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Disclaimer: this is my experience of being transgender as a Pakeha binary ftm (female-to-male) person. I do not speak for all transgender people, but these are challenges that I have observed and discussed with fellow transgender people.
Binary transgender people have a choice when they start to pass. They can be open about their transgender status or become stealth. I made the choice to transition from female to male when I was 17. I had a very messy break up, which allowed me to reassess what I wanted from life. This allowed me to look into transitioning. I decided that after I had started passing I would become stealth. Obviously, because you are reading this with my name on it, my plans of being stealth failed to eventuate.
When I first saw my doctor about being transgender, he had no idea what to do. I was sent to a clinical adolescent consultant psychologist at the local hospital. She also had no idea what to do. When I moved to Scotland, the waiting list was eight months to see the gender clinic. I was stuck there with no medical help, no people in the media, no one I knew who could show me that my life would be okay if I transitioned. You cannot become something you cannot see. Finally, upon returning to New Zealand after two years of working the medical system, I was able to get hormones and a year later I was able to receive top surgery funded through the Bowen Trust.
Currently the issues that transgender people face are multifaceted. They face barriers in receiving healthcare, when changing names and obtaining new documents, and socially by being harassed and not accepted within the wider community. The ways to solve them are even harder. The solutions to these problems are not simple, but there are possibilities for change.
One of the major issues for transgender people is access to resources for medical transition. Within New Zealand, the majority of GPs have never dealt with someone who is wanting to transition or even know how to treat a gender non-conforming person. To add to this, most mental health professionals have the same limited experience and are wary of diagnosing gender dysphoria. The heart of this problem comes from the lack of awareness and training about the needs of transgender people within the medical community and the lack of clear nationwide guidelines about the treatment of transgender people.
These issues create a system which is incredibly difficult for transgender people to navigate to access the medical help they need to transition. There are no clear guidelines detailing the pathway for a transgender person seeking hormones. In the Wellington region (which can cover as far as Nelson), transgender people are seen by the Diabetes and Endocrine Clinic at Wellington Hospital. The endocrinologists at this clinic are the medical professionals who decide whether a person is allowed to undergo hormone therapy. There is currently no psychologist or mental health professional who specialises in diagnosing gender dysphoria. Recent changes to the system mean that transgender patients who are deemed not mature enough must present a psychologist report stating that they are fit to receive hormones. However, there are no psychologists under the public service in Wellington who specialise in the treatment of transgender people, and only one person who does it privately. Most transgender people are stuck with many roadblocks in order to receive life-changing treatment, unless their GPs are specialised in dealing with transgender people.
The situation is even worse for surgery as most DHBs consider surgery to be cosmetic and refuse to fund it. Chest reconstruction surgery for transmen is often privately carried out in New Zealand for a cost of up to $18,000, for which many transmen pay out of pocket. For more complex surgeries such as genital reconstruction for both transmen and transwomen, overseas is the only option. The Government operates a high-cost treatment pool for surgeries that are unable to be carried out in New Zealand. However, the pool only funds three surgeries every two years. The cost of genital reconstruction is prohibitive, and makes surgery unattainable for most transgender people.
Legal and institutional
There is a brighter side to transgender rights in New Zealand—the law is very accommodating in regards to legal name and gender changes. X can be used as the gender marker on a passport rather than F or M, and an applicant can change their gender on their passport through statutory declaration. This means that they are only required to declare their preferred gender marker and how long they have maintained their preferred gender presentation. The declaration needs to be witnessed but no other proof or documentation is required. This measure greatly improves the lives and safety of transgender citizens. It allows them to obtain legal photo identification in their chosen gender, which means they can change their details on bank accounts and public records. This in turn allows them to be seen by the wider public as their chosen gender. It is also possible to change gender marker on a birth certificate by going through the Family Court. This can be costly experience, but community law services have been able to help applicants with the process.
There is much more that can be legally done to accept non-binary, genderqueer and agender people in our society. The New Zealand legal system and society is based on male and female roles, and this thinking is extended to most legal documents and forms. Often one must choose between male and female, and the 2013 census caused outrage in the queer community for that very issue. The lack of alternative options for people who do not identify as either male or female contributes to the erasure of gender non-conforming people, as well as intersex people. However, Statistics New Zealand recently announced a further category of “gender diverse” for documents and forms that are for statistical use.
