Gender and Sex Data protocol for primary care

Gender and Sex Data protocol for primary care The Ministry of Health has developed an interim Gender and Sex Data Protocol to support the primary health care sector to collect gender and sex assigned at birth data. The protocol will also support transgender and non-binary people when interacting with health care providers in primary care.

The protocol is a living document and future versions will be informed by the feedback received from the sector and engagement with Rainbow communities. The protocol is for guidance purposes on the collection and use of gender and sex assigned at birth data only, and the recommendations are not mandatory. Using the protocol in primary care is expected to support efforts to improve the capability of the workforce to meet the needs of transgender people. The MoH has acknowledged that current system restrictions are likely to prevent full implementation at present.

The mandate to develop this protocol arose from a Primary Health Organisation Service Agreement Amendment Protocol (PSAAP) meeting in late 2020 which identified an unmet need in primary health care for formal guidance on how to collect and utilise gender and sex assigned at birth information in a way that is inclusive for members of transgender and non-binary communities. A smaller PSAAP working group was established to develop this protocol.

The protocol seeks to reduce the harm and distress transgender and non-binary communities experience when they are misgendered or ‘outed’ unexpectedly. For example, a transgender person may not be ‘out’ in all parts of their life, and it may not be safe for them to reveal their transgender identity in some situations. Examples of such experiences are detailed in a report by the Transgender Health Research Lab that the University of Waikato released in 2019 called “Counting Ourselves: The health and wellbeing of trans and non-binary people in Aotearoa New Zealand”. The report stated that over a third (36 percent) of participants avoided seeing a doctor because they were worried about disrespect or mistreatment as a transgender or non-binary person and in the 12 months prior, 13 percent of participants reported being asked unnecessary or invasive questions from primary health care staff about being transgender or non-binary that were unrelated to the purpose of their visit The protocol is backed up by dataset specifications for recording gender and sex assigned at birth, published by the Ministry’s Health Information Standards Organisation (HISO) and Stats NZ. HISO standards are published by the Ministry as data and digital standards for the health and disability system. The HISO 10046:2021 Consumer Health Identity Standard includes a code data element and write-in option for recording gender. Additionally, Stats NZ published a statistical standard for gender, sex, and variations of sex characteristics that the Ministry’s specifications align to.

Further resources to help in applying the protocol are available on the Professional Association for Transgender Health Aotearoa’s (PATHA) website: patha.nz/ The protocol will be progressed by a broader piece of work being led by the Ministry around transgender health, which will support operational implementation, including guidance for specific workforces. Practice Management Systems (PMS) are an integral part of this work, and the sector will be kept updated on progress with PMS implementation. The PMS vendors have been advised of the protocol’s release.

Feedback on this interim protocol can be shared with Jenna Osborne-Taylor (Senior Advisor, Primary Care) – jenna.osborne-taylor@health.co.nz