Landmark Trans Health Report Shows Widespread Disparity

Landmark Trans Health Report Shows Widespread Disparity

Counting Ourselves, a national report on transgender health, has just been released.

The survey had 1,178 participants, from all regions of Aotearoa, ranging from 14 to 83 years old.


The research, funded by the Health Research Council and with support from University of Waikato and Rule Foundation, found that trans people experience discrimination at more than double the rate of the general population, almost half of trans people had someone attempt to have sex with them against their will since age 13, and almost a third reported someone did have sex with them against their will since age 13. Participants reported high or very high levels of psychological distress at a rate nine times that of the general population. In the last 12 months, more than half had seriously considered suicide, and 12% had attempted suicide.

key findings


In the last 12 months, 13% of participants were asked unnecessary or invasive questions during a health visit

17% reported they had experienced reparative therapy (a professional had tried to stop them from being trans) [note: sometimes called “conversion therapy”]

36% avoided seeing a doctor to avoid being disrespected

Stigma, Discrimination, and Violence

67% had experienced discrimination at some point

44% had experienced discrimination in the last 12 months – this was more than double the rate for the general population (17%)

21% were bullied at school at least once a week, much higher than the general population (5%)

83% did not have the correct gender marker on their New Zealand birth certificate

32% reported someone had had sex with them against their will since they were 13

47% reported someone had attempted to have sex with them against their will since they were 13

Compared to the general population, participants were almost three times more likely to have put up with feeling cold (64%) and gone without fresh fruit or vegetables (51%) in order to reduce costs.

Distress and Suicide

71% reported high or very high psychological distress, compared with only 8% of the general population in Aotearoa New Zealand

56% had seriously thought about attempting suicide in the last 12 months

37% had attempted suicide at some point

12% had made a suicide attempt in the last 12 months

Participants who reported that someone had had sex with them against their will  were twice as likely to have attempted suicide in the past year (18%) than participants who did not report this (9%)

Participants who had experienced discrimination for being trans or non-binary were twice as likely to have attempted suicide in the past year (16%) than participants who did not report this discrimination (8%)

Participants’ rate of cannabis use in the last year (38%) was more than three times higher than the general population (12%)

Protective Factors

57% reported that most or all of their family supported them. Respondents supported by at least half of their family were almost half as likely to attempt suicide (9%).

62% were proud to be trans, 58% provided support to other trans people, and 56% felt connected with trans community.

Full Report

The Counting Ourselves website is here.

Quick download the Executive Summary (PDF)

Quick download Counting Ourselves_Full Report (PDF)


Trans and Non-Binary Health and Wellbeing Report Reveals Severe Inequities

Kiwi Transgender and Non-binary People at Higher Risk of Suicide – Survey

Transgender and Non-binary People Suffer High Levels of Mental Health and Discrimination Issues, Report Finds

New Zealand Finds Nearly a Third of Transgender People Raped But Few Seek Help

How Our Health System Has Severely Failed Trans and Non-binary New Zealanders

Survey Shines a Light on Trans and Non-binary New Zealanders

Parliamentary Rainbow Network Welcomes Groundbreaking Report

Show Your Support With Transgnder Flag Bunting

Show Your Support With Transgnder Flag Bunting

Show your support for trans and intersex people with our beautiful ”We Belong” transgender flag bunting!

Transgender flag buntin.png

The design includes the transgender flag colours, with yellow stars for intersex. The starts are in the pattern of the Southern Cross constellation, otherwise known as Te Pae Mahutonga. Te pae mahutonga is also a Kaupapa Maori public health framework, based on the constellation, which guides our organisation. You can read about it here. It also carries the transgender symbol, with the words ‘We Belong’.

Graphic design by Ahi Wi-Hongi. Design published by Gender Minorities Aotearoa, Wellington, 2019.

Aotearoa Trans Healthcare Guidelines Released

Aotearoa Trans Healthcare Guidelines Released

We’re very pleased to announce that the national guidelines for trans healthcare in Aotearoa have been released, and can be found here. We will be updating links across our website to help facilitate their use.

