Guidelines for Gender Affirming Healthcare

in Aotearoa New Zealand

These guidelines were originally intended to be published in March 2025, but were prevented from publication by the Minister of Health until a decision was made about the use of reversible pubertal suppression for transgender children and young people with gender incongruence or gender dysphoria. Earlier in the year, PATHA made an Official Information Request for the guidelines, seeking to bring them into the public domain. Our request was declined. In November 2025, the New Zealand Government announced new regulations on the prescription of these medications, meaning the Minister no longer had a reason to withhold the guidelines.

As a result, PATHA is now able to publish the guidelines.

Te Whatu Ora have asked whether PATHA would like to write the changes the Minister has requested be made to align the guidelines with the new regulations (removing information about initiating GnRH agonists), and whether PATHA and the guideline authors would like to still be credited and named in the document that has the information about initiating GnRH agonists removed.

The PATHA Executive Committee is in agreement to decline these offers and instead publish the guidelines independently in their original form. We feel deeply uncomfortable putting our names and PATHA’s name to anything that does not align with best practice. We have no intention of compromising on our patients’ wellbeing, our values, or our professional reputation.

This is the version of the guidelines submitted to Te Whatu Ora for publication, and the version the Minister of Health refused to publish. It was approved by Te Whatu Ora’s Clinical Governance Group and Executive Leadership Team.

After the Ministry of Health published their position statement on the use of puberty blockers in November 2024, PATHA added some additional context to the section on prescribing GnRH agonists. PATHA is now taking the time to consider whether any of this content needs updating to align with international standards and best practice. 

In the meantime, we’re pleased to - finally - be able to share these 2025 Guidelines with you.

These guidelines were authored in 2018 by a collaboration of people working professionally for transgender health in Aotearoa New Zealand. They are also hosted on the University of Waikato website.

Primary Care Gender Affirming Hormone Therapy

Initiation Guidelines

These guidelines were released in March 2023 to support primary care clinicians to initiate gender affirming hormone therapy (GAHT) for adults in primary care settings. Many PATHA members authored or gave feedback on these guidelines. They are also hosted on the University of Otago website.

The Royal New Zealand College of General Practitioners have endorsed these guidelines.

These guidelines are accompanied by the following information sheets that may be useful to for patients and practice staff:

Patient information sheet - oestrogen

Patient information sheet - testosterone

Testosterone administration guidelines

WPATH Standards of Care Version 8

The current international standards of care for gender affirming healthcare from the World Professional Association for Transgender Health (WPATH). Also accessible here.

For further information see here.