Come to the Department of Internal Affairs (DIA) consultation on the BDMRR, to have your say on how amending birth certificates and getting legal gender recognition should work.
Attend an online hui, and/or make a written submission to the DIA.
Background
In December 2021, parliament voted yes unanimously, to change the Births, Deaths, Marriages and Relationships Registration Act.
When Act changes come into effect, they will remove the family court process for updating sex markers on New Zealand birth certificates, and replace it with a statutory declaration. This is a step forward for trans people, because they will no longer need to medically transition or prove their gender to a judge in order to get an accurate birth certificate.
Several aspects of the new process are regulations, so they were not written into the law. The DIA is seeking feedback from transgender and intersex people on what those regulations should be.
Which sex markers people should be allowed to use, besides Male and Female. There will eventually be a list of non-binary genders included in the regulations, and you will only be allowed to choose Male, Female or one of the genders on this list.
Who can support young people
People aged 16 or 17 will be able to amend their sex marker with a letter of support from either a parent or a “suitably qualified person” and people aged 15 or under will require a support letter from both a parent and a “suitably qualified person”. Exactly what is meant by “a suitably qualified person” is currently unclear, but will be specified in the regulations.
More than one update
The Act also states that people who have already changed their sex marker (or name) may face additional requirements to update their details again. Currently we don’t know what the additional requirements will be, but these will also be specified in the regulations.
People who do not have a NZ birth certificate
The old law made it possible for “anyone with the right to live in New Zealand indefinitely” to apply to the family court and receive a court ordered “declaration as to sex“. Since the family court process will be removed, this means that trans people born outside New Zealand no longer have access to legal recognition of their gender. The new law did not provide any options for people born overseas, but the government did commit to providing a solution. This process is a slightly different consultation, since it is not covered by the BDMRR Act. The Rainbow Path consultations will be addressing this process, and you can also speak about this in your written submission.
Find out more
Our submission on BDMRR covered some of these issues. Our position for youth was to loosen the requirements for support letters, and there is no longer a requirement for a supporting letter to come from a healthcare professional, which we spoke about in our submission. We believe that this should be loosened as much as possible, and anyone who knows a transgender young person should be qualified to write a letter in support of them amending their sex marker.
In our spoken submission, we focused on the added restrictions for people seeking to amend their sex marker more than once. Coming to understand your gender may be complicated, and may have several stages – people may go from a binary gender to a non-binary one over time for example. There should be no added restrictions for amending your sex marker more than once.
Together with Rainbow Path, we advocated for trans people born overseas to have their specific circumstances acknowledged, and for a process for recognition that works for refugees, asylum seekers, migrants and people on temporary visas to be included in the law. Whatever process the government decides to use, it is vital that everyone in New Zealand has access to documentation that shows their affirmed sex and which carries weight in their country of origin.
The government recently announced their latest budget, which includes funding initiatives to improve services for transgender patients.
Transgender healthcare
The government has allocated $2.18 million over four years, to improve primary healthcare services for transgender patients. Primary healthcare refers to a broad range of health services provided in communities, such as your regular doctor (General Practitioner), practice nurses, and others working in general practices. It does not include specialists such as endocrinologists or surgeons.
*Note that the new initiatives will not affect pre-existing initiatives – they will not replace the increased funding for genital reconstruction surgeries announced in 2019.
The new funding will, in part, go toward intensive upskilling at 8 clinics around the country, which will then specialise in providing gender affirming healthcare. With eight clinics around New Zealand, it is our hope there will be coverage for both the North and the South Island.
The details have not yet been decided, and will be developed by Health New Zealand.
The Associate Minister of Health Dr. Ayesha Verall has indicated that the budget will also include the development of guidelines and training for clinicians.
Pharmac and hormones
There has also been a significant increase to Pharmac’s budget.
Pharmac has put together a proposal on expanding the provisions of certain medications, including progesterone.
Progesterone can be included in gender affirming hormone treatment for transfeminine people.
Pharmac is seeking feedback on their proposal before 5pm on Thursday the 2nd of June 2022, and we urge anyone who takes, or would like to take, progesterone to read their call for submissions and send an email in support to consult@pharmac.govt.nz
Intersex healthcare
The budget also includes $2.5 million over three years to develop a rights based approach to healthcare for intersex young people. This is intended to develop a healthcare framework in which parents of intersex infants can receive supportive and accurate information which affirms intersex existence, and where intersex people can make their own informed decisions about the medical procedures they undertake, rather than being subjected to surgeries without their consent.
While mental health referrals are good and can sit alongside an informed consent process, they should be offered as additional support, and should not be part of getting informed consent.
March 31 is Transgender Day of Visibility, and we’re asking you to bring visibility to trans issues by writing letters to healthcare decision makers.
Your letter could be your opinions, or your own personal experience with gender affirming healthcare – whether your experiences were positive or negative. Personal experiences touch hearts, so speaking about the impact which healthcare struggles or joys had on you and your emotions can be a strategic decision.
