Below is the briefing that PATHA sent to the incoming (2020) Minister of Health on the topic of transgender health. We have made this public as they might be useful for anybody advocating to advance transgender people's health.

We thank the PATHA Policy and Advocacy Committee their expertise and work that they did to create these.

You can also use this link to download the briefing document.

We are pleased to announce that this symposium will be held at Tautoru TSB Space, Tūranga Central Library, Ōtautahi Christchurch on 25-26 September 2021. Click here for more information about this symposium.

WPATH, EPATH, USPATH, AsiaPATH, CPATH, AusPATH, and PATHA Response to Bell v. Tavistock Judgment

[Update 5/4/2021: This statement has been developed into a paper that was published in the International Journal of Transgender Health. It is available on the WPATH website here. The authors note “the current paper is an extended version of that statement including the scientific evidence and references which the necessary brevity of such policy statements precludes”.]

[Update 1/1/2021: AusPATH have also released their own statement about this ruling which is available here.]

Statement Regarding Medical Affirming Treatment, Including Puberty Blockers for Transgender Adolescents

The Boards of Directors of the World Professional Association for Transgender Health (WPATH), the European Association for Transgender Health (EPATH), the United States Professional Association for Transgender health (USPATH), the Asia Professional Association for Transgender Health (AsiaPATH), the Canadian Association for Transgender Health (CPATH), the Australian Professional Association for Trans Health (AusPATH), and the Professional Association for Transgender Health Aotearoa (PATHA) all strongly disagree with the recent judgement of the London High Court in Bell v. Tavistock. We believe this decision will result in significant harm to the affected children and their families. We oppose this ruling and urge that this ruling be appealed and overturned.

Click here for the full statement.

Annual General Meeting for the Professional Association for Transgender Health Aotearoa (PATHA)

June 20 2020

AGENDA

1. Welcome

2. Note any apologies and appoint minute taker

3. Receiving the minutes of the previous Society Meeting

4. President’s Report

5. Financial Report

6. Executive Committee recommended motions to amend PATHA rules: 

   1. Section 4.2: Increase number of General Executive Committee Members from 3 to between 3 and 5.

   2. Section 4.5: Amend the following sentence to include “between Māori and non-Māori people” as highlighted below: 
      “The mix of Officers and Executive Committee members should demonstrate a partnership between cisgender and transgender people, and between Māori and non-Māori people, working professionally on transgender health, whether in clinical, academic, community, legal or other settings.”

   3. Section 8.1: The role of the Executive Committee. Amended to include the following highlighted sentence: “Ensure that transgender Members are represented in any decisions made.”

   4. Section 10.2: Amend this to include “and transgender members are represented in decision making” as highlighted below: 
      “No Executive Committee Meeting may be held unless more than half of the Executive Committee Members attend and transgender members are represented in decision making.”

7. Election of Executive Committee Members 
8. Close meeting

The Australian Professional Association for Trans Health (AusPATH), established in 2009 as the Australian and New Zealand Professional Association for Transgender Health, is Australia’s peak body for professionals involved in the health, rights and wellbeing of trans people, including those who are gender diverse and non-binary (TGDNB). The AusPATH membership comprises approximately 300 experienced professionals working across Australia.

The Professional Association for Transgender Health Aotearoa (PATHA) is an interdisciplinary professional organisation working to promote the health, wellbeing and rights of transgender people in Aotearoa New Zealand. PATHA's membership includes over 70 professionals who have experience working for transgender health in clinical, academic, community, legal and other settings.

AusPATH and PATHA welcome the Royal Australasian College of Physicians (RACP) advice to Minister Greg Hunt, Federal Minister for Health, regarding the care and treatment of TGDNB children and adolescents, including those seeking medical intervention. This advice is based on the available scientific evidence and the expertise of those with relevant clinical experience across sub-speciality areas of medicine and bioethics.

AusPATH and PATHA agree with the RACP that ensuring children and adolescents who are trans, including those who are gender diverse and non-binary “can access appropriate care and treatment regardless of where they live, should be a national priority”, and that “withholding or limiting access to care and treatment would be unethical and would have serious impacts on the health and wellbeing of young people.”

As stated by the RACP, clinical care needs to be “non-judgemental, supportive and welcoming for children, adolescents and their families”.

AusPATH and PATHA also support the RACP recommendation that the Australian Government provide funding for research, especially in relation to the long-term health and wellbeing outcomes for trans, including gender diverse and non-binary, young people. Increased investment in research and expansion of the knowledge base, for young people and adults, will be vital in improving the current and disturbing high rates of depression, anxiety, suicide attempts and suicide amongst this cohort.

Improving outcomes can only be achieved by reducing the stigma, discrimination, bullying and harassment that trans people, including those who are gender diverse and non-binary, are subjected to on a daily basis. Negative, hateful media campaigns aimed at invalidating the experiences and strength of this community, and those who provide care for them, is reprehensible, harmful and must stop.

