Authors' objectives:

There is no public funding for gender reassignment surgery (GRS) in the public health system within New Zealand. Patients either self-fund or apply for funding from the nationally managed special high cost treatment pool (SHCTP). The current position of the Ministry of Health is that GRS does not meet criteria for the provision of funding through SHCTP. The Ministry of Health has requested this review with the aim of determining the level of evidence supporting the effectiveness of GRS in a subgroup of patients. This will better inform guidelines for the further consideration of applications under the SHCTP exceptional circumstances criterion.

Authors' recommendations: There is insufficient evidence to support the efficacy of gender reassignment surgery for specific subgroups of persons selected for surgical intervention. Subgroups of transsexual people who will most likely benefit from sex reassignment surgery are not identifiable from the evidence reviewed. The quality of the evidence is poor and based on a small number of studies with weak study designs and significant methodological limitations. The reviewed studies may indicate that early, rather than delayed, sex reassignment surgery is of greater benefit to transsexual people who have gone through rigorous assessment procedures and have been accepted for surgery. Also, the reviewed studies identify characteristics of groups defined as core and non-core transsexual people, but these characteristics are heterogeneous and anecdotal. Gender reassignment surgery may benefit some carefully assessed and selected transsexual people who have satisfied recognised diagnostic and eligibility criteria, and have received recognised standards of care for surgery. More research is required to improve the evidence base identifying the subgroups of transsexual people most likely to benefit from sex reassignment surgery.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://nzhta.chmeds.ac.nz/publications.htm

Year Published: 2002

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: New Zealand

Organisation Name: New Zealand Health Technology Assessment

Contact Address: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch, New Zealand. Tel: +64 3 364 1145; Fax: +64 3 364 1152;

Contact Name: nzhta@chmeds.ac.nz

Contact Email: nzhta@chmeds.ac.nz

Copyright: New Zealand Health Technology Assessment (NZHTA)