Plastic surgeon Peter Walker is the only doctor who has ever performed gender reassignment surgery in New Zealand.
Peter Walker recently retired - he looks back at his career and experience with trans people.
Dr Peter Walker: We were doing about three [sex changes] a year from 1992. New Zealand, as we may not all appreciate, is actually quite advanced and broadminded because the patients – after they’d had their operation – were able to go to the Department of Internal Affairs (quite aptly named) and apply to have their gender changed on not only their drivers license and their passport, but even their birth certificate.
If a patient comes to me – they’re 6’4” and bald with huge hands – it’s difficult for me to convert them into a woman.
These patients that came to me looked like a male, they had male genes, they had male anatomy, they had male hormones, but their brains were female.
Without doubt when I spoke to these patients and our psychiatrists helped make the diagnosis, we found that these patients really knew that they were different from other children right from the age of four, five, six years old.
If these patients weren’t accepted by their parents as being a girl, often they tried to prove that they were actually macho men. So they would have grunty V8s and Harley Davidsons, they would have tattoos, they would join the army and become SAS commanders and do everything they could to prove to anyone that they were male.
The ratios are 1 in 37,000 males want to become female and 1 in 150,000 females want to become male.
You need to have a big population in order to sustain a female-to-male clinic. And because New Zealand’s population is so small the number of patients wanting to go in that direction is insufficient to maintain the expertise that is necessary. The New Zealand government is very good in that they will pay for one patient every three years to undergo female to male change.
There are 61 people on the waiting list [in New Zealand]. If you do the sums – given the New Zealand population is 4.5 million – it means that there are perhaps 1,300 patients aged between 0 and 100 out there – far more than are on the waiting list.
We can make all the features that a female has out of the male genitalia – except of course a uterus. But I guess in the future somebody is going to catch one of the many hysterectomies that are done and implant that uterus into a male patient.
One day a male will give birth to a child conceived in a womb that they have had transplanted. That’s all in the future, but it will happen.