Great work from all involved in their development, we are looking forward to supporting healthcare providers in putting these guidelines into action in their practices. We encourage all transgender, intersex, and takataapui patients to download a copy and pass it along to their healthcare providers.

More information on gender affirming health care can be found in the national database by clicking on the main menu.

Transgender Health Care Now: Wellington Pride Parade

Transgender Health Care Now: Wellington Pride Parade

March 10th 2018, takataapui, transgender, and intersex people and supporters walked, danced, and rode along in the Wellington International Pride Parade with a clear message: trans health care now!

The float was hosted by Gender Minorities Aotearoa, The Gender Centre, Aunty Dana’s Op Shop, and InsideOUT, with support from NZPC.




Float participants carried a large banner, waved transgender flags, and held placards painted in trans flag colours with slogans such as ”stop non-consensual surgeries on intersex babies”, ”protect trans youths”, ”non-binary not confused”, and ”trans intersex taonga”. One placard posed the question ”40 year wait list?”, another read ”access to health care saves lives”,  ”transgender lesbians need HRT too”, ”support sisters, not only cis-ters”.

Behind those walking, Bicycle Junction cycled along playing an upbeat pop play-list compiled by one of the volunteers at Aunty Dana’s Op Shop. Following the music, Aunty Dana’s van ”Pash” carried participants with mobility access needs. A mannequin reclined in a chair on the roof, draped in a huge transgender flag which spread over the sides and back of the van. She wore a trans flag coloured headband and carried a sign that read ”health care for all”.

”Indigenous genders are real” read the final sign in the transgender health care float – strapped to the back of the van.

“The float was FABULOUS and beautiful and fierce and fun! Super amazing. It was such a great combined effort from everyone. From the playlist, to the bike guy, to the van driving, to the snacks! And the face paints! And placard painting! and the folks who coordinated the banner carry! and the waving of that flag in those heels!”

says Gender Minorities Aotearoa’s National Coordinator Ahi Wi-Hongi.

Audio interviews with Pride participants at here.

”A huge thank you to Amanduh and the WIPP organisers for all your hard work, to our pals at InsideOUT who we love working with, to NZPC who are strong advocates for trans health, to Jaye, Kerry, Sam, Jess, Ada, Lola, Dan, Dylan, Ella, and everyone who got involved and helped to make this happen. To the beautiful people of all genders who joined the float, and to the folks out there who came to watch and support.

”Nga mihinui ki a koutou katoa, we look forward to appropriate health care in the near future.

Gender Minorities Aotearoa is opening The Gender Centre in Wellington, Transgender Day of Visibility March 31st.

InsideOUT is holding Shift Hui n Wellington, April 20 – 23.

Follow Gender Minorities Aotearoa, The Gender Centre, and InsideOUT on Facebook

Photo Gallery:

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Gender affirming hormone treatment – a guide for patients

Gender affirming hormone treatment – a guide for patients

This is a guide to transgender hormone replacement therapy – or gender affirming hormone treatment.

You can scroll down to read it as a page, or use the PDF version.

PDF – read online or download

Fullscreen Mode

Gender affirming hormone treatment

This booklet is a simple guide to help you get started on gender affirming hormones in the simplest way possible.

It aims to give patients a solid foundation of knowledge, to help you make the best decisions for yourself, and to help you advocate for yourself with your healthcare provider. This guide is read over 10,000 times each year.

Whatever the process in your region, and whatever your age, the first step is usually your GP or sexual health clinic.


At 2023 there are no official national guidelines, however the commonly used guidelines are called the Guidelines for Gender Affirming Healthcare for Gender Diverse and Transgender Children, Young People, and Adults in Aotearoa New Zealand (2018).

There is a checklist at the end of this booklet, developed by Gender Minorities Aotearoa, based on international best practice and the best medical frameworks globally.

You can find comprehensive information at, including clinical guidelines, consent forms, and more.

In New Zealand, gender affirming hormone treatment is usually carried out in alignment with the World Professional Association for Transgender Health (WPATH).

