Gender Affirming Hormone Therapy (GAHT)

If you are a transgender or non-binary person 16 years or over wanting to start Gender Affirming Hormone Therapy (GAHT), see your GP first.  

Your GP may be able to get you started on hormone therapy; the Endocrine Departments support this (see Primary Health Care). However, at this stage, most GPs will refer to the Endocrine Departments at Capital, Coast and Hutt Valley. The Endocrine Department provides specialist secondary health care services, including supporting transgender and non-binary people who wish to start hormone therapy to affirm their gender.  

The Endocrine Departments provides the standard model of care for trans and non-binary people, as recommended by the World Professional Association for Transgender Health (WPATH) Standards of Care for the Health of Transgender and Gender Diverse People, Version 8 (SOC-8).

The Endocrine Department also follow the Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand (2018) 

Referrals to the Endocrine Department

To be referred to the Endocrine Department you need a referral from your GP and a completed Self-Assessment Gender Diverse Form. Ask your GP to check their Health Pathways for referral criteria and let them know if you need a copy of the Self-Assessment Gender Diverse Form to complete. All clients, including from the Hutt Valley, are referred to the Endocrine Department at Wellington Regional Hospital in the first instance. 

Please note, the Endocrine Department provides services for hormone therapy only. They do not accept enquiries or referrals for Gender Affirming Surgeries. They do not offer a counselling service or therapy for mental health, or provide support for people questioning their gender who do not require hormone therapy.  

Appointments

The first appointment is a psychosocial assessment with the Clinical Psychologist on the team. They are based at Wellington Regional Hospital. There is a significant wait list - up to 12 months at present.  For most people this is a single 90 minute appointment. On occasions you may require a second 90 minute appointment to complete the psychosocial assessment, or rarely, a third. The Endocrine Department does not provide ongoing therapy or psychological intervention, but can make recommendations for support, or refer you to appropriate services necessary. This is often at the same time as beginning hormone therapy.   

The psychologist will ask you about your goals and expectations from hormone therapy, discuss the irreversible and reversible effects of hormone therapy, and discuss reproductive options.  The psychologist does not assess gender, as this is self-determined by you.

You will be asked about your background and current circumstances, and given a space to explore the consequences of hormone therapy from a psychosocial perspective. This includes assessment of any mental health concerns or challenges, to minimise any negative impact on the outcome of hormone therapy. In exceptional circumstances, if there is concern regarding your capacity to give consent, or if gender incongruence is not your main presenting issue, then alternative options will be discussed on a case-by-case basis.  

If you have the financial resources you may opt to see a private clinical psychologist or psychiatrist (who adhere to SOC-8) to complete this initial appointment process. You will need to ask your GP to attach their letter or report with your referral. You will then be offered an appointment with an endocrinologist (or in some cases your GP may prescribe medication). 

This should be about 6-8 weeks after your first appointment and will be for 40-60 minutes. The endocrinologist will focus on your physical health, and will ensure you understand the irreversible and reversible effects of hormone therapy from a medical perspective. In most cases you will be prescribed hormone therapy at this appointment; in some cases further medical investigations may be required (e.g., awaiting blood test results).  

After about 3 months on hormone therapy the endocrinologist will invite you back for a 20-30 minute follow-up appointment to review progress. They may offer you a second follow up appointment, or discharge you back to your GP. Your GP is responsible for your long-term hormone therapy prescription. If you run out of hormones between appointments with the endocrinologist, please see your GP for a repeat prescription. At any time, your GP can contact the Endocrine Department for advice.  

Depending on your residential address, Capital, Coast and Hutt Valley offer the appointment with the endocrinologist at Wellington Regional Hospital, Kenepuru Hospital, Kapiti Health Centre or Hutt Hospital.