Transgender patients wanting sex change operations and hormone treatments say they are marginalised by disrespectful, ill-informed doctors and a baffling health system.
A Human Rights Commission report two years ago found transgender services are patchy and inaccessible.
This week, doctors and transgender people are joining forces on a one-year national project to improve them.
A member of the team, Waikato plastic surgeon Chris McEwan, says frustration with the system and the almost $40,000 cost of the operation drives two-thirds of patients overseas for treatment.
The Medical Association says not all doctors can be qualified in this area, but they are expected to treat all patients with respect.