Kate Harper has a Tinder date tonight.

As for many 22 year old women, "it's the way to meet guys".

She'd like a relationship, but has had some "Tinder duds" -- guys who just seem interested in sex, "like one guy who replied to my bio, with something really crude that made me think, 'Ugh, who says that to a girl?'"

Kate is nervous, mulling over what to wear, how to style her hair, what she will say.

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Her friends tell her she has nothing to worry about because she is "cute" and "gorgeous".

With thick, long, shiny brunette hair, pretty dimples and cheeky sense of humour, it's hard to understand why Kate has any dating worries. Like many women going on dates, she focuses on how the evening will end.

Kate is not stressing over the usual dating dilemmas, like whether to ask when they will see each other again. At the end of the night she plans just to say goodbye, as she also lets him know that she is Kate, but was born with the body of a man.

Kate was born Zak, but began the transition to become a woman while still at school. She is one of Tauranga's growing number of people who identify as transgender or gender fluid.

"I accept who I am, but sometimes I hate with a passion being transgender because it is just so hard. I wish I had been born a woman of course, as that is who I am, but because I was born with the body of a man, I know life would have been so much easier if I had been a straight guy, or a gay guy."

I accept who I am, but sometimes I hate with a passion being transgender because it is just so hard.

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There is, says Kate, a lot of misunderstanding about trans people, and more so outside Auckland and Wellington, but in the last year this is changing.

Tauranga local Kat Clarke, who started the Tauranga Pryde group in 2014 for the lesbian, gay, bisexual, transgender and intersex community aged 14 to 25 years, says that more than half the group, more than 30 people, is comprised of people who identify as transgender.

Clarke, a sociology student at Bay of Plenty Polytechnic who identifies as a gay woman says the number of transgender people in the polytechnic has prompted her to start another group there.

LBGT advocate Kat Clarke is setting up a group in Bay of Plenty Polytechnic. Photo/Andrew Warner.
LBGT advocate Kat Clarke is setting up a group in Bay of Plenty Polytechnic. Photo/Andrew Warner.

"There are many transgender students. Some have come here because they dropped out of school or college."

Clarke says in her generation, transgenders are more accepted but in Tauranga society as a whole not so much.

"I think Tauranga is still very conservative, particularly can be in the older population. But even in the younger population I have heard so many stories of bullying, people dropping out of schools, and discrimination over issues like toilets and uniform policy."

"Sometimes it is because people just do not have knowledge, of how to refer to people, it can be as simple as confusion over pronouns."

Awareness is growing, says Clarke.

"Celebrities have a lot to do with that... Caitlin Jenner, Laverne Cox from Orange is the New Black. There is even a transgender person on Shortland Street."

More accessible information on the internet, as well as laws against discrimination, are also prompting more people to be more open about their gender, says Clarke.

Kate Harper welcomes more awareness but would like transgender people to be just treated as "a normal part of the community" without any stigma or celebrity focus.

Even in the younger population I have heard so many stories of bullying, people dropping out of schools, and discrimination over issues like toilets and uniform policy.

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"I feel like this is our time. We are entering the beginning of a time when transgender people are gradually becoming more accepted. To be gay now, it is normal, accepted, whereas only in the last generation, gays would have been where transgender people are now, often misunderstood and marginalised."

Gender dysphoria, when a person is very uncomfortable with the sex or gender they were assigned at birth, is experienced by transgender people, and can lead to anxiety and stress if not recognised, says the New Zealand Mental Health Foundation. This combined with potential social isolation, rejection and discrimination which many transgenders experience mean they are more likely to present with mental health problems, including suicidal thoughts.

Findings from a large 2011 US survey by the National Center for Transgender Equality concluded that anti-transgender bias lead to some devastating outcomes for study participants. Among the findings were that 78 per cent of transgender individuals in school reported "alarming" rates of harassment due to their identity; 90 per cent reported experiencing harassment, mistreatment or discrimination on the job; and 41 per cent reported attempting suicide (compared to 1.6 per cent of the general population).

Kate tried to kill herself at 15.

"I was hiding who I really was. I always felt like a girl. I would hang out with girls as friends and get crushes on boys. When I was 13, I came across Chen Lili, she was well known at the time as a Chinese trans woman who was a singer and model and competed in Miss Universe. I Googled a lot, and I felt like that is what I was."

Her experience at a Bay co-educational high school was hard.

"I wasn't bullied physically, but people would ask if I was gay. Or mocked my high voice."

She moved to an all-boys boarding school.

"I felt like I had to Google to know how to talk to these boys about rugby. I had a gay friend and we talked about the Kardashians."

It must be one of the most extreme ways to come out as transgender- I did it in the common room at school in front of the first fifteen.

