Understanding gender diversity

When you are born, you are assigned a sex – male, female or indeterminate – depending on the appearance of your external genitalia. You may feel that the sex you were assigned is correct. This is called being 'cisgender'. You may feel that the sex you were assigned is incorrect. This is called being 'transgender'.

Key points 

  1. Gender identity refers to an innate sense of who you are. This may be the same as or different from the sex that was assigned to you at birth. How you choose to express your gender identity varies from person to person.
  2. Gender dysphoria is a term used to describe uncomfortable or distressing feelings that some people experience because the sex they were assigned at birth does not match their gender. Read more about gender dysphoria.
  3. If you are transgender, or experience gender dysphoria, you may want to take steps to be recognised as your gender, rather than the sex you were assigned at birth. These steps may include changing your name, wearing clothes that affirm your gender, taking hormones or having surgeries.
  4. Sexual orientation is different to gender. It refers to who you are attracted to and may be described as heterosexual/straight, lesbian, gay, bisexual, pansexual, asexual, takataapui or using other terms. 
  5. Gender diversity is a term to cover the range of possible gender identities, such as female, male, transgender, intersex, non-binary and takatāapui.
  6. If you are unsure about your gender, or your child is unsure about theirs, there is support available to help you.

What is gender identity?

When you are born, you are assigned a sex – male, female, or indeterminate – depending on the appearance of your external genitalia. You may feel that the sex you were assigned is correct. This is called being 'cisgender'. You may feel that the sex you were assigned is incorrect. This is called being 'transgender'.

A transgender person may identify as a binary gender such as a transgender woman (who was assigned 'male' at birth) or a transgender man (who was assigned 'female' at birth). Or a transgender person may identify as a non-binary gender – this includes any gender that is not male or female. 

'Intersex' is an umbrella term that refers to people born with one or more of a range of variations in sex characteristics that fall outside of traditional conceptions of male or female bodies. For example, intersex people may have variations in their chromosomes, genitals or internal organs like testes or ovaries. If a person has an intersex condition, they may be cisgender (agreeing with the sex they were assigned at birth) or transgender (not agreeing with the sex they were assigned at birth), or they may simply identify both their sex and gender as intersex. It is important to not make assumptions about this, but instead to let people define their own experiences.

What is gender diversity?

Gender diversity refers to a diversity of genders in addition to cisgender people.

Some people think of gender as a spectrum that includes female and male at either end and other genders in between. However, other people may think of male and female as two letters in an alphabet of other genders. Defining non-binary genders is like defining all the other letters of the alphabet, in every language. Genders are so many and varied across different cultures and throughout history. 

Some people have a consistent gender throughout their life, and for other people their gender changes. Some of the words that people might use to define or describe their gender, include aikāne, akava’ine, fa’afafine, faa’atama, fakafifine, fakaleiti, genderqueer, intersex, māhū, non-binary, palopa, takatāpui, tangata ira tāne, trans, transgender, transsexual, and whakawahine. 

What are some of the issues faced by people who are gender diverse? 

As a population or demographic, trans people experience significantly higher rates of mental health issues compared with the general population, such as depression and suicidality.

Research shows that the disparity in mental health outcomes is a result of experiencing elevated levels of minority stress, due to discrimination in education, housing, healthcare, employment, access to goods and services, participation in public social life and input into policy and legislative decisions which affect their lives. These factors also create significant barriers to healthcare in general. 

How can I support transgender people?

It depends on your relationship to them. For example, an employer has legal obligations to provide a safe workplace, a clinician has a legal obligation to provide safe and appropriate healthcare, and for whānau, support is more about accepting, respecting, learning and caring. If this is the beginning of your journey to support transgender people, there are many resources available to assist you in learning. 

The first step in any case, is to use the name and pronoun (eg, she/her, he/him, they/them) that the transgender person is comfortable with, and to respect their privacy by not telling others unless they give consent.

What support is available for gender diverse people?

Gender Minorities Aotearoa Gender Minorities Aotearoa is a cross-cultural, transgender-led organisation that operates on a kaupapa Māori public health framework. Its activities include research, providing information and resources, advocacy, education and training, operating services for gender minorities and providing support for takataapui, transgender and intersex people, and referrals to other services.
Transgender and Intersex NZ The Facebook group is the largest online transgender community support group with a New Zealand-based membership. This group is primarily for sharing information between people of diverse genders and sex characteristics, and has a secondary focus on supporting parents and whānau as well as those who work with trans people and supportive others.
Hauora tahine – pathways to transgender healthcare Secondary services that provide gender-affirming healthcare for transgender and gender diverse people across the Northern Region DHBS (Northland, Waitemata, Auckland and Counties Manukau).
Intersex Youth Aotearoa (IYA) Intersex Youth Aotearoa is a place for all people with intersex variations/DSD, and their whānau and friends to share information, find support and network with each other.
Naming NZ An organisation to help transgender, gender diverse and intersex youth with updating identity documents to correctly reflect their sex and gender.

For a full list of national and local support groups, see gender diversity support organisations.

Learn more 

The following links provide further information about gender diversity. Be aware that websites from other countries may have information that differs from New Zealand recommendations.   

Gender identity Common Ground, NZ
Families of gender diverse children and young people Families Like Mine, BeyondBlue, Australia
Let's talk – a resource guide for parents Outline, NZ
Breaking through the binary – gender explained using continuums itspronouncedmetersexual.com
Find information and services Gender Minorities Aotearoa
Hormone replacement therapy Transgender NZ Issue 1, Gender Minorities Aotearoa, 2017
Oliphant J, Veale J, Macdonald J, Carroll R, Johnson R, Harte M, Stephenson C, Bullock J. Guidelines for gender affirming healthcare for gender diverse and transgender children, young people and adults in Aotearoa New Zealand Transgender Health Research Lab, University of Waikato, 2018
Counting ourselves community report Counting Ourselves, NZ 
Trans and non-binary inclusive workplaces – a guide for employers and employees Outline, NZ


  1. Trans and gender diverse people Better Health, Australia, 2018
  2. Transgender New Zealanders Ministry of Health, NZ, 2017
  3. Gender dysphoria NHS Choices, UK, 2016
  4. Gender dysphoria Mental Health Foundation, NZ, 2015
  5. Health care for transgender New Zealanders Ministry of Health, NZ, 2018
  6. Gender dysphoria Patient Info, UK, 2018
Credits: Health Navigator Editorial Team . Reviewed By: Sex and Gender Diverse Health and Outcomes Working Group, Capital and Coast DHB Last reviewed: 06 Nov 2019