PRISM: Human Rights issues relating to Sexual Orientation, Gender Identity and Expression, and Sex Characteristics (SOGIESC) in Aotearoa New Zealand - A report with recommendations RECOMMENDATIONS: Urgently implement measures to address current disparities experienced by the SOGIESC communities in accessing services throughout the health sector; Develop practice standards to improve access to health and peer-led service delivery for marginalised SOGIESC-diverse communities, particularly Māori, Pacific peoples, people with disabilities, trans people in detention, and older people; Provide guidance, training, and resources for all workers in the aged care sector on diversity in sexual orientation, gender identity and expression, and sex characteristics; Require District Health Boards to ensure trans and non-binary people’s access to gender affirming health services available in New Zealand, over their lifespan, based on an informed consent model of healthcare, aligned with evidence-based international standards; Support the development of guidelines, training and resources for health professionals on an informed consent model of healthcare for trans and non-binary people and provide information and resources for individuals, families and communities about accessing gender affirming services; End the practice of medical interventions on people with variations of sex characteristics which can be deferred to a later age; Create clear pathways to access publicly funded reparative surgery and support for people with variations of sex characteristics through each District Health Board. 46