Trauma of transition

Finding the right sort of help is often a big problem for people who are transgender. But a Counties Manukau working group intends to make it easier for them. Joanna Davies explains.
Cathy Parker considers herself lucky. "I've never had any major hassles being transgender. It's a challenge, but I have two daughters who I have shared care of, and my transition was fairly public because I own my own business."
For four years Ms Parker has been living as a woman, even though she was born male.
A transgender person identifies with a different gender from the one they were born with. "It was something that I think was always part of me but, 20 or 30 years ago, it wasn't as acceptable to change."
For Ms Parker, getting the health care she needed was relatively easy but she knows this is not the case for everyone in her situation.
"I've worked in the media and I know how to do my research," she says. "But a lot of other people, they don't know where to find information."
For the transgender community in Auckland, and elsewhere in the country,  getting the same standard of health care as everyone else can be a real struggle.
But a working group based at Counties Manukau District Health Board hopes to improve transgender access to information and treatment.
Ms Parker, 53, says there are large gaps in services around the country. "In some centres there are no services, and in some centres the services are very hard to access."
Ms Parker  says transgender people sometimes find it difficult to source appropriate counselling and treatment.
"The surgical options here are very limited, and GPs don't know who to refer their patients to if they want to get hormone treatments or hair removal," she says. "I'm really passionate about making sure that young people can get hold of the information they need, because there are treatments to give them more time to decide what path they want to go down."
When the working group's research ends next year it will produce resources for doctors informing them of the treatment processes and basic health care needs, plus establishing a network for clinicians with interests in transgender health care.
Max Lawson, of Albany, who is also helping the working group, found most of the information he needed on the internet during his transition. "A lot of it was American though, so that didn't really help me."
The 31-year-old tried to find information through the public health system, but ended up getting treatment privately at some expense. "The places where I went just had one specific set of treatment, and they weren't for me," he says. "There was no individual treatment, just one standard."
Mr Lawson says a friend who is transitioning through the public system has encountered distressing circumstances, even at appointments with people who treat transgenders. "She's been patronised from the start. I just wonder why people feel that they can do this."
But Mr Lawson is optimistic transgender issues will benefit by being more visible in the community.
The project arose from a Human Rights Commission report into transgender discrimination in 2008. Its leader, Dr Rachel Johnson, is based at Kidz First Children's Hospital. She says this project is just the beginning.
"My ultimate goal is that all trans people should be able to access safe, respectful health services from informed clinicians to get the medications and surgery they require to meet their basic health needs," she says. "Access to services is hugely inequitable across New Zealand, but even across Auckland, with three district health boards, access to services varies considerably. Current services are often based on whether there is an interested clinician rather than the level of need."
Jack Byrne, a senior policy analyst at the Human Rights Commission, says the team hopes to dispel a lot of stereotypes about trans people. "A lot of people think that treatment means having sex change operations, but a lot of trans people just want access to counselling or even a GP that knows about the process. It's not uncommon for the patient to explain the procedures to their doctors."
Mr Byrne also says there are issues surrounding the gender listed on someone's medical records. "If someone is waiting in the emergency room and the nurse calls out a male name when the person is living as a woman, it can be very distressing for them. We want to create some guidance for doctors and make sure that people are not turned away when they are accessing healthcare."
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For more info on the transgender project see: http://www.healthpoint.co.nz
For transgender support and info in Auckland, ph 0800 844 357 or see:  www.genderbridge.org