A transsexual may return to prostitution to pay for gender reassignment surgery because the Government waiting list is too long.
The Health Ministry has provided funding for gender reassignment surgery under its High Cost Treatment Pool since 2004.
Jasmine Eastall, 28, is so desperate for the surgery - which she said is the final piece "to being the woman you really are" - she was considering returning to prostitution to fund it herself.
While Eastall was born with male genitalia, she said she never identified with being a male.
Although the cost of male to female surgery costs an average of $45,000 in New Zealand, the price in Thailand is about a third of that, said Racheal McGonigal, who recently wrote to Health Minister Tony Ryall urging him to consider alternatives to the current funding, including funding for surgery overseas.
The 12 operations funded by the ministry in the past eight years were all performed by a team of three Christchurch-based surgeons.
It has funded three people to travel overseas for female to male surgery, as there are no surgeons in New Zealand who can perform the operation.
"As NZ has specialists who can perform the male-to-female surgery we do not send people overseas for that surgery. This is policy in line with all other funding by the High Cost Treatment Pool,'' the ministry said in a statement.
The ministry said there are 53 people on the waiting list and an average seven-year-wait - but McGonigal said most people will have to wait much longer than that, considering only 12 surgeries have been performed in the last eight years.
"At this level of surgeries New Zealand transsexuals are being strongly disadvantaged and marginalised by our health system," she says.
"Here in New Zealand it is very much regarded as cosmetic surgery, but it's not.
"It's easy for people to just say it's plastic surgery, but it's basically a disability on a person born with the wrong genitalia."
Similar calls are being made overseas with the Parents and Friends of Lesbians and Gays in Australia calling on their government to make the surgery a priority.
McGonigal, 56, travelled to Thailand in 2006 to have the male-to-female surgery performed, but said many people cannot afford to do that.
Simone Whitlow has been on the waiting list since last year, but is also saving to travel to Thailand for surgery.
"As far back as I can remember I've felt completely in the wrong body," the Aucklander, who works in finance, said
The 36-year-old said she has lived as a female for about five years, has had hormone treatments and laser treatment on her facial hair, but said she will continue to feel "deformed" until she has the surgery.
"It's no different to someone who is a burns victim or has a cleft palate," she said.
"We struggle with this daily."
But Louise Gizzi, parent of four young children, said the ministry should consider sending people overseas as well as performing the surgery here.
The Dunedin-based systems engineer is now living as a female and is on the waiting list, while also saving for the surgery herself "because you're on the waiting list but you never think you're going to get there.
"Even if I did get the surgery tomorrow I would fight for others," she says.
"It's so fundamental to who we are."