PATHA backgrounder

started in 2019, when the Australia New Zealand Professional Association for Transgender Health split into AusPATH and PATHA

local chapter of the World Professional Association for Transgender Health (WPATH)

no qualifications required to join, open to anyone involved in transgender health

membership mix of clinicians and activists

overt role in advocacy

gender identity is a core aspect of being human, and that incongruence between gender identity and “sex assigned at birth” is both a natural variance within humans and may require medication and surgery

care should be given on the basis of ‘informed consent’

young people know who they

access to “gender-affirming health care” is a human right

a core purpose is to advocate for and build public acceptance of a single treatment pathway, “gender affirming health-care” (ignoring other possible treatment pathways)

PATHA endorsed and promotes WPATH’s Standards of Care (latest version is the 2022 SOC 8)

PATHA (est 2019) endorsed and promoted 2018 NZ Guidelines for Gender Affirming Healthcare published by the Transgender Health Research Lab based at University of Waikato.

PATHA unilaterally published new guidelines in 2025. The Guidelines were commissioned by Te Whatu Ora, but PATHA did not want to update the section on puberty blockers in line with Te Whatu Ora new policy.

WPATH and PATHA guidelines have been widely cited and promoted in the NZ health sector and were referenced, until recently, by government health agencies.

A 2024 systematic review of the quality of guidelines (commissioned as part of the Cass Review) found WPATH’s and PATHA endorsed guidelines were two of a large set of poor quality guidelines that rely on mutual cross-referencing to develop apparent consensus.

Assessed against internationally agreed standards WPATH Standards of Care— SOC 7 (2012) and SOC 8 (2022)—met one of the six minimum standards required to be recommended for use. New Zealand’s 2018 PATHA endorsed guidelines scored second to bottom of 23 guidelines and met none of the standards required to be recommended for use.

The poorly rated 2018 NZ guidelines were published by the Transgender Health Research Lab who who also produce and publish the Counting Ourselves surveys of transgender people. Counting Ourselves is heavily relied on for providing statistics on trans and gender youth vulnerability and their need for gender-affirming care.

The Transgender Health Research Lab is run by Jaimie Veale, who was prinicipal investigator for Counting Ourselves, inaugural president of PATHA and has served as secretary and exective member for WPATH and was co-author of WPATH’s SOC 8.

WPATH’s SOC 8 includes a chapter on eunuchs that advises clinicians on methods to entirely remove genitalia and sexual function for those who identify as eunuchs. The chapter was written in consultation with the Eunuch Archives, a fetish website, where readers share fantasies of the castration of young boys (p 588).

In SOC 8, WPATH removed the lower age limit recommendations for any medicine or surgery.

Phillida Bunkle, who was involved in the Cartwright Inquiry that resulted in New Zealand’s model of informed consent argues that the way informed consent is discussed in medical transition meets neither the criteria for consent nor the criteria for informed.