Universities and schools often refer to people who haven’t legally changed their name by their birth name, which outs transgender people to their peers.
Public institutions also have a long way to go when improving their facilities for transgender people. Universities and schools often refer to people who haven’t legally changed their name by their birth name, which outs transgender people to their peers. There is also a lack of gender neutral toilets in public spaces. For transgender people who do not pass and non-binary people, this creates an opportunity for violence and harassment. There are countless stories of transgender people who have been kicked out of bathrooms. The lack of opportunity for transgender people to access bathrooms mean they are forced to wait for hours, or often in schools they are forced to use the nurse’s office.
The social acceptance of transgender people is the most challenging. There are ways to make transgender people’s lives easier without improving the medical system. Some transgender people they aren’t able to receive or simply do not want medical intervention, but yearn for acceptance and acknowledgment from society about their identity. Transgender people feel like deviant members of society, and often face job discrimination and experience mental health issues.
Transgender people have an incredibly high suicide attempt rate. There is a long list of reasons why this is the case. Mostly it is related to social stigma. Transgender people are treated by the media as spectacles. Stories about transgender people are usually about how amazing it is that they have found love, or based around whether they have had “the surgery”. On television and film, transgender people are treated as the butt of jokes.
More important still is the safety of transgender people on a day to day basis. Transgender people experience violence, sexual assault, murder, and verbal assaults at much higher rates than the general population. It is hard for transgender people even to remain safe.
It is also common occurrence for “the questions” to be asked. These are the questions no person would even think of asking a cisgender person, such as questions about anatomy, or what your “real name” is.
What do transgender people need?
Socially, transgender people need to be accepted and treated with dignity. Medically, they need to be able to access the treatment they need, including access to trained mental health professionals. In the United Kingdom there are designated clinics where transgender people receive psychological help to make sure they are ready to transition, and then receive their prescription for hormones from this facility. There are such clinics all over the United Kingdom and they all follow the same guidelines for treatment. New Zealand needs a set of guidelines brought out by the Ministry of Health in regards to best practice for transgender people, similar to the World Professional Association for Transgender Health (WPATH) guidelines.
Transgender people are often students, unemployed or in low-paying work, meaning that it is hard for them to gather funds that would allow them to change their names on legal documents. If an individual changes their name or gender on their identification due to transition, it should be free. Until this becomes a reality, there is a newly-established charity called Naming New Zealand. Naming New Zealand describes themselves as an organisation to help transgender, gender diverse and intersex youth with updating their identity documents to correctly reflect their sex and gender. They offer funding for transgender people to update their documents and fall under the charity Outerspaces, which also includes Schools OUT and Tranzform—queer and transgender support groups in the Wellington region.
The social narrative around being transgender also needs to change. At the moment, the narrative is that transgender people hate their bodies, and need hormones and surgery to be happy. However, not all transgender people hate their bodies and some transgender people do not want medical intervention. Instead, society should push for all people to present their gender identity in any way they feel comfortable. Instead of pushing medical treatment as the first step, we need to start with gender-affirming activities like name changes, and create the support to allow people to socially transition and be seen as their chosen gender even before they start to medically transition. You do not need to medically transition to be transgender. You do not have to be incredibly masculine to be to be a transman, and you do not have to be incredibly femme to be a transwoman. Transgender people need the time to work out who they are and how they want the world to see them.
It would be helpful if the news media changed their coverage of transgender people. Often interviews with transgender people focus solely on their transition. Instead, transgender people need to be shown as successful members of society whose accomplishments are more significant than their identity. Celebrities who choose to transition can also be shown in a more constructive way. The best example of how to discuss transitioning was the Diane Sawyer interview with Caitlyn Jenner, because it was not about her physical transition but her emotional transition.
Lastly, transgender people need acceptance and to be treated like every other member of society. Use their real name. Refer to them by the pronouns they like. If you are not sure what pronouns they prefer, ask, or use “they” and “them”. Most importantly, do not ask them questions about their bodies or about their transition unless they bring it up. We want to be treated as people. We are loved, successful and important people.
Charlie Prout is a facilitator for Tranzform—a support group for youth under the age of 30 who identify as transgender, fa’afafine, whakawahine, tangata ira tane, intersex, two-spirits, genderqueer, non-gendered, questioning, and their allies. email@example.com