The current project to reform New Zealand’s health and disability system presents a real opportunity to develop a national health system for Aotearoa that better meets the needs of trans, intersex and rainbow people.
This page shares information about opportunities for takatāpui and rainbow health to be prioritised in the reforms, and our submission to the Pae Ora (Healthy Futures) Bill.
Health reforms
In 2021 the government announced a major overhaul of Aotearoa’s health system, prioritising Māori, health equity and consistent healthcare across the country. The Future of Health - Te Anamata o te Oranga website has more details about what is proposed, and how the changes are progressing.
Rainbow and takatāpui health has had limited visibility in the reforms so far. Minister Little acknowledged health equity for rainbow communities in announcing the reforms, but rainbow health was not considered in detail in the background to the reforms or the earlier Health and Disability System Review.
More recently, we’ve seen rainbow communities recognised in two of the key documents guiding the reforms:
Reflecting on progress for rainbow communities
If done well, the reforms could be significant for rainbow and takatāpui health. Moira has written some pieces about this:
April 2021: An opportunity for change: health system reforms and rainbow health
October 2022: A good start: rainbow communities and Te Pae Tata
March 2023: If I was writing a rainbow health strategy
PATHA has also written a vision for transgender healthcare under the current health reforms (also summarised in the NZ Medical Journal).
Pae Ora (Healthy Futures) Bill
The health system reforms include major changes to how the health system is structured, including replacement of the District Health Boards with central agencies and establishment of a Māori Health Authority. The Pae Ora (Healthy Futures) Bill puts these new structures in place.
We made a submission on the Bill focusing on takatāpui and rainbow health:
Our submission on the Pae Ora (Health Futures) Bill asking for the new health system to be required to develop a national takatāpui and rainbow health strategy, including provision of gender-affirming healthcare and progress on developing rights-based health services for intersex people.
A short summary of our submission.
A supplementary submission with the names of 21 organisations and 75 individuals who supported our call for a strategy, along with some of their thoughts about what should be prioritised.
A recording of our in-person submission to the Committee (starts at about 12:35).
The Committee’s report opted not to recommend a takatāpui and rainbow health strategy. Significantly, they did recommend that the new Hauora Māori Advisory Committee should include systems-level insights into takatāpui health. As of 4 May, the Greens have introduced a Supplementary Order Paper calling for the addition of a Rainbow Health Strategy.
Other rainbow perspectives on this Bill:
Rainbow Greens webinar recording
submissions: Intersex Trust Aotearoa New Zealand, Gender Minorities Aotearoa, Mani Bruce Mitchell, Rainbow Greens.