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It was in this environment that Kate finally came out as transgender, she started to take hormones to block testosterone and legally changed her name.

"It must be one of the most extreme ways to come out as transgender- I did it in the common room at school in front of the first fifteen. The boys were surprisingly accepting, they asked questions like not in a rude way, but just wanting to understand."

Kate's experience of high school rules has been less accommodating. Wanting to return to her high school in the Bay she was told that the school was ''not comfortable" with her coming to school as Kate and dressing in a girl's uniform.

Her boarding school said it could not "cater" for her needs. In the end, she became a day student at the boarding school, living with friends as Kate, but dressing up each day as Zak to go to school.

It was a double life.

"Kate was my legal name which was weird if we had a relief teacher, they would call the register in class and when they got to Kate they would look really confused."

It was only at university in Wellington where Kate could fully be herself, although her hopes of being accepted as female were dashed in the first few days when some people from her old school told others.

"Hey, you see that girl, she used to be a boy."

It is like when you walk down the street, you think that someone might look at you and say, 'hey you're not a woman'.

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Now back in Tauranga, she lives as Kate and likes to "fly under the radar", is working and hoping to be a medic.

Starting dating on Tinder, she first listed transgender on her bio, but felt "devalued" by the messages she would get,

"Men just saw it as a green light to ask about sex straight away."

She suffers from anxiety, which she says is due to fear of what trans people call "being clocked".

"It is like when you walk down the street, you think that someone might look at you and say, 'hey you're not a woman'.

"It makes me angry that I have to go through all this. Hormone injections, lasering hair. I can never just step out like a normal woman, who some days can't be bothered to do her hair or put makeup on. There is that pressure to look pretty, to look perfect. I mean if you are presenting as female, it is pretty rude of people to question."

Julia Linde, a trans woman, has started a charitable trust, Gender Dynamix. Photo/John Borren
Julia Linde, a trans woman, has started a charitable trust, Gender Dynamix. Photo/John Borren

Julia Linde, 39, says she has been asked that "rude" question: "Are you a man or woman?"

But she says she would rather people ask than wonder.

Born a man, after two marriages and 10 suicide attempts, she finally came out as Julia a decade ago when working for a store in Tauranga. While her colleagues welcomed Julia into the team, some customers were not so accommodating,

"Some would ask 'are you male or female?'. Someone called me a freak. Or worse things. I just would smile and say, 'let me get you someone else to serve you'."

Meet Julia Linde, 39, born a man but who felt like she was living in black and white while everyone else was living in colour. Eventually she couldn't live the lie any longer and came out as the beautiful Julia.

Like Kate, when growing up, Julia had brushed aside her feelings of being female, and she was relentlessly bullied at school.

"I always had a soft side. My peers were scathing... called me 'queer', 'sissy'."

Like Kate, she struggled to understand her feelings.

"From a young age, I knew something was not right. The best analogy is that I was living in black and white while everyone else living in colour. I really wanted to be in that place of colour where I could reveal the real me, but instead I did what society expected of me. I studied to be a pilot. I got married. Twice."

Eventually she "couldn't live the lie" any longer.

"I could see how destructive it was becoming to my mental health, it was like a pressure cooker, trying to keep a lid on who I really was."

Julia says accessing medical advice was hard in Tauranga, and in the end she went to Auckland to receive hormone treatment and voice surgery.

Kate also experienced lack of medical knowledge in Tauranga.

Consultant physician at Tauranga Hospital Massimo Giola said the first stop for a person identifying as transgender is their GP.

"Medical options involve treatment with hormones and psychological support with the transition. The hormones are funded once a prescription is issued by a specialist (endocrinologist or sexual health physician). Some counselling may also be funded."

Although both Kate and Julia present as women there are still circumstances they find uncomfortable. Despite living in a seaside town, neither go to the beach.

They both would like to complete their transition with gender reassignment surgery.

"I would have surgery in a heart beat, but the cost is too prohibitive," says Kate.

The cost of male-to-female surgeries is about $35,000-$40,000. For female to male it can be as much as $180,000, says Dr Andrew Simpson, acting chief medical officer, Ministry of Health.

There is public funding in New Zealand but as is the case worldwide, demand for gender identity services is outstripping government funded channels.

In New Zealand there is public funding for three male-to-female and one female-to-male surgeries every two years, with funding provided from the Ministry of Health's high-cost treatment pool.

However waiting lists are long, with 71 people currently waiting for male-to-female genital reassignment surgery, and 17 waiting for female-to-male surgery.

Dr Simpson says female-to-male surgery, being highly specialised, has always been carried out overseas. Since the retirement of the one plastic surgeon on the gender reassignment surgery team in 2014, now there is no one in New Zealand with the specific expertise and training to carry out the male-to-female surgery.

