our services. Feedback, anonymous or otherwise, can be submitted using this online form (external link) .

*Transgender – This term is used as a generic word which acknowledges the diversity of terms that people may use to describe themselves. This can include (but is not limited to): Aikāne, Akava’ine, Fa’afafine, Faafatama, Fafafine, Fakaleiti, Māhū, Trans, Transsexual, Genderqueer, Tāhine, Whakawahine, Tangata ira tane, Vakasalewalewa, Palopa and non-binary.

July 2017

In this update:

  1. Work plan adopted by Advisory Group
  2. Improving referrals to Auckland Sexual Health Service
  3. New mechanism for providing feedback on Transgender Health Services
  4. NRTCCAG Membership
  5. Work plan adopted by Advisory Group

At the Northern Region Transgender Clinical and Consumer Advisory Group (NRTCCAG) meeting on 27th June 2017, the members voted to formally adopt a work plan for Transgender Health.  The plan consists of a mix of short term, achievable goals; as well as longer term, wider reaching aspirations.

The work plan development was led by Project Manager Duncan Matthews, and takes into account the significant amount of work done within the four Northern Region DHBs to date on transgender health, including community consultations held in 2015.  The work plan was reviewed and revised extensively by members of the NRTCCAG, with a prioritisation process to ensure the Clinical Lead, Project Manager and other staff at the DHBs pursue a plan of action focussed  on those areas indicated by the NRTCCAG.

A copy of the work plan can be found here [PDF, 96 KB]. The NRTCCAG, Clinical Lead and Project Manager are excited by the work plan getting to this stage, as it helps form a clear vision for Transgender Health Services in the Northern Region over the next few years.

Improving referrals to Auckland Regional Sexual Health Service

Based off feedback from transgender and gender diverse users of the Auckland Regional Sexual Health Service, which sees the majority of patients for transition related care in Auckland, a new process has been put in place to ensure that the correct name is used at all times, from the first time someone interacts with the service.

Previous issues with old names from old medical records being used was recognised as not good enough. A process allowing any new person entering the Auckland Regional Sexual Health Service for transgender health purposes has been established that allows the correct name to be identified in the very first conversation. Any communication to first appointment will be in that name. Future improvements are still in the works, allowing the referring clinician to identify the correct name directly in referral documentation, working around the limitation of existing patient management systems.

New mechanism for providing feedback on Transgender Health Services

The NRTCCAG has established a channel for providing feedback on the transgender health services received by people in the Northern Region (Northland, Waitemata, Auckland and Counties Manukau DHB’s). Similarly to improving referrals to Auckland Regional Sexual Health, the NRTCCAG members hope to receive feedback that enables them to make meaningful improvements to the health care that transgender and gender diverse people receive in the region.

Feedback can be submitted anonymously, and will be presented to the regular NRTCCAG meetings for consideration and discussion by the group. Click here to go to the online feedback form (external link) .

NRTCCAG Membership

The Northern Region Transgender Clinical and Consumer Advisory Group is now meeting regularly.

The Northern Region Transgender Clinical and Consumer Advisory Group

Rear, L-R: Duncan Matthews (Project Manager Transgender Health), Lorraine Bailey (Funding, Planning and Outcomes), Val Yeung (Turu Ora), Susan Moller (GP), Joe Macdonald (Affinity Services)

Front, L-R: Mo Harte (HealthWEST), Taine Polkinghorne (RainbowYOUTH), Rachel Johnson (Centre for Youth Health), Jeannie Oliphant (Clinical Lead Transgender Health), Peter Thomas (Mahitahi Trust), Shannon White (member Ahakoa Te Aha), Phylesha Brown-Acton (Pasefika LGBTQI Whanau Ora - F'INE)

Absent: Rick Cutfield (Endocrine), John Kenealy (Auckland Regional Plastic Surgery), Lyndon Moore (Auckland Regional Sexual Health Service), Mike Roberts (Northland DHB), Abbi Pritchard (Social Worker ADHB and Genderbridge) 

February 2017

Both the Clinical Lead and Project Manager for the project have now been appointed.  Dr Jeannie Oliphant and Duncan Matthews will bring new focus and energy in progressing this work.  Each of their roles run for a period of two years. They will support the development of the regional Transgender Health service based on the service specification developed out of community and advisory group input in 2015.

This process will be guided by the establishment of a new advisory group. The Northern Region Transgender Clinical and Consumer Advisory Group (NRTCCAG) will include both clinical and consumer representation which  will be an ongoing feature of the Transgender health services project going forward. Applications are open until 12 March 2017. Please contact the Project Manager Duncan Matthews: duncan.matthews@waitematadhb.govt.nz for more details.

