1. The possible gender dysphoria patient presents to the General Practitioner. The General Practitioner decides whether the patient has a gender dysphoria.

   The General practitioner refers the patient for Endocrine Assessment. If there is an endocrine disorder - it is treated.

   General Practitioners will make a full Medical Assessment and will have blood tests done including full blood count, electrolytes, liver function tests, renal function tests, cardiology and respiratory function tests, Chest X-ray and determination of the presence of HIV, hepatitis A, hepatitis B, hepatitis C.

    

2. The General Practitioner sends the patient for two psychiatric reports, and establishes the patient as a transsexual.  Psychiatrists* determine:

    

   psychiatric illness sociopathology psychopathology

   severe personality disorder intelligence

    

   * In Christchurch - Dr P Renison, Dr A Young 

   If the patient lives in Christchurch only one report is required as the programme psychiatrist will do the second one. Diagnosis of Transsexualism follows. If suitable, hormone treatment is started:

    

   • feminising hormones

   • anti androgen therapy

    

3. The patient should have been living as a woman in the community for 2 years.

    

4. The General Practitioner refers the patient (together with the psychiatric reports and results of recent blood tests), to the Gender Dysphoria Programme through the centralised office of Mr E P Walker. Thereafter appointments are made with:

    

   Programme Psychiatrist: Dr P Renison, Dr A Young

    

   Psychologist: Rosemary Smart
   gender issues, motivation, ability of patient to cope:

    

   self esteem alcohol/drug dependency personality structures

   stability risk of depression support of peers and family

    

   Psychosocial appointment with Social Worker: Rosemary Smart

    

    

   

 

Appointments are made with a Psychiatrist and Social Worker, and the patient is notified of the time and approximate costs of each appointment. These fees are to be paid on the day. The patient must pay for preoperative assessments but will get a refund of the balance if no surgery takes place.

 

5. An appointment one to two days later will be made with:

    

   The Surgeons: Mr. E P Walker, Mr. Richard Perry, Mr. Stephen Mark who will discuss the surgery.

    

   The Anesthetist: if necessary.

    

   The patient must pay all consultation fees on being seen by the Gender Dysphoria Team.

    

6. A case conference (or conference call) will follow for a Yes or No decision re surgery. Patients coming from Overseas may have to make two trips - one for the consultations and one for the surgery.

    

7. All accounts must be paid prior to the operation taking place, e.g. Hospital, Theatre, Anesthetist, three Surgeons, disposables. An allowance should also be made for X-rays and Physiotherapy and any unforseen costs.

    

8. Surgery takes place at the Southern Cross Trust Hospital, 131 Bealey Avenue, CHRISTCHURCH 1, NEW ZEALAND.  The patient is looked after by the Southern Cross Hospital ward staff, and regular postoperative visits made by the surgical team.