New Zealand has a new sex-change surgeon, almost four years after our first and only  practising one retired. It is believed Auckland-based Dr Rita Yang will be the first surgeon in the country able to perform female-to-male as well as the more common male-to-female gender reassignment surgery. While Dr Yang is employed by Counties Manukau District Health Board, she isn't performing surgeries yet due to a lack of an "appropriate multi-disciplinary clinical team", said the DHB's acting chief executive Gloria Johnson in response to an Official Information Act request. The fact she was working at all, however, was an exciting development for the transgender community in New Zealand, said Ahi Wi-Hongi, national coordinator for Gender Minorities Aotearoa who is on the waitlist for female-to-male surgery. Wi-Hongi hoped a in-country gender reassignment surgeon would help spur the Ministry of Health to speed up gender dysphoric Kiwis' access to surgery. Gender dysphoria — the medically-diagnosed condition of being born one gender, but identifying as another — is linked to severe anxiety and depression, as well as high suicide rates. "What surgery would do for lots of people, myself included, is let us feel comfortable enough in our bodies to just get on with our lives," Wi-Hongi said. Until she heard a domestic surgeon was heading home, Wi-Hongi had written their own gender reconstruction off as a pipe dream. Wi-Hongi said self-funding the operation, which can cost up to $180,000, was "impossible" and waiting decades for publicly funded surgery at the current rate would "kind of defeat the point". The ministry currently funds up to three gender reassignment surgeries every two years from its high-cost treatment pool. They have all been performed overseas since 2014,  when New Zealand's last sex change surgeon Dr Peter Walker retired. The backlog of people waiting for surgery has ballooned in recent years; Ministry data shows that since 2015, only two surgeries had been funded while 39 trans people were added to the waitlist — which now sits at 102. President of the New Zealand Plastic Surgeons Association Dr John Kenealy warned that re-starting the surgeries was a "complex" task needing time, money, and political will. "Yes, the surgeon is a key part, but there isn't a major in the country not up to its eyeballs in other work — we have a woeful shortage of capacity," he said. "So when the surgery starts, it will likely be displacing something else." Kenealy said the first thing the Ministry of Health needed to decide was whether GRS funding would continue to be from the high-cost treatment pool — which currently only funds procedures unavailable at New Zealand's public hospitals — or get left up to individual district health boards. What would happen and when, he said, depended on whether new health minister David Clark chose "to put it on his priority list". The ministry declined to comment on when gender reassignment surgery would again be performed in New Zealand. Wi-Hongi said that improved access to counselling and hormone treatments were "still at the top" of trans advocates' agenda. Battles with homelessness, workplace discrimination, and school bullying were also ongoing issues. But a sex-change surgeon in the country did give trans Kiwis hope "that things are changing", Wi-Hongi said. "I'm relieved one of our fights has been won — this was one of the big issues we've been pushing for for years." Dr Yang declined to be interviewed for this article. The New Zealand Institute of Plastic and Cosmetic Surgery website described her as having worked with the most experienced gender-related surgeons worldwide, and said she returned to New Zealand near the start of the year.