Use of Govt funds for sex-change surgery upheld

01:43, Jan 31 2009

A Christchurch surgeon and the Ministry of Health have defended taxpayer-funded sex-change operations after criticism by a national report into transgender people's rights.

The 100-page report by the Human Rights Commission, released yesterday, said the ministry contracting to one surgeon, Christchurch's Peter Walker, who specialises in a specific surgical technique, limited the options of transgender clients.

"Evidence submitted to the inquiry suggests mixed outcomes from this technique," said the report.

"Effectively, the right of trans women to quality health services is severely limited."

The ministry funds up to four sex changes every two years.

Male-to-female operations typically cost $20,000 to $30,000, and female-to-male operations up to $70,000.


Four publicly funded male-to-female operations were performed by Walker in 2006. Another three patients were referred by Walker, a plastic and reconstructive surgeon, for ministry funding last year.

Walker temporarily stopped doing gender reassignments last year while he underwent surgery himself - an elbow reconstruction, a double hip replacement and an acute gall bladder operation. He has been sidelined for another few months by a broken leg suffered in a jet-boat accident this year.

Female-to-male operations are done overseas because there is no specialist in New Zealand.

The ministry's chief clinical adviser, Sandy Dawson, told The Press it had every confidence in Walker's services.

"He is an internationally respected and peer-reviewed surgeon," Dawson said. "Given the complex nature of gender reassignment surgery, post-operative complications are not uncommon."

Walker said his technique was more complicated than those used elsewhere in the world.

"We have very high standards and consequently our levels of complications are less or equal to the best elsewhere in the world," he said.

The inquiry found there was no clear process for selecting transgender people for publicly funded surgery.

Trans people and health professionals expressed serious concerns about the appropriateness of a single private provider making such decisions.

When complications occurred, the small number of operations done and lack of knowledge of trans health issues meant few health professionals had experience in post-surgical care, the report said.

Walker, in consultation with the ministry, is appointing a GP who will co-ordinate the assessment of clients and provide follow-up care in future.

Joanne Proctor, who won a fight for a publicly funded sex change after promised surgery was withdrawn by a regional health authority, suffered complications after a Walker operation in 2002.

"I couldn't urinate properly for two years," she said.

Proctor said she struggled to get her post-surgical complications rectified.

Proctor estimates her operation and after-care ended up costing the state $40,000 to $50,000.

Christina Loughton, who co-ordinates transgender support group Agender Christchurch, believed the ministry's fund should allow trans women to travel overseas for surgery.

Most transgender people were paying privately to go to Thailand for surgery because it was cheaper.

"There are folk who have had problems, but this arises whether they have it in Thailand or here. It's just different procedures are used by different surgeons," she said.


The Press