With the establishment of a new Advisory Group, one of their first tasks will be to develop a work plan for the Transgender health services project.

In the interim, the Transgender Health team have been hard at work on a number of immediate priorities for the region, including updated pathways and information for GPs/Primary Care, and better connection and collaboration between secondary services that are currently providing services for Transgender people.  This work will be open for review with the Advisory Group once established.

April 2016

Initial funding is in place to lay the ground work to deliver better health services for transgender communities in the Northern DHB region covering Counties Manukau, Auckland, Waitemata and Northland DHBs.

The first steps will be to appoint a project manager and a chairperson to lead a Northern Regional Transgender Advisory Group. Job descriptions will be ready for circulation in the next four weeks. The aim is to spread the word widely to people with the experience and knowledge who might be interested in taking up the roles. There will be regular updates on progress.

With support from the DHBs, the team will develop a plan for a Northern region Transgender Care Pathway based on feedback from community and online forums, clinical advice on best practice and a robust evidence base.

Flowchart showing the pathways to care available for our transgender communityPathways to Care

The Pathways to Care diagram (agreed at community workshops) is based on five key principles: 

  • Access - Transgender culturally competent health care services at primary care and community NGO level.
  • Safety - Gender diversity and cultural competence including flexible care pathways .
  • Wellbeing - A whole of health and well-being approach to service delivery.
  • Respect - Self-identification and informed consent.
  • Diversity - Accepting and facilitating conversations in public health context.

The focus of the plan will be to put in place regionally consistent, multi-disciplinary gender health services for children, adolescents and adults experiencing gender identity issues and seeking health services as part of a gender transition. These services may be provided locally or regionally and by one or more providers. 

The Pathways to Care plan will seek to bridge the gaps that have made it hard for transgender patients to access health care. At the heart of the new model is a multi-disciplinary team of health professionals with a broad range of clinical, social and community expertise. Transgender patients would work with a culturally appropriate key worker, who can be any member of the multi-disciplinary team, at their points of contact in their journey through the care pathway.

The overall goal is to provide clinical care to “assist transsexual, transgender, and gender-nonconforming people to achieve lasting personal comfort with their gendered selves, in order to maximize their overall health, psychological well-being, and self-fulfillment.” (World Professional Association for Transgender Health).

January 2016

There has been a positive response to the proposal for future health services for transgender health services in the northern DHB region, covering the Auckland metropolitan DHBs (Auckland, Counties Manukau, Waitemata DHB) and Northland DHB.

The proposal went to senior leaders from the northern DHB region in December 2015, who said it was a robust analysis that set out a pathway to respond to the need for better health services for people in the transgender communities. The project team thanks the Clinical and Consumer Transgender Advisory Group, which includes representatives from specialist and community service providers, NGOs and consumers from the transgender communities for their time, effort and insight.

The next steps will be to seek formal endorsement at senior management and board level in order to create a work plan for 2016 to progress the project.

October 2015

We held a series of community forums in July 2015 to provide input into the development of a proposal for better health services for people from transgender communities, in the northern region. Read the combined summary of feedback from the community forums and online survey [PDF, 354 KB] from September 2015.

June 2015

The Northern region district health boards (DHBs), Northland, Waitemata, Auckland and Counties Manukau are working on a proposal to develop a better health service for people in the region’s transgender communities. An advisory group with transgender representatives will listen to and talk with community groups and health professionals about how to develop a better health service. The project advisory group has to finalise its proposal for consideration by the DHB Boards by December this year.

This advisory group has agreed on some simple principles to create a process that is inclusive and robust:

  • Transgender communities are as diverse as their health needs and health services need to reflect this.
  • We need to focus on the span of life, young and old and wellbeing.
  • We acknowledge the strength and diversity of the transgender communities.
  • By working together we can help to shape a proposal for a health service that responds much better to diverse and complex needs.
  • Transgender people come from all communities and age groups and health services need to reflect this.
  • We acknowledge the many terms used by communities related to their gender identity. Transgender will be used when a generic term is needed.

If you have feedback or would like to register your interest in this work, please do so by contacting: engagement@waitematadhb.govt.nz

By working together we can help to shape a proposal for a health service that responds much better to diverse and complex needs. Transgender people come from all communities and age groups and health services need to reflect this. We acknowledge the many terms used by communities related to their gender identity. Transgender will be used when a generic term is needed. You can read Frequently asked questions [PDF, 184 KB] (external link)  about the project here.