WPATH is a slow moving and somewhat conservative body, which admits that international best practice is often ahead by the time new standards of care are published.

The current WPATH standards of care (v8, published 2022) require the following to initiate hormone treatment.

WPATH standards of care v8 (SoC8)

These are the WPATH SoC8 recommendations for adults, unless ‘suggestion’ is stated.

If your GP is confident

If your GP is confident, they can give you information at your first visit, assess whether you’ve understood the info and are able to make your own healthcare decisions, and accept your informed consent

They may need to ask some standard health questions and run some blood tests, but should be able to proceed with a prescription at this point.

Medically speaking, they do not typically need to wait for your blood test results as complications are extremely rare. and individual patients can be contacted if they need to discontinue the medication.

Technically they can carry out the checklist at the back of this booklet and prescribe for you at the first visit.

This is international best practice, as provided by Planned Parenthood Great Northwest (USA).

There are consent forms on our website, though these are not technically required..

In reality, many GPs haven’t done this before and don’t feel confident.

They may ask you to see a psychologist to assess whether you can give informed consent, and/or an endocrinologist for blood tests. However, unless there is a reason to believe you are not capable of making your own healthcare decisions, or you have other known health complications, you shouldn’t need to see one of these specialists. Your primary provider (such as your GP) should provide this care.

Working with your healthcare provider

Gender affirming hormone therapy can be a long-term process, so it’s important to build a healthy relationship with your healthcare provider. Whether you end up working with an experienced provider, or with one who has never met a transgender person before, having rapport with your provider can help you get the best care that is available to you.

Don’t be afraid to ask them to explain things to you, or justify their reasoning, or to ask to try a different medication.

Not all healthcare providers have the knowledge or experience to optimally provide you with hormones, nor are the most common pathways and treatments the best for everyone. Your provider may not know about the availability of certain medications, they may not be aware of publicly funded treatments, or they may not know about the common side effects of the medicines they prescribe.

This may mean that your own personal knowledge of the process and treatments available could be the difference between optimal and non-optimal care.

It is important that both you and your provider work to build a relationship that facilitates open two-way communication. This helps to facilitate addressing any problems that may arise with treatment,.

It is also important that your provider is committed to providing you with the safest and most effective treatment, tailored to your needs.

If your healthcare provider is not open to tailoring your treatment to best benefit you, you may need to provide them with the most up to date Guidelines for Gender Affirming Healthcare in Aotearoa New Zealand, or to seek a different provider.


After age 16, patients have the right to make healthcare decisions for themselves, and the same right as adults to use informed consent..

People aged under 16 can also give informed consent to the extent that they are able to understand and make healthcare decisions. The Gillick Competency framework is sometimes used to determine their capacity to understand and consent.

“Consent requires the cognitive capacity to understand the risks and benefits of a treatment and the potential negative and positive outcomes. It also requires the ability to retain that information for the purposes of making the decision (using aids as necessary) as well as the cognitive ability to use that understanding to make an informed decision” – WPATH SoC8

For people aged under 16 years, the process is different depending on their age, regional pathways, individual providers, and parental support.

Gender Minorities Aotearoa advocates for a ‘harm reduction’ model that removes barriers to care, but currently it can be challenging.

The current recommendation is to use the Guidelines for Gender Affirming Healthcare. (2018).

Initial discussion with your healthcare provider

First, establish how they can show basic respect for your gender. Be clear with your provider about the sex/gender you were assigned at birth, whether you are intersex (if you know this), and what your actual gender (or ‘gender identity’) is. Tell them how you like to be referred to (she, he, ko ia, they, etc).

Next, it may help if they know it’s not a passing idea – if you’ve felt this way for a long time, tell them.

They may ask about your support system, such as whether you have supportive family or friends, whether you currently present to the world as your gender (or if you are ‘out’), whether you have any history of substance use, or whether you have any mental health issues such as depression or anxiety.

These are all standard lines of questioning. While you can probably guess the ideal answers, none of the less ideal answers should prevent you from being prescribed hormones.

