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The provision of gender affirming hormone therapy for transgender and non-binary people is a rapidly developing area of gender affirming healthcare. While research indicates the benefits of providing gender affirming hormone therapy through interdisciplinary primary care-based models, less is known about how service users and providers construct their understandings of affirmative approaches. In this paper, we present findings from a discourse analysis of four service users' and four healthcare professionals' talk about a primary care-based pilot clinic providing gender affirming hormone therapy in Aotearoa New Zealand. Participants employed notions of pathologisation, time, and agency in their talk to construct the clinic as a personal setting which gave service users time to make their own health decisions, while constructing hospitals as impersonal with lengthy wait times. The assessment-driven nature of best practice guidelines that governed clinicians' decision-making was constructed as constraining users' agency. Findings highlight the ongoing importance of aligning gender affirming hormone therapy with other non-disease types of healthcare, and suggest new ways for achieving this through affirmative approaches to healthcare. [ABSTRACT FROM AUTHOR]

The increased use of information technology in health care allows researchers to generate data on rates of medication use among population groups, raising questions as to whether these rates are too high or too low. This paper presents findings from a study of records of all prescription medication dispensed in one New Zealand region (Te Tāirawhiti) over a one year period. The study examined patterns of psychotropic medication use amongst older people, by age, gender, ethnicity and socio-economic position. It concludes that the chances of being defined as needing psychotropic medication, that is, of being 'medicalised', are not evenly spread through the elderly population. Gender, age and ethnicity impacted significantly on whether prescriptions were received. Our results suggest the need for a nuanced understanding of the medicalisation of unhappiness and deviant behaviour amongst the elderly which takes into account barriers to treatment for some social groups. [ABSTRACT FROM AUTHOR]

Many western countries have experienced increased rates of youth suicide over recent years. This has been an issue of particular concern in New Zealand, since it had the highest rate of youth suicide among OECD countries in the mid-1990s. However, while attention is drawn to the now declining youth suicide rate by politicians and policy-makers, what is obscured is a cohort effect. In this paper we will argue that a cohort effect is clearly visible; suicide rates among 15-24 year olds came to the fore in the mid-1980s, peaking 10 years later, and were displaced by that among 25-35 year olds by the late-1990s. Further, this century has been characterised by the rise of suicide rates among 35-44 year olds. This effect correlates with a dramatic downturn in the New Zealand economy in a five-year period bracketing 1970. We argue for an increased focus on social and economic factors underlying suicide. [ABSTRACT FROM AUTHOR]

New Zealand research suggests that CAM use by GPs has decreased, while referral to CAM practitioners by GPs has increased, and that patients often do not tell their health practitioners when they are using CAM. The New Zealand Medical Council has developed guidelines for GPs who use CAM. However, there is no research in New Zealand that looks at how patients and GPs respond to CAM issues in the consultation. This paper uses data collected for two research projects on doctor-patient interaction. For this research, consultations between 105 patients and nine GPs were video-recorded. In this data set, all doctors but one were 'orthodox' and to some degree reserved judgement on CAM, albeit remaining cautious in how they made this evident. Patients on the other hand demonstrated a variety of strategies to get CAM on the agenda, and GPs were careful to couch any criticism in such a way as to protect the 'face' of patients. [ABSTRACT FROM AUTHOR]

Living kidney donation is an alternative treatment option for end-stage renal failure. Prospective donors are protected from risk by counselling and assessment processes, to ensure they are fully informed about all the stages of donation. Drawing on in-depth interviews with 25 living kidney donors from across New Zealand, this article discusses donors' experience of the pre-donation screening process, donation workup coordination, psychological preparation, and post-operative follow-up care and support. In particular, the article examines donor perceptions of the informed consent process. The findings indicate that donors' experience of the consent process may be at odds with the New Zealand Code of Health and Disability Services Consumers' Rights 1996. Instead of a primary healthcare focus on the threshold elements of informed consent, this study indicates that more effort should be made to adequately inform donors and to clearly spell out each stage of the donation process to better meet donors' needs. [ABSTRACT FROM AUTHOR]

Peer support is a fast growing type of service provision within the mental health sector. This study draws on interviews with peer supporters and peer support managers to explore the ways that risks of violence, suicide and self-harm are managed within peer support settings in Aotearoa New Zealand. Drawing on Nikolas Rose and other theorists, who define risk thinking as an attempt to 'discipline uncertainty', we argue that the philosophy of peer support is in tension with a 'risk consciousness' because it sees crisis as a learning opportunity. We contend that peer supporters are pulled towards the 'risk consciousness', which pervades the mental health sector, and that they address this by managing risk in various ways. Finally, we show that peer supporters challenge this risk consciousness by working with risk through a philosophy of engagement and relationship. As peer support becomes more integrated into the wider health system, the challenge will be to continue the development of risk practices which work within a strong peer support philosophy. [ABSTRACT FROM AUTHOR]

Organ donation and transplantation has the potential to save lives. Organ transfer also raises a number of ethical and emotional issues, especially in discussions around anonymity protocol and in relation to the invisible but tangible presence of shared corporeality in the course of organ transfer. In this article, which is based on in-depth interviews with organ transplant recipients and members of donor families, these issues are addressed from the perspective of a sociologist interviewing people about their experiences in this domain. In particular, the article examines what it means to do sociological research on sensitive topics with vulnerable groups in light of institutional ethics guidelines that require protecting the emotional safety of researchers and research participants during the research process. In so doing, I identify several problems with formal ethics approval procedures for researchers engaging with vulnerable groups such as organ donor family members and transplant recipients, and some of the risks associated with taking an empathic approach to social research interviewing. [ABSTRACT FROM AUTHOR]

In an online survey of transgender people conducted in Australia and New Zealand, half the respondents (50.6%) reported having made attempts to amend formal documentation to reflect their current gender identity, and that this was crucial to their sense of personal and identity recognition, as well as an affirmation of citizenship. Experiences and outcomes varied, even within the same organisation, leading to different degrees of difficulty and frustration. For gender to be changed on some documentation, the individual is required to show evidence of having had a related surgical procedure. Almost 90% of participants who had undergone surgery had also made attempts to change documentation, and a quarter of participants who had not undergone any surgical procedures had made similar attempts. Participants who had been able to successfully change their documentation experienced this as affirming of their gender, and as recognition of civil belonging. [ABSTRACT FROM AUTHOR]