A Policy A Day: Trans Rights

In the lead-up to the election, we are examining a policy a day. We’re exploring a variety of policy areas, explaining the background and analysing some of the policy options, with a mixture of technocracy and values-based approaches. Inevitably, some opinion will make its way in and we make no apology for that — after all, we’re voters too. A list of all the articles is available here. Enjoy!

Today’s post is by Claire Black

Cisgender people, those of us who identify with the gender we were assigned at birth, have a pretty poor track record when it comes to supporting the rights of trans people [1]. While marriage equality passed its four-year anniversary last weekend, there are still many pressing issues facing trans people in New Zealand today. A non-exhaustive list includes safety in prisons, safety in schools, homelessness, dehumanising or hateful media coverage, access to health services, and legal protections against discrimination.

Thanks to the hard work and advocacy of trans activists in New Zealand, some of these issues have made it onto some party policy agendas for the coming election. But it is important that we are all more aware of the obstacles facing trans people in New Zealand, which politicians are actually proposing solutions, and how to help hold them accountable to these promises and push for more. There are two main policies on the table this election: improving trans healthcare access and amending the Human Rights Act to explicitly protect trans people.

Trans Healthcare in New Zealand

Access to gender-affirming healthcare access is hugely important, even life-saving, for many trans people. Yet in New Zealand, trans people seeking such health care face high costs, massive wait times, bureaucratic hoops, hard-to-find information, and prejudice from health professionals.

Most notably, the waiting lists for publicly funded gender reassignment surgeries are inhumanely long. Last year, 88 people were on the waiting lists. With the government funding only four surgeries per two years, this means estimated wait times of 34 (for trans masculine people) to 50 years (for trans feminine people). This is an unimaginably long amount of time to wait for anything, let alone an essential surgical procedure. These already huge numbers do not account for people who would otherwise like to be on the list but cannot afford the prerequisite steps or who have been discouraged by the wait.

Other forms of gender-affirming healthcare can also be hard to access. Nine out of twenty District Health Boards provide no healthcare services for trans people, and services and treatment pathways are inconsistent across the remainder. Groups such as The Sex and Gender Diverse Health and Outcomes Working Group have been pushing for change at local levels, but there is a clear need for greater political action and public funding in these areas.

Amending the Human Rights Act

The New Zealand Human Rights Act (1993) is intended to ensure that all people in New Zealand are treated fairly and equally. It outlaws discrimination against people for a number of reasons, such as on the grounds of sex, race, disability, and age, and gives the Human Rights Commission the power to mediate disputes relating to instances of discrimination.

While the Act prohibits discrimination on the basis of both sex and sexual orientation, it does not include gender identity or expression. This is where things get tricky for trans people. Many people argue that in an actual instance of discrimination, a trans person would legally be protected by the Act’s ‘sex’ category, but while ‘sex’ can be interpreted to cover trans people, this is by no means guaranteed. Just last month in the US, Republican representatives submitted a bill that would prevent the federal government from interpreting sex (or gender) protections to include gender identity, which would essentially ensure that trans people there are not covered by civil rights protections. New Zealand is obviously not the United States, but there have been instances of New Zealand legislation that do differentiate between sex and gender identity. Why should we leave the legal protection of trans New Zealanders — a marginalised group who often do face various forms of discrimination — up to interpretation? Enshrining gender identity protection in the Human Rights Act provides explicit recognition and protection of trans and gender diverse people that does not leave wriggle room for discrimination or depend on people interpreting the Act in particular ways.

The Party Policies

The political party policies on trans rights range from promising (but lacking in concrete details) through to non-existent.

Labour has pledged to “improve access to affordable health care for younger, trans and intersex New Zealanders” by providing health professionals with necessary training, reducing barriers to gender-affirming healthcare, and ensuring ‘fair access’ to publically funded surgical options for trans people. This is a significant improvement from just two years ago when high-ranking MPs, including former leader Andrew Little, said that transgender health needs were not a priority for the party. They also state they will follow recommendations from a 2008 New Zealand Human Rights Commission report, including ensuring easier changes to official documentation and preventing misgendering in the justice system. Labour has also said that they will amend the Human Rights Act to include gender identity as a protected category.

The Greens do not currently have any relevant policy listed on their website, but in email correspondence they have agreed with recommendations made to MPs earlier this year: to support development of training and resources around trans healthcare, to ensure trans people’s access to gender-affirming healthcare, and provide ‘sufficient funding to enable timely access’ to gender reassignment surgeries not available through the public health system. They also have a long-standing policy to include gender identity as a basis of non-discrimination.

As of Peter Dunne’s resignation announcement, United Future doesn’t look set to have much chance of implementing them, but they are nonetheless another party that has announced a set of LGBT+ policies. Among these, they pledge to ensure that health providers have appropriate plans and practice standards for rainbow community health needs. A press release states that they would ensure trans and gender diverse people have access to gender-affirming health services, and again, provide ‘sufficient funding to enable timely access’, when this is not available in New Zealand, but this point is missing from their website. United Future also states that they will amend the Human Rights Act to include ‘gender identity, gender expression and sex characteristics’ as prohibited grounds for discrimination, a broader proposed addition.

The Mana Party provides a list of ways in which they propose to support Takatāpui (a term for Māori who identify with diverse genders and sexualities) [2], including “having fair and equitable access to health care to address their particular needs”, but they do not get into specifics.

None of National, NZ First, the Māori Party, TOP, or ACT currently have any Rainbow policies at all readily available. Notably, National boasts of “better healthcare” and “less waiting, more operations” under their leadership, while not addressing the need for action on trans surgery waiting lists, and as of last year, Health Minister Jonathan Coleman stood by the current funding policy.

Conclusion

While some parties are clearly doing better than others, none of them have detailed exactly what their proposed improved access to healthcare would look like, especially when it comes to cutting surgery waitlists. Language such as ‘fair access’ and ‘timely access’ fail to give a clear indication of just how much improvement trans people on currently or hoping to be on these waiting lists can expect. To really sell these policies, supportive parties should listen to calls by trans people for greater specificity.

In 2015, Labour MP Stuart Nash justified voting against a policy to improve trans people’s access to hormones and surgery, and justified this on the basis that he didn’t “think it’s an issue that’s important to the people of New Zealand”. As trans activist Jen Shields points out, the issue is one of human rights, not popularity. But that doesn’t mean that we shouldn’t prove Nash wrong. All of us who support human rights also need to be aware of these issues and support trans activists in pushing political parties for accountability.

Further reading and listening:

https://jenniferkateshields.wordpress.com/2015/09/24/ministry-of-health-release-information-about-grs-funding/

http://www.radionz.co.nz/national/programmes/the-weekend/audio/201785675/making-the-transition

https://genderminorities.com/2017/04/03/is-new-zealands-healthcare-system-prejudiced-against-trans-people/

https://www.vice.com/en_au/article/ex95xm/transparent-trans-road-block-in-nz

Claire Black is an eternal student, currently completing a MA thesis in Social Anthropology about how young LGBTQ people in New Zealand use digital technologies.

[1] I use trans as an umbrella term for people whose gender identity differs from that assigned at birth.

[2] This is the term that Mana uses to “describe all those who are part of the lesbian, gay, bisexual, transgender, queer, intersex and asexual communities.”

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