A doctor has accused the Ministry of Health of inflicting "cruel, cynical, hopelessness" on transgender patients, in emails obtained by ONE News.
Laird Madison, an endocrinologist at the Taranaki District Health Board, wrote to a Ministry staff member last year, asking why the Government maintains such long waiting lists for gender reassignment surgery.
"Why in God's name put a patient on a 40 year waiting list?", Dr Madison wrote.
"Isn't 40 years outrageous enough for the Government to admit failure – they want the list to grow?
"I suppose they do, that makes it much more an intractable problem and puts it into the 'too hard' category.
"I think it is just inflicting cruel, cynical, hopelessness on the patient – generate a false sense that something is being done."
In reply, a Ministry of Health senior adviser sympathises with the doctor's position.
"I share your frustration. I am hoping that we will get approval to increase the volume of surgeries we are mandated to provide."
Eighty-eight people are now awaiting gender reassignment surgery, with an average of two operations funded from the public purse each year.
Dr Madison declined to comment further, saying the comment to the Ministry effectively explained his opinion.
The Health Minister, Jonathan Coleman, is standing by the funding policy, saying spending needs to be prioritised across different areas.
"I have total sympathy for these people who are seeking this type of surgery but the health system has never been able to deliver absolutely everything that absolutely everybody has wanted, and we've got to focus on essential care."
The Ministry of Health says the cost of male to female surgeries is about $35k-$40k, while for female to male surgery can be as much as $180k and the surgery needs to be undertaken overseas.
The emails were obtained by transgender woman, Jennifer Shields, through the Official Information Act, after they were initially withheld by the Ministry of Health.
The 21-year-old puts the wait for male-to-female surgery at about 50 years, with 71 individuals awaiting an operation.
Three of the procedures are funded every two years.
"If I got on [the waiting list] today I would be 71 by the time I got the surgery and by that time it would probably be a health risk to go ahead with it. You get on it in the hopes they'll fix it sometime before you die."