The only “hard nos” are hormone-sensitive cancers (such as testicular cancer).

Your provider is likely to ask for a blood test, check your blood pressure, carry out cardiovascular and respiratory exams, and ask some other physical health questions.

Some providers may recommend weight loss prior to starting treatment. However, no amount of dieting is generally effective long term, with over 90% of diets failing to produce long term weight loss.

Managing other risk factors is a much more attainable goal – consider reducing or stopping smoking, alcohol and other drug use, supporting your health by drinking lots of water every day, getting enough sleep, getting enough food, and managing vitamin and salt intake to support your liver, heart, bone health, and circulation.

It’s all about weighing risks vs. benefits, so lower your risk factors and be sure to tell your healthcare provider how positively hormone treatment will impact your life!

Let your provider know that you understand all the possible effects of hormone treatment.
Include your mental health – such as relief of anxiety, feeling more comfortable, reduction in stress – and the physical effects too, discussed later in this booklet.

Include both the positive and possible negative effects.
Show them that you have a holistic and realistic understanding.

Discuss with them your intended journey and where you want to be. For example you may want to take hormones and have voice coaching but not have surgeries, or you may only want hormones in order to be allowed Genital Reconstruction Surgery (though this is not technically required).

Fertility preservation should also be discussed.

There is no one right or wrong way to transition, and accessing medical treatments is becoming simpler as more people transition in a variety of ways.

Categories of medicine

There are two main categories of medicine involved in treatment:.

The first category is “blockers”, which pause puberty, suppress testosterone in adults, or stop certain hormones from affecting your body. Blockers are fully reversible – if a patient stops taking blockers, their natural hormones will begin to affect their body again. These can be prescribed from the start of puberty.

The second category of medicines are often referred to as “gender affirming hormone treatment” or “hormone replacement therapy” (HRT), and consist of various sex hormones which add effects to your body.

Some of these can also do the job of blockers, eliminating the need to take blockers completely.

Sex hormones are usually prescribed from age 14-16, though there is emerging medical evidence which suggests it may be best to begin earlier, as would naturally occur at the onset of puberty.

Forms of administration

Some hormone treatments are available in multiple forms, or can be taken in multiple ways. These different preparations and delivery methods can have an effect on how well the medicine works, its side effects, and its risks. It’s good to be aware of what options are available to you and how one medicine, its preparation, or delivery method might be better for you than another.

Some forms of administration are:

Injectioninto either muscle or fat
Pellet implantusually injected into fat
Patchstuck to and absorbed through the skin
Pillswallowed orally, dissolved under the tongue sublingually, or absorbed rectally via suppository
Topicalapplied to the skin as a gel or cream

Availability and cost

It may be useful to be aware of which medicines for HRT are available in Aotearoa, and whether or not they’re funded for NZ citizens and permanent residents. Medicines are not usually funded for people visiting NZ on a temporary visa.

Ask your healthcare provider, or check whether a medicine is available using the Medsafe website (

You can see whether a medicine is funded using the pharmaceutical schedule website (

If you request a particular form of the medicine (for example, you prefer injections rather than pills), these may not be funded. However, your doctor can still prescribe them so long as you are willing to pay for them yourself, and they are available in New Zealand, or you can import them using an international pharmacy which ships to New Zealand.

If a medicine you’ve been prescribed is no longer funded by the government, the funded brand of the medicine may have changed, so your doctor will need to update your prescription accordingly.

If you cannot afford the medicine that has been prescribed to you, you may be able to have it funded through Work and Income NZ (WINZ) on a disability allowance.

You do not have to be unemployed or disabled to do this. It is also possible to get other transition-related treatments such as laser hair removal or electrolysis funded through this pathway (see the health section on our website for more information).


Puberty blockers

Gonadotropin Releasing Hormone Agonists (GnRH agonists) – or ‘puberty blockers’, suppress or pause puberty changes.

Puberty blockers are safe and fully reversible, and do not affect long term fertility. They have been used for decades to treat Precocious Puberty (early puberty at 6 or 7 years old) in cisgender children.

