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Dr David Sar Shalom, of the Invercargill Medical Centre, says new guidelines for accessing gender-affirming healthcare will remove the demeaning barrier for transgender patients to see a psychologist before starting hormones. [file photo]

Gender diverse people will no longer have to see a psychologist before being able to access hormone treatment in Southland.

Invercargill Medical Centre Dr David Sar Shalom said the first southern-specific pathway to accessing gender-affirming hormones went live in April.

Prior to the introduction of the pathway, Sar Shalom said patients were facing waits of up to two years to access gender-affirming hormone treatment.

The delay was because adults seeking access to hormone therapy in the Southern DHB were required to be assessed by a psychiatrist or psychologist before being seen by an endocrinologist, despite the fact being gender diverse is not a recognised mental illness.

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This meant there was often a six to eight month wait to see a psychologist to provide a referral, and then a further six to eight months wait for endocrinology, he said.

Gender-affirming hormone treatment is the process of using hormones to alter a persons physical appearance to more closely align with their gender identity, and includes the prescription of estrogens, testosterone blockers and testosterone.

In its study of gender-affirming healthcare in Aotearoa New Zealand last year, the Professional Association for Transgender Health Aeotoroa (PATHA) found marked differences between each DHBs pathway to accessing hormones.

In some DHBs, including Southern, there were requirements for psychologist referrals to access endocrinologists whereas in other areas, such as Canterbury, gender-affirming hormone treatment was led by GPs, with studies showed this reduced stress amongst patients.

It was this Canterbury model which had been loosely adapted for Southland, Sar Shalom said.

The change in requirements for psychological assessment only impacts adults looking to receive gender-affirming hormones, and does not cover gender-affirming surgery or children looking to access hormones.

He pointed out that psychological assessment before hormone prescription was not common in other areas, such as when the contraceptive pill is prescribed, with the change reducing stigma for the gender diverse community.

Now we have these very clear guidelines that you dont need to have a psychologist assessment to access these gender-affirming hormones ... being gender diverse is not a mental illness, so to require psychological assessment is quite demeaning.

Kavinda Herath/Stuff

Number 10 director Jude Crump says her North Island colleagues were shocked to hear of the wait times required in the Southern DHB to access gender-affirming hormones. [File photo]

Number 10 director Jude Crump said wait times to see psychologists in order to access gender-affirming hormone therapy had been one of the biggest issues being seen by the centre.

According to the New Zealand College of Clinical Psychologists website, there are three psychologists specialising in transgender, sex and gender diverse services in Dunedin, and none in Invercargill.

As a result, patients had been spending long periods on wait lists, with many younger patients struggling with fuel costs and time spent travelling to Dunedin.

I dont know how much longer it is but colleagues in the North Island that hear how long our wait times are, were shocked, she said.

There had been an increase in the amount of gender diverse people seeking to access to hormones, she said, which was likely due to more information and acceptance around the rainbow community.

Sar Shalom encouraged patients to be aware of the guideline changes in order to advocate for their rights.

Its a work in progress ... but theres a clear pathway now, for any GP practise to follow.

See the article here:
Guideline change removes 'demeaning' barrier to hormone therapy - Stuff

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