Latest News

Transgender patients turn to internet to buy hormones, say they lack health system support

Published

3 years ago

September 5, 2023

One person said she had been using patches (pictured) and pills prescribed by the GP but had not been seeing any body changes (file image). Photo: BMJ
Hormone TherapyInjectable estrogen is legal in New Zealand but very difficult to get prescribed. Photo: 123rf
Some transgender patients are turning to the internet to buy gender-affirming hormones, saying they are not getting the support they believe they need from the health system.

They say taking unprescribed hormone treatment is risky, and they would prefer to receive treatment under medical supervision.

Auckland Sexual Health says demand for its services from trans patients has increased six-fold since 2016.

National guidelines for gender-affirming health care have been rolled out to GPs around the country, but some in the trans health sector say work is still needed to upskill many doctors.

‘I would just like people to listen to their trans patients more’
Aucklander August Ward had hoped to medically transition with her GP’s support but ended up resorting to do-it-yourself hormone treatment.

Ward said she had been using patches and pills prescribed by the GP but had not been seeing any body changes.

She made numerous visits to the GP over a three year period but was still within the acceptable male range for estrogen which was frustrating and she felt desperate, she said.

“So I switched to buying injectable estrogen from the internet, which helped a lot.”

In an attempt to find out why the hormone treatment she was receiving from her doctor was not having the desired outcome, Ward said she did some online research.

Treatment guidelines from other countries were quite different to New Zealand’s, she said.

“Like they recommend that you have higher estrogen levels in order to achieve the changes that you want.”

Ward said her doctor may have been worried about blood clots associated with higher estrogen levels, but she did not believe that was “so much of a risk”.

Ward’s doctor told her that she was already on the highest possible dose of patches and pills and that estrogen injections were not prescribed for trans people in New Zealand – but that turned out not to be true, she said.

Buying estrogen online was straightforward other than needed to use crypto currency to purchase it, she said.

The hardest part was working out what dose to take and self injecting the hormone, she said.

Ward said she informed her GP that she was injecting the estrogen and although the GP was not happy about it and would not aid her in doing it, the GP did inform her what to look out for in terms of side effects and continued to monitor her hormone levels via blood tests.

Ward felt that injecting estrogen was the right decision for her although she said trans people should not have to resort to using the internet to source it.

Asked what changes she would like to see as a result of her experience, Ward said it would be very easy for GPs and Auckland Sexual Health to prescribe estrogen injections.

“I would just like people to listen to their trans patients more.”

‘It’s really difficult to get in NZ’ – Trans on Campus
Avery Zavoda from the University of Auckland group Trans on Campus said it was very common for people not to respond to one or more forms of estrogen that was available to them.

“Because of that they need to resort to injectable estrogen but unfortunately it’s really difficult to get in New Zealand and because of that they have to get it online.”

More than 100 trans people in the wider New Zealand trans community sourced their estrogen online, Zavoda said.

Those who did source injectable estrogen online were encouraged to talk to their GPs by others in the trans community, Zavoda said.

“Where it does fall down is where the GP does deny the monitoring tests and does deny this oversight … and that’s when it can kind of fall apart, when the doctors tend to just deny it because they don’t want to see people doing it.”

Some GPs, particularly in larger organisations, were being held back by those who had shaped New Zealand’s guidelines on injecting estrogen for trans people, with the guidelines in this country differing from those overseas, Zavoda said.

“Injectable estrogen is technically [and legally] available in New Zealand to prescribe, unfortunately that’s not particularly back up, or well resourced within New Zealand, internationally it is.”

Not having that information readily available meant GPs and clinicians often lacked the confidence to do what was right for their patients, Zavoda said.

Funding for the national guidelines sat with Te Whatu Ora, Zavoda said.

It was essential to provide GPs with accessible information about what was available for their patients knowing that it would be backed up nationally, Zavoda said.

Not yet known if injectable estrogen safe enough to include in guidelines – Stephenson
GP Cathy Stephenson, who co-authored the national guidelines around gender-affirming healthcare, said the guidelines were only part of it.

“What we don’t yet have is the accompanying education and upskilling of the workforce so that all our GPs feel competent and safe to work in this space.”

However, it was coming and Te Whatu Ora was keen and had provided some funding for it, she said.

