Mainstream media discourse around top surgery in New Zealand: a qualitative analysis

**Background**: Gender-affirming breast surgery (colloquially known as ‘top surgery’) can be an important intervention for transgender individuals. Top surgery is also a key component of care for non-binary and gender non-conforming individuals. New Zealand (NZ) secondary care physicians are not aware of all available services, and no studies have investigated public perception of availability and funding of top surgery in NZ. **Method**: To investigate public perception around top surgery in NZ, we analysed the text and comments sections of all relevant NZ news articles over a five-year period, utilising a general inductive thematic analysis approach. **Results**: The analysis resulted in a model of four themes–public funding, [trans] experiences, [trans] issues amenable to intervention and [trans] issues not amenable to intervention. **Conclusion**: The discourse around top surgery in NZ is mixed; some individuals consider top surgery to be an essential medical procedure deserving of public funding, while others describe it as a frivolous cosmetic procedure. The perspectives of transgender individuals clearly communicated a frustration around a lack of funding and transparency in the availability of top surgery in NZ. We recommend the release of clear criteria from the Ministry of Health regarding public funding and availability of top surgery across NZ to address this frustration.