These are generally Leuprolide (Leucrin, Lucrin, or Lupron) by intramuscular injection (usually every 3 months), or Goserelin (Zoladex) chip implant (usually every 10-12 weeks).

These are prescribed to people who are starting puberty, and are funded up to the age of 16.

“this treatment is fully reversible, it is regarded as an extended time for adolescents to explore their gender identity by means of an early social transition” – WPATH SoC8

Blocking Testosterone in adults

The sex hormone testosterone can be ‘blocked’ or ‘suppressed’ using puberty blockers as above, or by using anti-androgens – sometimes referred to as “T blockers”.

T-blockers should not be taken long term without a replacement sex hormone, as sex hormones are vital for bone health (among other things), and the risk of osteoporosis increases the longer an adult patient is without sex hormones.


Cyproterone Acetate (brand names Androcur, Procur, or Siterone), is a commonly prescribed anti-androgen pill, usually taken orally on a daily basis. Note that while much higher doses are often prescribed, 25mg is usually a sufficient dose and generally shouldn’t be exceeded unless testosterone suppression is insufficient.

Micronised Progesterone (brand names Utrogestan or Prometrium), a pill taken regularly, usually orally, sublingually, or rectally. It can have testosterone suppressing effects but is not commonly prescribed for this sole purpose.

Spironolactone (brand name Spiractin), is a pill taken orally daily. Much like Cyproterone, Spiro is also commonly prescribed. Some studies have linked taking Spironolactone with a higher likelihood of seeking breast augmentation surgery.

Bicalutamide (brand names Binarex, Bicalox, or Cosudex), is a pill taken daily orally. Bicalutamide has fewer side effects compared to other anti-androgens.

The Monotherapy Method (oestrogen-only therapy) is another option for blocking testosterone. With a pmol/L of 367.09 (the minimum level recommended by The Endocrine Society), many trans women do not need blockers. With a pmol/L level of 734.19 (the high end of the range recommended by The Endocrine Society) most trans women do not need blockers.

To gain these levels of oestrogen through oral administration, a patient would need to take a dose that would likely present risks for their liver function. However, other methods (such as injections) bypass the liver.

Many healthcare providers in NZ are unaware that injectable oestrogen can be obtained by prescription from compounding pharmacies, and that bioidentical oestrogens do not pose the same health risks as synthetic oestrogens. Therefore they are often unwilling to prescribe for the recommended pmol/L levels, or use the monotherapy method.

5alpha-reductase inhibitors – or ‘DHT blockers’, prevent testosterone from being converted into the more powerful androgen dihydrotestosterone. DHT causes scalp hair loss, and preventing its production can help regrow a receding hairline. These include:

Finasteride (brand names Propecia, Ricit, or Finpro), is a pill taken daily orally. Some people have reported strong negative side effects on mental health.

Progesterone (brand names Utrogestan or Prometrium), is a pill taken daily, usually orally, sublingually, or rectally. Progesterone is also available in a cream which can be bought from compounding pharmacies, and administered to the hairline.

Blocking Oestrogen and menstruation in adults

The sex hormone oestrogen can be ‘blocked’ or ‘suppressed’ using puberty blockers, as discussed. For adults, sex hormones are necessary, so continued use of blockers long term without taking testosterone is not advised.

If a patient is taking testosterone (discussed overleaf), they no longer need to take (GnRH) agonists as the testosterone will suppress their natural oestrogen.

However, birth control is still necessary. Progesterone based Long Acting Reversible Contraceptives (LARCs) such as Depo provera, Jadelle, or an IUD or IUCD are suitable forms of contraception.

Sex hormones

Taking Oestrogen & Progesterone

The sex hormone oestrogen (also known as estrogen or “E”) is a primary sex hormone. Progesterone is sometimes taken in addition to oestrogen, to enhance breast development and assist in regrowing hair.

These hormones are available in the following forms:

Oestradiol Valerate (brand name Progynova), is available as a pill, usually taken orally or sublingually, and can be taken rectally. This is usually taken daily. It is also available as an injection taken every 3-7 days in either gluteus muscle or subcutaneous tummy fat, that can be ordered from a compounding pharmacy with a prescription.

