Home | Browse Topics | Individual rights & freedoms | Gender and sexuality | Gender-affirming healthcare

Individual rights & freedoms

Getting healthcare

Gender-affirming healthcare

Some people need surgery or medical treatment to affirm their gender or sex. Some gender-affirming healthcare is available for free through the public health system, other gender-affirming treatments are only available self-funded, and some are not available in New Zealand.

Funding for genital reconstruction surgery

The Ministry of Health recently created the “Gender Affirming (Genital) Surgery Service” to help trans people access publicly funded gender affirming genital reconstruction surgery. There is only one surgeon in New Zealand who can perform these surgeries, and the funding is limited. The average wait time for publicly funded surgery is 10-13 years.

The specific types of reconstruction surgery available include surgery to construct a penis (metoidioplasty or phalloplasty) and surgery to construct a vagina and vulva (vaginoplasty).

How do I start the process to get gender-affirming genital reconstruction surgery?

Getting a referral for a First Surgical Assessment (“FSA”)

First, talk to your usual GP. In some regions, your GP can refer you to the waiting list for a “first surgical assessment” (FSA).

If your GP cannot do this, they can refer you to a specialist who can, and ask them to refer you to a transgender health professional. This is usually a sexual health physician or a specialist in hormone-related treatments. In some cases, your GP might be a transgender health professional themselves.

To be eligible for a FSA referral, you will need to have a psychological appointment. If you have already had one in relation to starting hormones, you won’t need another one until you reach the top of the FSA waitlist.

The transgender health professional will give you more information about the options available for gender-affirming surgery, and what the eligibility requirements are. If you both agree, they will refer you to see a surgeon for an FSA.

Waiting and preparing for your FSA

There are currently long wait times for an FSA. You’ll be asked to complete a review form once every 12 months while you are waiting for an appointment date to be set.

When you are near the top of the FSA waiting list, you’ll be sent additional forms, which will ask for specific health information, including your BMI and questions about smoking and vaping. If you don’t meet the eligibility requirements at this stage (for example, if you were required to stop smoking but you didn’t), you will be removed from the waiting list.

When the appointment date is set, you’ll be asked to complete some further forms. You’ll also be given more information about what to expect in the assessment.

At your FSA

At your FSA, you’ll meet with a surgeon and discuss the surgery in more detail. The surgeon will give you information about the surgical techniques they can offer, and answer any questions you have.

If you want to go ahead with the surgery, the surgeon will give you information about the timeframe for receiving the surgery and any steps you need to take next.

Funding for top surgery and other gender-affirming surgeries

Other types of surgery are sometimes available through public funding. These include:

  • top surgery (removing or constructing breasts)
  • uterus removal (hysterectomy)
  • ovary removal (oophorectomy)
  • testicle removal (orchidectomy)

If you are interested in any of these treatments, you can talk to your GP about your next steps.

Funding for non-surgical gender-affirming treatments

Public funding is also available for some non-surgical gender-affirming treatments. These include:

  • Hormone therapy
  • Your GP can prescribe you hormones as part of your gender-affirming care. To do so, they just need to complete a screening with you. If they don’t feel confident doing this, they might refer you to an endocrinologist or a psychologist first.
  • Hair removal and voice therapy

Gender Minorities Aotearoa has free and low-cost hair removal clinics for trans people in Wellington, Tauranga, Whangārei, and Auckland. You don’t need a medical certificate to access these clinics. To find out more, see: “Where to go for more support” at the bottom of this page.

You can get funding for voice therapy or permanent facial hair removal through Work & Income if you meet the financial requirements for a “disability allowance”. You don’t have to be on a benefit to access this funding. In most cases, if you are a single adult, you just need to earn less than $786.69 per week before tax.

You will need a medical certificate from a doctor or specialist to access this funding from Work & Income, which says this is an “essential medical treatment” for a medical condition you are diagnosed with. The “medical condition” can include gender dysphoria.

Self-funding your gender-affirming healthcare

If you are denied public finding, you may still be able to get your healthcare if you fund it yourself.

