The Health Needs and Management of Young People Accessing Paediatric Hauora Tāhine (Transgender Health) Services in Te Tai Tokerau.

Aims: Gender diverse tamariki and rangitahi (children and young people) have unique medical care needs. It is essential that this group receives timely and individualised care, provided locally and includes access to psychological support. We sought to describe the health needs and management of young people accessing Paediatric Hauora Tāhine (Transgender Health) services in the Te Tai Tokerau region of Aotearoa (New Zealand).

Methods: A retrospective review of referrals and secondary care records of all patients referred to Te Tai Tokerau General Paediatric Department for Hauora Tāhine care from 1 January 2020 to 30 June 2023. Medical management provided, time to first assessment, access to mental health support, and fertility counselling were described.

Results: Forty-five young people living in this region received Hauora Tāhine care. Mean (range) age at referral was 13 (8-15) years. Ten (22%) were Māori. Twenty-seven (60%) had co-existing mental health diagnoses and 5 (11%) had had a previous suicide attempt. Fourteen (31%) had possible or confirmed autism spectrum disorder (ASD). Median (interquartile range) time from referral to first specialist appointment was 90 (53-157) days. All received psychological support. Fifteen (33%) did not require medical treatment to affirm gender identity. Twenty-one (68%) had pubertal suppression with Lucrin and 10 (36%) with other menstrual suppressants. Gender-affirming hormone treatment was prescribed to 11 (24%), who also had prior psychology assessment and fertility discussions.

Conclusion: Gender diverse young people require a range of treatments to support their gender identity. There is a high level of co-existing mental health needs and ASD in this group.