For funded surgeries, the ministry provides information on suitable surgeons overseas including the United Kingdom, the United States, Belgium and Thailand, but Dr Simpson says it is the responsibility of individual district health boards to find a surgeon for their patients.

Since April this year, the ministry has been in contact with endocrinologists with regard to five cases, says Dr Simpson. In two instances, the ministry is still waiting for details of the overseas provider and an application for funding, in another two the individuals originally wanting surgery now no longer want it, and in one case, the person has another health condition which must be treated first.

The ministry's view is that transgender health services are best organised, developed and provided on a regional basis but this means that services are unequally offered throughout New Zealand.

A recent report to the Health Select Committee found that while 11 health boards provide gender reassignment services to some degree, through their sexual health services, mental health services, youth services, medical services, nine say they do not.

Secondary surgery (e.g . mastectomy-breast removal, hysterectomy, orchidectomy -testes removal) is provided to a limited extent at just four health boards: Auckland, Canterbury, Capital & Coast, and Counties Manukau.

The select committee also found there was variable access to psychiatric and psychological services for transgenders across the health boards.

Research has shown a transgender person may significantly more likely to attempt suicide and have a high risk of depression.

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In the Bay of Plenty, there is no specifically dedicated transgender clinic but access to assessment is provided, says Massimo Giola, of Tauranga Hospital.

"The paediatric and CAMHS services run a transgender service for people up to age 16. There are locally based specialists in medicine and psychiatry who have an interest in adult transgender issues and can provide assessment or guidance with regards to accessing services."

Kate thinks that the minimal funding for genital reassignment surgery is "appalling".

"We pay our taxes like anyone else, and this surgery is as essential to our health as say having a hip replacement. For some, it is the difference between life and death."

Julia says the lack of funding is "a slap in face considering our health budget when you are talking about one of the most vulnerable groups in our society".

She says discrimination against transgenders is not an issue just for the transgender community, but for society as a whole.

"Research has shown a transgender person may significantly more likely to attempt suicide and have a high risk of depression. Yet research also shows that when a transgender person is supported by family, and their community that risk reduces exponentially."

Julia has recently set up a charitable trust, Gender Dynamix, with a view to providing a service to trans people to make transition easier. The trust is Tauranga based but will have a national reach, she says. Fellow board members include two lawyers and a mental health professional.

The trust's first goal, Julia says, will be to have each transgender person in New Zealand have access to an endocrinologist and a quality mental health professional.

"It will be a guide for professionals, a way of softening that experience for us when we first visit a GP as that can be traumatic."

Also in her plan is to create resources and support groups for both transgenders and their families.

"Parents may not understand. They may think they are losing a son or daughter, so educating them is key to to a person's transition."

Addressing the issue of funding and access to genital reassignment surgery is also on the radar for Gender Dynamix, says Julia, with an idea to approach urologists in New Zealand who may be able to take on the procedure. She herself had her testicles removed.

Te Puke man Traye Aavan, aged 51, was born as Tracey, and agrees with Kate and Julia that it is only in the last year that coming out as transgender is becoming more acceptable in Tauranga.

"When I was growing up the word transgender wasn't even known. It meant I had no language, no understanding of who I was. I always felt like a boy, and so came out as gay at 19, but I didn't feel that was really what I was. It was hard enough coming out in the '80s in Tauranga as gay, to say I wanted to be a man would have just been unheard of so I hid it."

Traye says he identified as a boy from as young as 3.

"I remember getting a doll and just looking at it. But when I got a green sword, you couldn't get it out of my hand."

He always hung out with boys, did rough and tumble, had short hair and although his mother put him in dresses he would secretly delve into her brother's wardrobe and try on his clothes. A defining moment when he was 10.

"Me and three boys used to help out at this old lady's house with yard work. She saw us as four lads. Then one day she looked closely at me and said, 'oh, you're a girl'. It was the most crushing moment of my life."

Traye hated puberty.

"For someone who didn't want breasts, I got a huge pair, size F."

He lived as a gay woman for several decades, and had relationships,

"I didn't like anyone touching my breasts. When I looked in the mirror it wasn't me. I felt in conflict, but had no knowledge of what was going on with me. It was lonely."

With transgender issues being more debated in recent years, recently Traye decided not only to come out as transgender but to seek surgery. Public funding was out of reach, with waiting lists and so few funded surgeries mean people could face up to a 50-year wait.

"There was such a humongous waiting list. I would be dead before I became a man."

Traye sought the advice of Jackie Brown, Tauranga owner of Bums, Gums and Tums, an agency that takes Kiwis to Thailand for cosmetic surgery.

Says Brown: "I had not taken anyone for transgender surgery before, but had done my homework.''