There is much work for us to do to improve the lives of all trans people in Australia and Aotearoa New Zealand. Both AusPATH and PATHA look forward to assisting the clinicians, researchers, educators and advocates across our two countries to continue the provision of high quality, patient-centred, human rights-focused and comprehensive gender affirming care and treatment.

Further reading:

Royal Australasian College of Physicians’ Statement

Royal Australasian College of Physician’s Letter to Minister Hunt

Royal Children’s Hospital, Melbourne Statement

Australian Standards of Care and Treatment Guidelines for Trans and Gender Diverse Children and Adolescents 

AusPATH Position Statement on the Hormonal Management of Adult Transgender and Gender Diverse Individuals

Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand

This statement was originally authored by AusPATH and signed on to by the PATHA Executive Committee on 11 March 2020.

PATHA asserts that the provision of gender affirming healthcare for transgender and gender diverse people is a medical necessity and that the lack of equitable access to this healthcare in Aotearoa is causing harm.[1]

PATHA notes that in He Ara Oranga (The Report of the Government Inquiry into Mental Health and Addiction) rainbow populations are recognised as being negatively impacted by “the cumulative effects of discrimination, bullying, prejudice and exclusion,” and that in addition limited access to gender affirming healthcare “has a negative effect on the mental health and wellbeing of people seeking to access them (p72).[2] 

It is the opinion of PATHA that limited and inconsistent access to essential healthcare (such as puberty blockers, fertility preservation, gender affirming hormones, mental health support and gender affirming surgeries including chest reconstruction, hysterectomy and orchiectomy) is itself an aspect of discrimination. 

PATHA recognises the right of transgender and gender diverse people to be able to make informed choices for themselves regarding gender affirming healthcare and that as a minimum, District Health Boards (DHBs) should provide timely access to the following services: puberty blockers, fertility preservation, gender affirming hormones, mental health support and gender affirming surgeries including chest reconstruction, hysterectomy and orchiectomy.

Currently, there are large variations in the provision of gender affirming healthcare services across the 20 DHBs in Aotearoa, New Zealand.[3] PATHA strongly recommends that all DHBs provide clear information about pathways to access gender affirming healthcare services delivered by DHBs and primary health care. PATHA recognises that these healthcare services should involve transgender people, including Māori transgender people, in the development and provision of services.[4] 

PATHA affirms that all health services in New Zealand must provide equitable and accessible gender affirming healthcare services that are evidence based and align with international standards and community feedback. To that end, PATHA recommends that DHBs enable flexible and responsive pathways that are based on informed consent and self-determination.[4]

References

[1] For a list of medication organisations who affirm the medical necessity of gender affirming care see: https://transcendlegal.org/medical-organization-statements. For more information about the health of transgender people in New Zealand and the negative impact of inconsistent access to gender affirming healthcare see Veale J, Byrne J, Tan K, Guy S, Yee A, Nopera T & Bentham R (2019) Counting Ourselves: The health and wellbeing of trans and non-binary people in Aotearoa New Zealand. Transgender Health Research Lab, University of Waikato: Hamilton NZ. https://countingourselves.nz/index.php/community-report/.

[2] See the full report here: https://www.mentalhealth.inquiry.govt.nz/inquiry-report/he-ara-oranga/

[3] For more details on the lack of consistent gender affirming services across New Zealand see: https://patha.nz/news/is-the-provision-of-gender-affirming-health-care-equitable-across-the-district-health-boards-in-aotearoa-new-zealand

[4] Oliphant J, Veale J, Macdonald J, Carroll R, Johnson R, Harte M, Stephenson C, Bullock J. Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa, New Zealand. Transgender Health Research Lab, University of Waikato, 2018, p8-9. https://researchcommons.waikato.ac.nz/handle/10289/12160

The Professional Association for Transgender Health Aotearoa (PATHA) committee would like to express collegial and professional support for those working professionally for transgender health in Australia during a time where there are media attacks against the provision of gender-affirming care in that country.

PATHA supports the increasing focus in both countries on informed consent models of gender-affirming care in position statements, standards, and guidelines developed and endorsed by both the Australian Professional Association for Trans Health (AusPATH) and PATHA. These are based on local and international research, and user feedback in this rapidly-developing area of medical care.

PATHA supports AusPATH in their work to improve the quality of and access to gender-affirming care, for those who need it. Leading medical organisations have stated the medical necessity of gender-affirming care, including the American Academy of Pediatrics, American Medical Association, World Medical Association, and the World Professional Association for Transgender Health. Lack of services, withholding care, and so-called reparative therapies are harmful and contravene international human rights standards that apply to both Australia and Aotearoa New Zealand.

There is a very close working relationship between those working professionally for trans health in Australia and Aotearoa New Zealand, whether through formal bodies (such as ANZPATH until recently and various Australasian Colleges) or through online and face-to-face collaborations. This level of collaboration was always envisaged when PATHA was established and we intend for continuing and strengthening collaboration between PATHA and AusPATH.