One of the main points the guidelines outlined was that “the earlier we can provide safe, close to home, gender-affirming care for trans and non-binary people – the better the outcomes”, she said.

“The guidelines also talk about using medication that’s got a long-established evidence base, and that has been used over many years so that we understand the risks and the safety profiles.”

Currently the guidelines did not consider that injectable estrogen fell within that safe level of evidence, she said.

That was probably because injectable estrogen had not been used for many years within the trans community, she said.

“What we do know is that when you first inject estrogen you tend to get very high and often fluctuating levels in the body and they may go well above physiological female levels of estrogen.”

At this stage it was not known whether or not that was safe and it was probably associated with an increased risk of blood clots and even of cancers, she said.

Until more was known it was hard to know whether to put it into the guidelines, but it was a rapidly changing field, she said.

“My hope is that over the coming years we will understand more and more about which medications are best and which ones will get the best outcomes for individuals.”

VIA RNZ

Latest News

Police say person who fired gun at officers still at large

Published

2 days ago

November 12, 2026

News Staff

Police say a person who fired a gun at officers in Napier is still at large.

Eastern District Commander Superintendent Joel Lamb said Police tried to stop a vehicle in the Pirimai Area at about 10pm on Tuesday.

He said someone in the back seat pointed what was presumed to be a firearm at officers pursuing the vehicle.

“Staff have then heard two distinct gunshots as the firearm was discharged.

“Fortunately, neither of our officers were injured, and the patrol vehicle did not sustain any damage.”

He said hours later, the vehicle was seen travelling north on the Waikato Expressway towards Auckland.

Police seized the vehicle at an address in Manurewa, but they had not found the alleged offender.

Lamb said people who lived at the Manurewa address were engaging with Police.

He said Eastern District and Counties Manukau Police were making enquiries.

“Presenting a firearm at a Police officer is a serious escalation that puts our staff and the wider community at risk. This behaviour is entirely unacceptable.

“We are taking this incident extremely seriously and will be pursuing all lines of enquiry to locate the offender and hold them accountable.”

Police asked anyone who witnessed the incident to contact Police on 105 or online using the reference number 261111/3764.

Information could also be provided anonymously via Crime Stoppers on 0800 555 111.

rnz

Latest News

New Zealand sides named for RLWC finals

Published

3 days ago

November 11, 2026

News Staff

The players tasked with ending Australia’s Rugby League World Cup dominance have been named.

The Kiwis and Kiwi Ferns have announced their squads for this Sunday’s World Cup finals in Brisbane.

Both sides are chasing their first titles since 2008, and both are looking to end their opponents run of three crowns in a row.

“Our Kiwi Ferns have been so dominant in years gone by, and we want to bring dominance back to this jersey, so I think it will be a case of who wants it more,” said co-captain Georgia Hale of the impending clash.

The Kiwis get a major boost for the final as they welcome back Ronaldo Mulitalo after he served a one-match ban for a high tackle against Fiji Bati.

Mulitalo replaces Charnze Nicoll-Klokstad, who moves to the six-man bench, which again includes utility Te Maire Martin, middle forwards Naufahu Whyte, Erin Clark and Xavier Willison plus fullback Keano Kini.

Loose forward Joseph Tapine will make his 30th Test appearance in a familiar pack again, including second-rowers Isaiah Papali’i and Briton Nikora, and props James Fisher-Harris and Moses Leota.

Winger Jamayne Isaako is on the cusp of claiming the New Zealand record for most Test points.

His five goals against Tonga lifted his career points tally to 225 – level with Shaun Johnson – while centre Casey McLean goes into the final with 16 tries in just eight Tests.

Fisher-Harris will again captain the team.

Fullback Ponga said the goal of the group was clear.

“We have high expectations around what we want to achieve, and obviously winning a world Cup is one of them.”

Meanwhile, Ricky Henry has selected a settled side to take on the Jillaroos, led by their lethal centre combination of Stacey Waaka and Mele Hufanga.

Veteran Apii Nicholls takes the number one jersey, Leianne Tufuga and Mackenzie Wiki on the wings.

Henry has stuck with his halves pairing of Chantay Kiria-Ratu and Raecene McGregor with Alexis Tauaneai, Georgia Hale and Otesa Pule up front.

