A new report has raised concerns about long waiting times, uneven access, and systemic barriers facing transgender people seeking healthcare in regional Aotearoa New Zealand.
The Regional Transgender Healthcare Report 2025, released by advocacy organisation Gender Minorities Aotearoa, is based on a national survey of 100 transgender people and parents of transgender young people conducted between November 2024 and May 2025. The report examines access to hormone treatment, specialist referrals, and surgical care across multiple regions.
According to the findings, nearly half of respondents said it was difficult to access the transition-related healthcare they needed in their region, while a further five per cent said it was impossible. Only one in ten respondents reported that all of their healthcare needs were currently being met.
The report highlights long delays at almost every stage of care. For hormone treatment, more than 80 per cent of respondents waited longer than a month, almost half waited more than six months, and one quarter waited more than a year. Many respondents reported being referred to specialists such as psychologists or endocrinologists as a routine requirement, before being offered hormone treatment.
The report describes access to care as depending on a small number of clinicians or specialist services, creating bottlenecks and long delays. It notes that while informed consent models are recognised as best practice, fewer than half of respondents who wanted to use informed consent were actually able to do so.
Surgical care emerged as another significant area of concern. Respondents seeking genital reconstruction surgery reported waiting years just to obtain a referral, before being placed on a national waiting list that the report estimates is more than a decade long. Some respondents said they were removed from waiting lists after several years without a clear explanation. Others reported turning to private care, fundraising, or travelling overseas due to the lack of timely public options.
The report also points to big regional differences. Access to services such as hormone initiation, voice therapy, and referrals varied widely depending on location, with some regions requiring specialist sign-off for care that is managed in primary care elsewhere. Respondents in smaller or rural regions frequently reported needing to travel or use telehealth services to access treatment.
Alongside delays, respondents described poor communication, lack of information about available services, and limited GP knowledge of transgender healthcare. Some reported experiences they believed breached patient rights, including unwanted psychiatric assessments, privacy breaches, or being discouraged from transitioning.
Gender Minorities Aotearoa argues the cumulative effect of these barriers may place transgender patients at risk of poorer health outcomes. The report frames many of the issues as systemic rather than individual, pointing to funding constraints, workforce shortages, and inconsistent service design across regions.
While the report does not assess policy responses, it calls for more consistent access to services across regions and for transgender healthcare to be integrated into standard healthcare provision rather than treated as a specialist exception.
The findings add to ongoing national debates about healthcare equity and access, particularly as pressure on the public health system continues. The report’s authors say the survey was intended to document lived experiences and provide evidence of barriers that are often reported anecdotally, but not consistently measured.
