Gender Identity Concerns - Where and How to Refer 29 Mar 2019

GPs and other primary care health professionals might be the first port of call for people with gender identity concerns – identifying as transgender, non-binary genderqueer, or simply questioning their assigned gender at birth.

GPs and other primary care health professionals might be the first port of call for people with gender identity concerns – identifying as transgender, non-binary genderqueer, or simply questioning their assigned gender at birth. The Children and Adolescent Mental Health Services, Paediatric Department, Consultation Adult Psychiatry, and Sexual Health Service (Clinic 2 in Tauranga) are closely cooperating to ensure no one is left behind and patients with gender identity concerns can access the care they need in our area right across the life spectrum.

• Patients < 16yo should be referred to CAMHS/Paediatric.
• Patients > 18yo should be referred to Clinic 2/Consultation Adult Psychiatry.
• Patients between 16 and 18 years who were already known to CAMHS/Paediatrics will continue to be under their follow-up until internally transitioned - no need for any GP action.
• Patients between 16 and 18 years who were not previously known to CAMHS/Paediatrics are still under CAMHS (particularly if still at school) for their mental health needs. They should be referred there for the first assessment, but will be seen at Clinic 2 for their medical care if deemed appropriate by CAMHS.
• At any time, if there are serious concerns regarding acute mental health needs (attempted suicide or suicidal ideation, self-harm, severe anxiety/depression) an urgent referral should be made to the age-appropriate mental health service. The crisis team should be involved in life-threatening situations as GPs would normally do for any mental health crisis.

Clinic 1 (the EBOP sexual health service, based at Whakatane hospital) currently operates at a primary healthcare level only, with no sexual health specialist clinics. Therefore, adult patients from the EBOP with gender identity concerns should be referred for their medical care to Clinic 2 in Tauranga.