Project Conclusion

The Trans Pregnancy Care Project has been undertaken in response to growing calls both globally and in Aotearoa to improve healthcare access and delivery for trans people as a fundamental part of achieving health equity. There are unique considerations for health services that have historically assumed that users of care are cisgender women, including gynaecological and reproductive health services, to ensure system and workforce readiness to provide trans affirming and inclusive care. Collectively, findings from both phases of our study highlight both the challenges that trans people and whānau can face in these services, and strategies that all perinatal services and professions can implement to better serve trans people and whānau.

As our findings show, some providers and services are already implementing these initiatives, primarily led by Lead Maternity Carers who champion affirming and inclusive community-based care. Improvements are needed to ensure that trans people and whānau can anticipate care that is consistently affirming and inclusive when they engage in all types of perinatal care beyond their lead provider, particularly when they receive hospital-based care. Historically, the perinatal workforce has not been adequately prepared to provide affirming and inclusive care and most providers are willing and open to engaging in education to support affirming and inclusive practice. Warming the Whare: A Te Whare Takatāpui informed guideline and recommendations for trans inclusive perinatal care provides guidance and recommendations to promote both system and individual provider level changes to ensure all trans people and whānau can thrive in perinatal care. This guidance should ideally be implemented holistically, noting that each of the six values presented in the framework are interwoven.