Today, the Government announced in their budget $3 million (or really, just under) towards gender confirmation surgeries. That's $750,000 per year over four years.

It's genuinely great to see this getting some funding, and I really hope this means these surgeries are moving out of the High Cost Treatment Pool - currently, under this pool, the waitlist is managed by the Ministry, it's a clunky process, and it's not transparent whatsoever - at the first Aotearoa New Zealand Trans Health Symposium earlier this month, surgeon Dr Rita Yang mentioned she's seeing some people on the list who have been on it for decades, and some that have only just got on. This care being off the HCTP would mean the waitlist is managed by Rita herself, and would enable more transparency into these processes.

But, and I hate to say this, $3 million is essentially nothing. I ran the numbers:

According to Stuff in February this year there were 104 people on the wait list for 'MTF' surgeries, and 31 on the list for 'FTM' surgeries (side note, those terms suck).

According to Newsroom's article when the cap was lifted:

Ministry of Health figures put the average cost of male-to-female  surgery at $53,382, with individual surgeries costing between $25,587 at  their lowest up to $81,975.
The costs for female-to-male surgery are higher, averaging $218,892, with a range of $45,169 to $525,034.

Using these estimates (rounded to $53k for male-to-female and $218k for female-to-male, and rounding the annual funding to $750k for simplicity), we get, for example, two female-to-male surgeries a year (coming to $436,000) and 5 male-to-female surgeries a year (coming to $269,000).

At that rate, it'd still take fifteen years to clear the female-to-male list, and 20 years to clear the male-to-female list.

There are other ways you can divide that funding in terms of how many of each surgery per year, but none of them come out good.

At the absolute lowest costings the Ministry has given, $25k and $45k, we could do eleven of one and ten of the other - still working out to 10 years to clear the male-to-female list and three to clear the other (which, granted, is a little better but still quite absurd). That Newsroom article mentions the surgery being performed in New Zealand would reduce post-operative complications and related costs, but it's not clear what numbers they're working with.

This doesn't take into account a likely continued growth in the wait list - that Stuff article talked about a five-fold increase, and I'd imagine if that rate hasn't grown, it probably hasn't slowed. In the months before the cap was lifted, we worked out that the waitlist was growing at a faster rate than surgeries were being performed. I personally don't have time to go OIA-ing for waitlist changes to see what the current growth rate is, but this amount of funding indicates they're not performing much more than 10 per year, and we know (from Counting Ourselves data, presented at the Symposium and due to be published in the coming months) that demand is much higher than that.

We need clear information from the Ministry about what this means for funding - realistic timelines for what the wait time is likely to be, and in particular whether this means those services have moved out of the High Cost Treatment Pool.