Rounding out the starting pack is Shaniece Monschau, Kaiyah Atai, and Angelina Teakaraanga-Katoa.

“We have been building well throughout the tournament; we understand the Jillaroos side, and will give it our all to make New Zealand proud this weekend,” said Henry.

RLWC Finals:

Kiwi Ferns vs Jillaroos- 6.10pm

Kiwis vs Kangaroos – 9.35pm

Sunday November 15

Suncorp Stadium, Brisbane

Live blog updates on RNZ

Kiwi Ferns:

1. Apii Nicholls 2. Leianne Tufuga 3. Mele Hufanga 4. Stacey Waaka 5. Mackenzie Wiki 6. Chantay Kiria-Ratu 7. Raecene McGregor 8. Alexis Tauaneai 9. Georgia Hale 10. Otesa Pule 11. Shaniece Monschau 12. Kaiyah Atai 13. Angelina Teakaraanga-Katoa.

Interchange: 14. Ashleigh Quinlan 15. Annessa Biddle 16. Shannon Mato 17. Ivana Lauitiiti.

Reserves: 18. Brooke Anderson 19. Zahara Temara 20. Brianna Clark 21. Abigail Roache 22. Tenika Willison.

Kiwis:

1. Kalyn Ponga, 2. Jamayne Isaako, 3. Dane Gagai, 4. Casey McLean, 5. Ronaldo Mulitalo, 6. Kodi Nikorima, 7. Jahrome Hughes, 8. James Fisher-Harris (c), 9. Jeremy Marshall-King, 10. Moses Leota, 11. Isaiah Papali’i, 12. Briton Nikora, 13. Joseph Tapine (v/c).

Interchange: 14. Te Maire Martin, 15. Naufahu Whyte, 16. Erin Clark, 17. Xavier Willison.

Reserves: 18. Keano Kini, 19. Phoenix Crossland, 20. Charnze Nicoll-Klokstad, 21. Scott Sorensen, 22. Leo Thompson.

rnz

Latest News

Parliamentary Service working on extra chairs and offices for increased number of MPs

Published

3 days ago

November 11, 2026

News Staff

The chief executive of the Parliamentary Service is confident there will be enough room to accommodate the increased number of MPs and their staff coming into Parliament.

On current numbers, up to 131 MPs could be sitting in the Chamber following the election, brought on by a record overhang result.

Clerk of the House of Representatives Dr David Wilson told the Spinoff that currently the debating chamber had enough chairs to seat 124 MPs – including the Speaker of the House – and work was being done to accommodate more by altering the seating arrangement.

In a statement, Parliamentary Service chief executive Rafael Gonzalez-Montero said planning for a larger Parliament had been going for “some time”.

“Now that the election results have confirmed an increase to the number of members we are looking at several options.

“We are confident we will be able to accommodate all members within the Chamber.”

Chief Executive of the Parliamentary Service Rafael Gonzalez-Montero appears before select committee. — Parliamentary Service chief executive Rafael Gonzalez-Montero.

VNP / Phil Smith

Gonzalez-Montero said office accommodation for members and their staff would be “stretched” for a short time, but the new Members’ Building was only a few months away from “practical completion”.

That building – located behind Parliament – was due to be ready to occupy in April next year and had capacity to accommodate around 30 backbench MPs.

“All members should be in fit-for-purpose accommodation from that point,” Gonzalez-Montero said.

Following the 2023 election, 123 MPs sat in the Chamber – a record number at the time. That decreased to 122 following the resignation of National MP Judith Collins.

Collins held the seat of Papakura and stepped down in May and Parliament voted against holding a by-election because it was too close to the election.

The election result also meant high-ranking National Party MPs like Chris Bishop, Paul Goldsmith, Nicola Willis and Gerry Brownlee – Speaker of the House and an MP for 30 years – would likely not make it back into Parliament.

Only resigning or retiring MPs were permitted to give a valedictory speech meaning none of them would get the chance to give a valedictory statement.

Asked if their would be special allowances for valedictories, Wilson said in a statement that normally only MPs were allowed to speak in the House but the House could suspend its own rules or temporarily alter them.

“It could do so to allow former members to address the House.”

Wilson said no such arrangements could be made until the next Parliament opened and members sworn in.

rnz