Public Referral Pathway

Gender affirming genital surgery within the New Zealand public health system is managed through Health New Zealand’s national Gender Affirming (Genital) Surgery Service. Dr Rita Yang performs gender affirming surgery at Wakefield Hospital in Wellington and may assess patients referred through the national public service.

WHO CAN MAKE A REFERRAL?

New referrals must be made by:

• A public hospital transgender health specialist (usually an endocrinologist or sexual health physician), or
• For people in the Wellington and Christchurch districts only, an authorised General Practitioner (GP)
   

Referrals must be submitted using the official Gender Affirming (Genital) Surgery Service referral form and sent to:

gender.surgery@tewhatuora.govt.nz

Referrals sent directly to an individual surgeon or hospital will not be accepted for publicly funded care.

ELIGIBILITY CRITERIA

To be considered for a First Specialist Assessment (FSA), a person must:

• Be 18 years or older
• Be eligible for publicly funded healthcare
• Be residing in New Zealand with a current NZ residential address
• Be physically and mentally fit for anaesthesia and complex surgery
   

BODY MASS INDEX (BMI)

For patient safety and optimal surgical outcomes, the Service requires:

• Referrals are currently accepted for patients with a BMI under 35
• Patients with a BMI between 30–35 are expected to actively engage in a GP-supported weight management programme while waiting
• Patients must have a BMI under 30 to progress to a First Specialist Assessment or surgery
• Higher BMI levels are associated with increased risk of complications in complex genital surgery.

Patients are encouraged to speak with their GP about weight management programmes or eligibility for a Green Prescription.

NICOTINE-FREE REQUIREMENT

Patients must be completely nicotine-free (including nicotine-based vapes and nicotine replacement therapy):

• For at least 12 weeks prior to referral
• Throughout their time on the waiting list
• During the pre-surgical pathway
• For at least 12 weeks after surgery
   

Remaining nicotine-free is a strict requirement to stay on the waitlist.

THE WAITING LIST

The waiting list is for a First Specialist Assessment (FSA) — not surgery.

Important points:

• The number of people on the list changes regularly
• Referral position does not determine the exact timing
• Some patients may be removed if they:
  • Cannot be contacted
  • No longer wish to proceed
  • Need to address health optimisation first
     

Preparation before surgery may include:

• Weight optimisation
• Mental and physical health stabilisation
• Hair removal
• Surgical readiness assessments
   

Hair removal is not reimbursed if completed prior to the First Specialist Assessment. After assessment, funding coordination may be arranged if required.

KEEPING CONTACT DETAILS UPDATED

Patients must ensure their contact details remain current at all times, including:

• Email address
• Phone number
• Residential address
• GP details
   

If Health New Zealand or the Service cannot make contact, the patient may be removed from the waiting list.

If details change, notify: gender.surgery@tewhatuora.govt.nz

AFTER REFERRAL SUBMISSION

Once a referral is received:

• Health NZ may request additional information before progressing the referral, or
• The Service provider will contact the patient directly to offer a First Specialist Assessment
   

Patients must promptly provide any requested information to remain eligible.

RESIDENCY STATUS

New Zealand citizens are eligible for publicly funded services while living in New Zealand. Publicly funded surgery is not available to those residing overseas.