Gender affirming surgery

Find out about transgender surgeries.

This page discusses genital reconstruction surgery and other types of gender-affirming surgeries. It is important to note that this is a general overview only – processes can change, and systems do not always operate exactly the way they are planned, so your experience may differ.

Publicly-funded surgeries

Genital reconstruction surgery (GRS)

The first step is usually to talk with your GP. In Wellington, your GP can refer you to the waiting list for a “first surgical assessment” (FSA). 

In other regions, your GP can refer you to a specialist who can refer you for a FSA. 

In order to be eligible for a FSA referral, you will need to have a psychological appointment. If you have already had one in relation to starting hormones, you won’t need another one until you reach the top of the FSA waitlist.

Your FSA will be conducted once you are at the top of the FSA waiting list – current wait times are approximately 10 years but this could change at any time, so it may be much sooner.

Once you are on the FSA waitlist, the Ministry of Health will contact you every 12 months by post or email. They will ask you to complete a review form confirming that you wish to remain on the FSA waitlist.

When you are near the top of the FSA waiting list, you’ll be sent additional forms, which will ask for specific health information, including your BMI and questions about smoking/vaping. Your answers will influence whether you remain on the FSA waitlist or are considered ineligible.

At your FSA, you’ll meet with a surgeon and discuss the surgery in more detail. The surgeon will give you information about the surgical techniques they can offer, and answer any questions you have. 

If you wish to proceed, and you are considered to be a suitable/eligible candidate for surgery, the surgeon will give you information about the timeframe for surgery and any steps you need to take next. These steps may include permanent hair removal in the surgery area which can take several months to complete, and is funded by the Ministry of Health.

You can access the application/referral form for FSA, along with more information, here.

Other surgeries

The NZ health system also funds some other gender-affirming surgeries. These are different in each region (previously DHB), and are often not provided consistently even in regions where they are technically available.

The first step is generally to speak with your GP or sexual health physician and ask for a referral. 

It is usually a long process to apply for a referral for a first surgical assessment (FSA), there are usually several prerequisites, the criteria for referral is often quite narrow, and wait times are usually long. In some cases you may wait less than 6 months, but in other cases it may take a year or more to receive a FSA. 

The process, prerequisites, and criteria will be different depending on the procedure, regional pathways, and individual surgeon.

At the FSA, the surgeon will discuss the surgery with you and usually confirm whether you meet the criteria of eligibility to receive surgery. If you do, you will receive an appointment notice from your regional health services by post.  

To find out which surgeries are available in your region, see the list here.

Self-funded surgeries

If you plan to pay for a surgery yourself, you have a lot more options regarding the surgical technique you want, the options for surgeons which use the technique you want, and the timeframe you want to receive the surgery. This information is true regardless of the type of surgery you are self-funding.

The first step is usually to research the different techniques (or methods of surgery) and find surgeons who perform the technique you want. 

Next you will contact the admin teams of the surgeons you are most interested in choosing. 

You can ask them any general questions you have, and they will usually send you some info sheets. 

Sometimes they can offer you a price range if you know which procedures you’re interested in. Other times they will not be able to offer a price range until they have more information from you or until you’ve had a consultation with the surgeon. 

In Aotearoa, you will usually need to visit the surgeon in person for a consultation. 

For international consultations, this is usually done online either by video call, or by asking you in depth questions by email. You may be asked for photographs, depending on the circumstances and the type of surgery you are requesting.

At your consultation, you can ask the surgeon any questions you have, including anything specific to your body or particular circumstances.

Different surgeons have different requirements in terms of pre-treatments, and depending on the type of surgery this may include things like permanent hair removal on the surgery or donor site (if they need to take tissue from elsewhere on your body), requirements to take hormones for a certain time period prior to surgery, or psychological appointments.

Your surgeon or their admin team will inform you what these requirements are, and discuss a time frame for receiving your surgery.

Surgical techniques

Find out about surgical techniques and types of surgeries.


Find Aotearoa based and international surgeons.

Surgical considerations

Things to consider when planning your surgery. Some of these only relate to genital surgeries, and others relate to gender-affirming surgeries more broadly. You have a right to ask your surgeon questions about the surgery, and in NZ they have a legal obligation to tell you about your options.

Other considerations

Other costs and issues to consider when planning your surgery.


  • How do you feel about visible scars?
  • Do you prefer some scars over others?
  • Is skin sensation important to you?
  • Is sexual sensation important?
  • Is it important to urinate standing up?
  • Is it important to have penetrative sex using your surgically created vagina or penis?
  • Do you have any health conditions or disabilities which may restrict your options?
  • Do you know the risks involved with the surgery/technique, and how do you feel about the risks?
  • Are you prepared to have more than one surgery or revision?


  • Financial considerations.
  • Medical documents/records.
  • Health insurance/travel insurance.
  • Transport costs.
  • Time away from home/work.
  • Accommodation after surgery.
  • Recovery period.
  • Having someone to support you at the clinic.
  • Support while you’re recovering.