A national support group for transgender people says the $500,000 of public health funding spent on gender realignment surgeries over the past five years is woefully inadequate.
Figures obtained by The Press under the Official Information Act show that just seven male to female operations and three female to male operations have been publicly funded in recent years.
"There is no reason why it should be that way," said Agender New Zealand spokesperson Claudia McKay.
"It's just laughable."
McKay is one of many trans-people who have given up any hope of getting gender realignment surgery in New Zealand because of the hoops they have to jump through.
Instead most are opting to save up to have the surgery overseas, most commonly in Thailand.
In 2006 the Human Rights Commission launched the world's first inquiry by a national human rights institution into discrimination experienced by transgender people.
It found that most trans-people could not access the gender reassignment services necessary for them to live in their gender identity and appropriate sex.
The vast majority of services were not available within the public health system, resulting in many bearing the cost of private assessments and medical treatments, either in New Zealand or overseas.
The inquiry, which took two years, concluded the cost of gender reassignment services was a significant barrier to many trans-people.
Since that inquiry the Ministry of Health has done work to improve the standard of health services provided to trans-people but the barriers for accessing sex change surgery remain high.
Before publicly-funded surgery can even be considered, a transgender person must be officially diagnosed with gender identity disorder, obtain psychiatric and psychological reports from two senior psychiatrists and a senior psychologist with experience in the field, and have undergone more than 12 months of continuous hormonal treatment.
"They gear it so that only the people they consider the most suitable get through, but we know our own minds," said McKay.
"We know what it takes to live a more fulfilled life but we have to convince a whole panel of people that that is what is right.
"Part of the problem is the district health board system. Each health board decides how it is going to spend its money and we are always at the bottom of the list."
Ministry of Health chief medical officer Dr Don Mackie said there was funding through the Special High Cost Treatment Pool to provide just three male to female surgeries and one female to male surgery every two years.
The male to female surgeries were performed in New Zealand but the female to male surgery was performed overseas.
Asked what the ministry had done to address the health issues raised by the Human Rights Commission in its inquiry findings, Mackie said the ministry had completed a document to assist health professionals with the management of trans-people seeking support, treatment and advice from health services.
"The document was primarily written for health professionals, recognising that in most instances health practitioners would not necessarily have experience of managing the care of trans-people.
"It is also a valuable resource for trans-people providing them with a well-referenced New Zealand document when they are seeking health-care," Mackie said.
"It includes guidance for the assessment and principles of care for trans-people, information about current best practice for hormone therapy treatment, information about the availability of surgery, and a significant section on the specific needs of children and young people."
- © Fairfax NZ News
Why are fewer teens learning to drive?Related story: Teen non-drivers lazy 'narcissists'