''We met in a Greerton cafe. We both ended up laughing as Traye is partially deaf and wears a hearing aid. At one point I was shouting in the cafe, 'Do you want a penis?', and she said, sorry I can't hear you, and I shouted, 'a penis, because you can have a penis from your clitoris, or they can grow a penis on your arm.' The whole cafe just fell silent."

Brown's matter-of-fact approach and sense of humour appealed to Traye, and last month, Traye completed what is known as top surgery in Thailand -- breast removal and squaring off of his chest.

"The surgery took approx four hours. I was a little knocked around for the first couple of days but the morning after the operation I was up taking small walks. Emotionally I feel relief as I am finally starting to look and feel on the outside like the person I have always felt on the inside. It is uplifting and humbling at the same time. This surgery has been the rebirth of me. I may have technically been born in May but August the 26th will be the second birthday I celebrate each year."

Traye will continue his transition with approved testosterone shots but could only get these in Auckland.

Traye sympathises with other transgender people particularly in provincial areas such as Tauranga.

Although everyone where he works as an employment consultant has welcomed his decision, some acquaintances have not, with one telling him ''don't come near me after that surgery or I will punch you in the face''.

Traye is pragmatic.

"There will always be haters. Tauranga is an extremely conservative town, very opinionated."

He has set up a Facebook support group where people can ask questions about transition or surgery or anything they want,

"There are lots of kids out there harming or even killing themselves because they can't be themselves.

People in my age group in particular have no support. There may be people like me who have never been themselves. They might think they are too old. But my take is if I can live 20 years as the man I feel inside, they are 20 good years, instead of being stuck in a body that has never been mine."

Traye may consider what is known as bottom surgery in Thailand, in which a penis can be fashioned from a clitoris enlarged by hormones, or by using a tissue graft from the arm, stomach or thigh, but for the time being is focusing on his recovery and helping others.

"I might even grow a beard."

Julia Linde also encourages people of any age to connect with others and to be more open about gender identity.

"There are people out there sitting in their homes, wanting to be themselves but not knowing how to do it. I would urge them to open up -- even if it is just to talk. Once you take the first step, it becomes easier."

As more transgender people "come out", Julia believes societal attitudes will change, even in Tauranga.

"Times are changing. People need to move with it. We are all people at the end of the day, whatever your body. Show respect for each other. It is okay to be different. We are not trying to harm anyone, just trying to be ourselves. "

Kate has also looked into surgery in Thailand but at the moment the cost is too prohibitive.

In the meantime, Traye has some advice for Kate on her Tinder date,

"When I began transitioning people often were confused. Some asked if they should refer to me as a she or he. Did I want to be called a woman, a man or transgender. They asked how was I going to present myself to people. We are so used to putting people in a box, wanting a label for someone without finding out who that person is. It is who the person is that matters."

Kate agrees.

"Of course I have to tell people that I am in a relationship with but I would like to think, if it is the right person, it doesn't even matter. It is not like I am a transgender, ie that is who defines me. I am a woman.

At the end of the day I am me. And, guess what? Five years before Caitlin Jenner, in little old Tauranga, I was already saying, "I am Kate."

GENDER DYSPHORIA

Gender dysphoria is when a person is very uncomfortable with the sex or gender assigned at birth. A person may feel as though their gender identity (sense of identification as male, female, neither, both, or somewhere in between) does not match their body.

Gender dysphoria develops when a person suffers distress related to their gender identity.

Distress may be related to whether they are accepted and valued by family, friends and community.

Many people who experience gender dysphoria are transgender, or gender diverse.

Gender identity is not the same as sexual orientation. People who are transgender may identify as straight, gay, lesbian, bisexual, asexual or any other sexual orientation.

"Transitioning" is a process many transgender people go through to change appearance or presentation to match their gender identity. For most transgender people, going through the transition process they choose helps reduce gender dysphoria.

It could include:

- "coming out" as transgender, or another identity
- dressing and living as preferred gender
- changing name
- asking people to use different pronouns (for example he, she, or they)
- having gender changed on legal identification documents
- taking hormones (oestrogen or testosterone), or having surgery, to change which include genital surgery or facial or chest reconstruction surgery.
Source Mental Health Foundation.
Where to get help:

Lifeline: 0800 543 354 (available 24/7)
Suicide Crisis Helpline: 0508 828 865 (0508 TAUTOKO) (available 24/7)
Youthline: 0800 376 633
Kidsline: 0800 543 754 (available 24/7)
Whatsup: 0800 942 8787 (1pm to 11pm)
Depression helpline: 0800 111 757 (available 24/7)
Rainbow Youth: (09) 376 4155
Samaritans 0800 726 666
If it is an emergency and you feel like you or someone else is at risk, call 111.

Tauranga Pryde meets every Wednesday evening in the Historic Village. For more information email taurangapryde@gmail.com.