Micronised Oestradiol Hemihydrate (brand name Estrofem), is available as a pill taken daily, usually orally or sublingually. Because it is micronised, Estrofem is especially good for sublingual delivery.

17beta-oestradiol (brand name Estradot), is available as a patch, usually re-applied twice a week.

Progesterone is a secondary sex hormone which some people take in addition to oestrogen. Progesterone enhances breast development in cisgender women and causes “gynocomastia” (breast development) in cisgender men. However, due to a lack of trans-specific research, there is currently no medical indication for progesterone in treating trans women. As a result, most healthcare providers in NZ will not prescribe progesterone.

Progesterone is available in NZ as micronised Progesterone (brand names Utrogestan or Prometrium), a capsule pill which can be taken orally, sublingually, or rectally. Progesterone is also available in a cream which can be bought from compounding pharmacies. Oral delivery is not recommended as it can have a greater chance of causing side effects such as drowsiness, and sublingual delivery can be hard due to the bad taste of the oil in the capsule.

Progesterone is sometimes taken cyclically (referred to as “cycling”) i.e. for a set duration of days every month, in combination with lowering the dose of oestrogen during this period, in order to mimic the ovarian secretion of the hormone as seen in menstruating people. Some endocrinologists have indicated that this method is very effective, however some people find that cycling can cause side effects such as mood swings.

Due to the current difficulty of obtaining a prescription for progesterone, some patients import it without a prescription and self-medicate, however this is not recommended. If a patient does do this, they are still entitled to have their hormone levels monitored by a healthcare provider, and it is recommended to have regular blood tests.

“Previously used conjugated estrogens have been abandoned in favor of bioidentical estrogens.” – WPATH SoC8

Tests for people taking estrogen or progesterone

Annual blood tests: Electrolytes – monitor more frequently if on spironolactone, LFT HbA1c – if risk factors suggest indicated, Lipids – if risk factors suggest indicated, Oestradiol – aim for normal female range (The Endocrine Society recommends target 367.09 pmol/L to 734.19 pmol/L), Testosterone (aim for level < 2 nmol/L).

Taking testosterone

The sex hormone testosterone (also known as “T”) is a primary sex hormone. Adequate levels of testosterone also usually suppress oestrogen and prevent monthly bleeding, however there is still a possibility of becoming pregnant while on this treatment.

Testosterone is available in the following forms:

Testosterone (brand name Androderm), is available as a patch re-applied daily. It’s common for the skin around the patch to feel irritated.

Testosterone is also available as a non-branded injection into muscle or subcutaneous fat (SubQ) from compounding pharmacies such as Optimus Health and CompoundLabs. The advantage of this option is higher concentrations can be ordered than those that are fully funded, meaning that the volume of liquid injected is much smaller.

Testosterone esters (brand name Sustanon), are available in combination as an injection into muscle or subcutaneous fat, usually administered every 2-3 weeks.

Testosterone cipionate (brand name Depo-Testosterone), is available as an injection into muscle or subcutaneous fat, usually every two weeks. Subcutaneous injections are often easier and less risky to administer than intramuscular.

Testosterone undecylate (brand name Reandron), is available as an injection into muscle every 10-12 weeks. This is usually administered by a healthcare provider, and patients are not permitted to self-administer.

Dihydrotestosterone – or ‘DHT’, is a more powerful androgen than testosterone. It can be topically applied directly to the genitals to increase growth. However, the cream is not available in Aotearoa and should not be used without the supervision of a qualified professional.

Tests for people taking testosterone

FBC – every 3 months in first year, then 1-2 times yearly, LFT HbA1c – if risk factors are indicated, Lipids, Testosterone (aim for normal male range).

Physical and physiological changes

Overleaf are the main physical and physiological changes which you need to be aware of before discussing with your provider. The lists are not exhaustive.

There are also psychological, emotional, spiritual, and social changes to consider.