In some circumstances, it is possible to withdraw funding for surgeries from your KiwiSaver, if you have one. This is done on a case-by-case basis. You will need to talk with your KiwiSaver provider to find out their policies.

Some surgeries and hormone medications are not publicly funded, but are available in Aotearoa if you can self-fund. You can find information about these treatments on the Gender Minorities Aotearoa website, here (or go to genderminorities.com and search: “Gender affirming hormone treatment – a guide for patients”).

You can also talk with your GP or specialist about the treatments available through self-funding.

Did this answer your question?

Gender and sexuality

Where to go for more support

Legal information

“Lag Law: Your Rights Inside Prison and on Remand” booklet

This booklet contains practical answers to common questions relating to prisoner rights, including transgender rights in prison. A useful guide for people going to prison, in prison, or getting out of prison and their whānau.

Community Law Wellington and Hutt Valley

Phone: (04) 499 2928

Email: publications@wclc.org.nz

Visit www.communitylaw.org.nz to buy a copy or access free

Rainbow Rights


Rainbow Rights is a website developed by Rainbow Youth and YouthLaw (a Community Law Centre) to provide legal information about rights for LQBTIQ young people.

Legislation NZ


This has all of New Zealand’s current Acts and regulations.

Law Society

To find a lawyer


(04) 472 7837

Gender Minorities Aotearoa


Phone: (04) 385 0611

Mobile: 02040492568

GMA maintains a national database of transgender, takatāpui, and intersex information, resources, and links.




InsideOUT is a national organisation that provides workshops, resources and support to help make schools, community organisations and workplaces inclusive for rainbow people.

Rainbow Youth


(09) 376 4155

RainbowYOUTH provides a number of services for queer and gender-diverse youth and their wider communities all across Aotearoa.



Genderbridge is a peer-to-peer transgender community organisation providing support to transgender and gender-diverse people, their whānau and friends throughout Aotearoa New Zealand.

Naming NZ


Naming NZ is an organisation to help transgender, gender-diverse and intersex youth with updating their identity documents to correctly reflect their sex and gender. Naming NZ can only provide financial assistance to youth in the Wellington region.

Government departments, agencies and courts

Department of Internal Affairs


0800 25 78 87

The Department of Internal Affairs processes applications to legally change your name.

Family Court


0800 268 787 or (04) 918 8800

The Family Court make decisions about applications to change your sex on your birth certificate.

Oranga Tamariki / Ministry for Children

International Surrogacy – Fact sheet


Human Rights Commission


You can contact the Human Rights Commission if you want to know more about discrimination and human rights, or if you want to complain about discrimination:

0800 496 877 or text 0210 236 4253


“To Be Who I Am”, 2007 Report of the Inquiry into Discrimination Experienced by Transgender People is available on the HRC website

Human Rights Commission Intersex Roundtable


NZ Transport Agency


0800 822 422

The NZTA deals with changes to drivers’ licences, including changing your name or gender on your driver’s licence.

Ministry of Health

Guidance for health professionals


Gender affirming surgery


Health and Disability Advocacy Service


The Health and Disability Advocacy Service can provide a free advocate to help you make a complaint about a health or disability service.

Ministry of Business, Innovation and Employment

Guide about Transgender Employees


Department of Corrections

Placement of transgender prisoners

You can read their policy (Movements M.03.05) relating to placement of transgender prisoners on their website, at:


Also available as a book

The Community Law Manual

The Manual contains over 1000 pages of easy-to-read legal info and comprehensive answers to common legal questions. From ACC to family law, health & disability, jobs, benefits & flats, Tāonga Māori, immigration and refugee law and much more, the Manual covers just about every area of community and personal life.

Buy The Community Law Manual

Help the manual

We’re a small team that relies on the generosity of all our supporters. You can make a one-off donation or become a supporter by sponsoring the Manual for a community organisation near you. Every contribution helps us to continue updating and improving our legal information, year after year.

Donate Become a Supporter

Find the Answer to your Legal Question

back to top