title: Specialist services for management of individuals identifying as transgender in New Zealand.
abstract: OBJECTIVE
  In light of the rising number of referrals to secondary level services of people who identify as transgender, and the Human Rights Commission concerns regarding the care of this group in New Zealand, we felt it was timely to determine the availability of services for people who identify as transgender and whether there are variations in management protocols.
  
  
  METHODS
  We contacted 100 physicians involved in providing a secondary level service to care for people who identify as transgender, and asked them to complete a questionnaire about the services available in their region. This questionnaire consisted of two parts, a 'general questionnaire', which focussed on the consultants' understanding of services available locally, and a 'clinical questionnaire', which presented hypothetical clinical case histories and asked respondents to indicate how they would manage the case.
  
  
  RESULTS
  Sixty-two of the physicians responded. Of these, 18 (45% of the 40 physicians that answered the question) believed they could access a psychological or psychiatric opinion in the public sector for a patient who identifies as transgender, whereas 28 (82% of the 34 that answered the question) knew of access in the private sector. There was a conflict of opinion on the availability of psychological and surgical services in several DHBs where there was more than one clinician responding. This may reflect the case experience of individual clinicians. There was restricted access to common surgical procedures in the public sector, and about half of respondents did not know if techniques were available locally.
  
  
  CONCLUSIONS
  Our results support the development of specialist care services in tertiary centres in addition to the secondary services already available in New Zealand for people who identify as transgender. Development of multidisciplinary management and improved access to psychological support services for individual cases is required.
authors.affiliation: Department of Medicine, University of Otago Wellington, PO Box 7343, Wellington 6242. john.delahunt@otago.ac.nz.
authors.forename: John W
authors.initials: JW
authors.lastname: Delahunt
authors.forename: Hayley J
authors.initials: HJ
authors.lastname: Denison
authors.forename: Jane
authors.initials: J
authors.lastname: Kennedy
authors.forename: Jackie
authors.initials: J
authors.lastname: Hilton
authors.forename: Heather
authors.initials: H
authors.lastname: Young
authors.forename: Owais B
authors.initials: OB
authors.lastname: Chaudhri
authors.forename: Marianne S
authors.initials: MS
authors.lastname: Elston
mesh_terms: D001291:Attitude of Health Personnel; D019468:Disease Management; D005260:Female; D019538:Health Care Surveys; D006297:Health Services Accessibility / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009520:New Zealand; D010817:Physician-Patient Relations; D011320:Primary Health Care / Q000379:methods*; D063106:Transgender Persons