The charts of changes and times which you may have read online are always somewhat inaccurate, as the effects of hormone treatment are very different from person to person, and the time at which different changes may occur or complete are even more so.

For example, many charts will say breast growth on oestrogen will stop after 2 years, but many transfeminine people report breast growth happening up to 10 years after starting, sometimes with changes in medications or doses..

Because of the variability from person to person, we have not included expected time frames.

Managing your expectations is important. Transition looks different for every patient, and it’s important to remember that puberty takes time – usually around 7 years to completely finish. However, if you’re getting notably unsatisfactory results from your treatment, making changes to your lifestyle, medication, delivery method, or dosage amount may improve your results.

Estrogen based treatment

Change in body scent and sweat smellMore fat in lips
Decreased production of sperm and ejaculatory fluidSlower growing and finer face and body hair
Decreased libido and ability to have erections, though erectile function can usually be maintained if desiredDecrease in muscle and redistribution of body fat to hips, thighs, buttocks, and breasts
Breast growthSlowed or stopped scalp hair loss
Softer skinChange in genitals – erections may become less firm, decrease in testes size, penis may become smaller and change shape, becoming more like a clitoris

Testosterone based treatment

Change in body scent and sweat smellDeeper sleep and increased snoring (heightened risk of sleep aponea)
Increased libidoFacial and body hair growth – thicker, darker, and more
Increase skin oil and acneScalp hair loss
Increased ejaculatory fluidIncrease in muscle, and redistribution of fat from buttocks, hips, and thighs to tummy
Lighter or absent menstruationDecreased vaginal lubrication, thinning of vaginal tissues, vaginal canal may shorten
Voice cracking and droppingGenitals change – clitoris may become larger and change shape becoming more like a penis

Getting the right support

Most providers will want to be supportive, even if they’re not sure how to support you. In these cases, providing information to them can help.

Gender Minorities Aotearoa has a web page of comprehensive healthcare resources, research reports, and information at There is also a database of trans-friendly healthcare providers by region.

Remember that even if it’s frustrating, unfair, discriminatory, or takes a long time, you will have an easier time in the long run if you keep your cool. If something needs to change, making a complaint is better done in writing than in the heat of the moment.

You are also entitled to a second opinion. This isn’t always easy to get, you may live rurally, have limited time or other resources, and yes, you shouldn’t have to. However, if you’re not getting anywhere, a well written formal complaint can be effective, and if your complaint is not addressed, it can be used to make a complaint to an external body such as the Health and Disability Commissioner.

For a faster solution in some cases, a change of provider may be the simplest course of action. A supportive healthcare provider is everything.

Appropriate health care is a human right, and you are legally entitled to get the right health care. Don’t give up! It may take time but you will get there.

For more in depth information, ideal doses, friendly doctors in your area, or to talk with us, please see our website or get in touch.

Checklist for initiating gender-affirming hormone treatment

This checklist is for your GP, and is based on international best practice.
These are the questions you should expect.


Checklist for initiating gender affirming hormone treatment (2022)., Gender Minorities Aotearoa.

Code of Health and Disability Services Consumers’ Rights – Health and Disability Commissioner.

Australian Informed Consent Standards of Care for Gender Affirming Hormone Therapy (2022)., Australian Professional Association for Transgender Health.

A Primary Care Toolkit (2023)., Trans Care BC Provincial Health Services Authority.

Guidelines for Gender Affirming Healthcare (2018)., Jeannie Oliphant, Jaimie Veale, Joe Macdonald, Richard Carroll, Rachel Johnson, Mo Harte, Cathy Stephenson, Jemima Bullock, David Cole, Patrick Manning.

Endocrine Treatment of Gender-Dysphoric/Gender-Incongruent Persons: An Endocrine Society Clinical Practice Guideline (2017)., Wylie C Hembree, Peggy T Cohen-Kettenis, Louis Gooren, Sabine E Hannema,Walter J Meyer, M Hassan Murad, Stephen M Rosenthal, Joshua D Safer,Vin Tangpricha, Guy G T’Sjoen.

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