A flood of letters from trans people can make a huge difference, going far, far beyond raising visibility.
Context
The government is planning to replace the District Health Board (DHB) system through the Pae Ora healthcare reforms, so now is a great time to raise the profile of trans healthcare. In our Pae Ora Legislation submission, Gender Minorities Aotearoa focused on the current failure of the healthcare system to meet gender affirming healthcare needs.
You have a legal human right to receive appropriate healthcare, and you have a right to be heard when the government fails to provide it.
For the system to work, there need to be changes at every level: better funding leading to increased capacity to meet the demand without unreasonable surgical requirements, better administration creating better and consistent health pathways and better trained doctors who are not themselves an obstacle to transgender people getting the healthcare we need.
For these sweeping changes to happen, we need Health NZ, and the Ministry of Health, to show strong leadership by first acknowledging the problem and then taking effective action to fix it.
What we want
We call on the government to establish a healthcare system which meets the needs of all trans people. This means a system which acknowledges our rights under the Code of Health and Disability Consumer Rights to access necessary healthcare via informed consent/assumed competence. This also means a system which sustainably provides:
Voice therapy/training
Permanent hair removal by electrolysis, laser or IPL
Chest binding prosthetics (binders)
Chest reconstruction (double mastectomy and contouring)
Breast augmentation
Fertility preservation of both eggs and sperm
GnRH puberty suppressants (puberty blockers)
Quick and accessible readiness assessments to establish capacity for informed consent (only in situations when they are really needed)
A diverse range of hormone therapy options to suit the diverse needs that exist
Hysterectomies and oopherectomies
Orchiectomies/orchidectomies
Clearing the backlog for genital surgery, and a sustainable funding plan
Improved access to psychologists and counselors when needed
National, standardised pathways that relocate more responsibilities into primary care (GPs)
Where to send your letter
Your letter could be directed to the healthcare officials within the Ministry of Health, or the acting officials of the future Health NZ. It could also be directed to MPs who have more influence over how funding is allocated at the highest level, MPs who are already committed to championing rainbow rights, or MPs who hold a responsibility to speak out on healthcare issues.
Government healthcare officials
Health and Disability Review Transition Unit Department of the Prime Minister and Cabinet Parliament Buildings Wellington 6160
Dr Ashley Bloomfield (Ashley.Bloomfield@health.govt.nz) Ministry of Health 133 Molesworth Street Thorndon Wellington 6011
Martin Hefford, acting chief executive of the interim Health NZ – Martin.Hefford@health.govt.nz Ministry of Health 133 Molesworth Street Thorndon Wellington 6011
Members of Parliament
This includes MPs who have influence over the yearly budget, MPs whose portfolios cover healthcare, and MPs who are already supporters and who will be likely to amplify our concerns
Hon Grant Robertson MP (Grant.Robertson@parliament.govt.nz) Minister of Finance PO Box 18 888 Parliament Building Wellington 6160
Hon Ayesha Verrall MP Associate Minister of Health responsible for Rainbow Health PO Box 18 888 Parliament Building Wellington 6160
Hon Andrew Little MP Minister of Health PO Box 18 888 Parliament Building Wellington 6160
Dr Elizabeth Kerekere MP Green Party spokesperson for Health and Rainbow Communities PO Box 18 888 Parliament Building Wellington 6160
Chris Bishop MP National Party representative for the cross parliamentary rainbow network PO Box 18 888 Parliament Building Wellington 6160
Dr Shane Reti MP National Party spokesperson for Health PO Box 18 888 Parliament Building Wellington 6160
We provided 1:1 peer support over 2,000 times, and there were over 600 visits to our Wellington drop in centre. Our website was visited over 101,000 times with 209,000 page views.
Our healthcare referral system was used over 6,000 times, and we received over 1,100 referrals from healthcare providers across the country. Our HRT guide was read over 5,000 times. We also trained over 500 healthcare workers, particularly in mental health and addictions.
Our Rainbow Housing NZ group grew by 500 members to 3,100+, Housing was an area which suffered greatly due to covid 19, so this year much of our work in this area was in supporting individuals to find housing.
We held a successful campaign to pass the BDMRR Bill for self determination/self ID on birth certificates. Our resources were read 15,600+ times, we distributed 100’s of pamphlets and posters, the community turned out amazing submissions, and the law was passed. Our guide to updating your birth certificate sex marker updates was also read 2,000+ times, and a member of our staff became a Justice of the Peace to witness birth certificate documents.
We facilitated connectedness for 2,100+ trans people, whānau, and supporters in our online Transgender and Intersex NZ group, our “trans 101” resource was read more than 42,000 times (15,000 more times than in 2020), and our main parents resource was read more than 1,000 times (double 2020).
We released 6 new healthy relationships and sexual violence prevention resources in 2021. We also began work with Intersex Aotearoa on a joint project – ARC (Anti-violence Resource Centre) which will launch in 2022. We worked on the government’s National strategy to eliminate family violence and sexual violence, together with other members of the Rainbow Violence Prevention Network (RVPN).
