Examining the State of Health Research on Pacific Rainbow Communities in New Zealand; Literatrure Review

Main Article Content

Patrick Thomsen
Sarah Mclean-Osborn
Hollyanna Ainea
Allyssa Verner-Pula


Pacific Health Research, Pacific Rainbow Health, Manalagi Project, Queer/Rainbow Health, MVPFAFF, LGBT


Introduction: Pacific Rainbow/Queer Communities (PRCs) in New Zealand (NZ) have had scant attention paid to the specificities of their health and wellbeing needs in research. Recently, the Health Research Council of NZ funded its first Pacific-specific PRC project (The Manalagi Project) executed through the University of Auckland’s Centre for Pacific Studies. This paper reports a literature review conducted to ascertain the current state of health research on PRCs, Rainbow/Queer and Pacific communities’ health in NZ.

Methods: A scoping review was conducted where relevant public health database search engines were accessed, which included PubMed and Medline to explore both national and international health research pertaining to PRCs, Pacific communities and Rainbow/Queer communities. Additional Google searches were undertaken to identify more ‘grey’ material such as reports, websites, other relevant government sources, as well as non-profit organisation and educational resources not visible via scientific databases.

Findings/Outcome: The review identified published journal articles (n=20), books (n=1), reports (n=25) and theses (n=3) as well as other documents relevant to the study, such as websites and news articles pertaining to PRCs in NZ and abroad. It reveals a severe paucity of health research focused on PRCs domestically and internationally. Although more research is being conducted into the space of Pacific communities, as well as Rainbow/Queer communities, research that is PRC-focused is urgent and critical at this time.

Conclusion: Both Pacific and Rainbow/Queer communities in NZ are socially marginalised, thus experience a raft of health challenges represented by a racist and cisnormative heterosexist health system. This literature review reveals a lack of understanding around the nuances that exist when these experiences intersect and coalesce in the body and experience of PRC members. It has identified a significant gap in Pacific health research that exists in NZ and abroad that urge us to frame future research to also be intersectionally-informed to capture the unique needs and context of PRCs.

Abstract 185 | PDF Downloads 55


1. Stats NZ. New Zealand’s population reflects growing diversity | Stats NZ 2019. https://www.stats.govt.nz/news/new-zealands-population-reflects-growing-diversity (accessed January 14, 2021).
2. MVPFAFF. Rainbow directory n.d. https://rainbowdirectory.co.nz/glossary/mvpfaff/ (accessed January 26, 2021).
3. Weedon A. Understanding the Pacific’s alternative genders. RNZ 2019. https://www.rnz.co.nz/international/pacific-news/397872/understanding-the-pacific-s-alternative-genders (accessed January 26, 2021).
4. Rainbow mental health. Understanding the diversity of experiences among Rainbow People. Supporting Aotearoa’s rainbow people n.d. https://www.rainbowmentalhealth.com/understanding-the-diversity (accessed January 26, 2021).
5. Oranga Tāngata, Oranga Whānau. Rainbow communities, mental health and addictions a submission to the Government Inquiry into Mental Health and Addiction 2018.
6. Stevens MW. Rainbow health: The public health needs of LGBTTI communities in Aotearoa New Zealand with policy recommendations 2013.
7. Jon E. Grant, Brian L. Odlaug, Katherine Derbyshire, Liana R. N. Schreiber, Katherine Lust, Gary Christenson. Mental health and clinical correlates in lesbian, gay, bisexual, and queer young adults 2014;62:75–8. https://doi.org/10.1080/07448481.2013.844697.
8. Flonnoy S. Too queer to be here: The negative effects of homophobia on lesbian, gay, and bisexual individuals. ProQuest. University of West Georgia, 2020.
9. Smith E, Jones T, Ward R, Dixon J, Mitchell A, Hillier L. From blues to rainbows: Mental health and wellbeing of gender diverse and transgender young people in Australia. Melbourne: The Australian Research Centre in Sex, Health, and Society; 2014.
10. Health Promotion Agency. Wellbeing and mental health among Rainbow New Zealanders 2019.
11. Reisner SL, Poteat T, Keatley J, Cabral M, Mothopeng T, Dunham E, et al. Global health burden and needs of transgender populations: A review 2016;388:412–36. https://doi.org/doi:http://dx.doi.org/10.1016/S0140-6736(16)00684-X.
12. Lucassen M, Clark T, Moselen E, Robinson E. Youth’12 The Health and Wellbeing of Secondary School Students in New Zealand: Results for Young People Attracted to the Same Sex or Both Sexes. 2014.
13. Veale J, Byrne J, Tan K, Guy S, Yee A, Nopera T, et al. Counting ourselves: the health and wellbeing of trans and non-binary people in Aotearoa New Zealand. 2019.
14. Te Kotahi Research Institute (TKRI). Honour Project Aotearoa. Waikato: Māori Research Institute for Innovation, Well-being and Inspiration: University of Waikato.; 2020
15. Semp D. Questioning heteronormativity: using queer theory to inform research and practice within public mental health services. Psychology & Sexuality 201; 2:69–86. https://doi.org/10.1080/19419899.2011.536317.
16. Semp D, Read J. Queer conversations: improving access to, and quality of, mental health services for same-sex-attracted clients. Psychology & Sexuality 2015; 6:217–28. https://doi.org/10.1080/19419899.2014.890122.
17. Veltman A, Chaimowitz G. Mental health care for people who identify as lesbian, gay, bisexual, transgender, and (or) queer. Can J Psychiatry 2014; 59:1–7.
18. Fraser G. Rainbow experiences of accessing mental health support in Aotearoa New Zealand: A community-based mixed methods study. University of Wellington, 2020.
19. New Zealand, Human Rights Commission. To be who I am: report of the inquiry into discrimination experienced by transgender people = Kia noho au ki tōku anō ao : he pūrongo mō te uiuitanga mō aukatitanga e pāngia ana e ngā tāngata whakawhitiira. Auckland, N.Z.: Human Rights Commission; 2008.
20. Birkenhead A, Rands D. Improving mental health and addiction services for Rainbow Communities: Let’s Talk About Sex (sexuality and gender). Auckland District Health Board: 2012.
21. Grant JM, Mottet LA, Tanis J, Harrison J, Herman JL, Keisling M. Injustice at Every Turn: A Report of the National Transgender Discrimination Survey. Washington: 2011.
22. Counties Manukau District Health Board. Gender Reassignment Health Services for Trans People within New Zealand 2011.
23. University of Waikato. Education is key for gender-affirming health care. 2019

24. Carroll R. Why the way we approach transgender and non-binary healthcare needs to change. The Conversation n.d.
25. Pega F, MacEwan I. Takatāpui, lesbian, gay and bisexual scoping exercise: Report to the Alcohol Advisory Council of New Zealand. Wellington, New Zealand: Alcohol Advisory Council of New Zealand; 2010.
26. Murphy, Strongman S. Trans healthcare a harmful postcode lottery. RNZ 2020.
27. Walters KL. Urban lesbian and gay American Indian identity: Implications for mental health service delivery. Two Spirit people: American Indian lesbian women and gay men., London, UK: Harrington Park Press; 1997
28. Health and Disability System Review. Health and Disability System Review - Final Report - Purongo Whakamutunga. Wellington: HDSR; 2020.
29. The Royal Australasian College of Physicians. Health Equity n.d. https://www.racp.edu.au/advocacy/make-it-the-norm/health-equity (accessed January 26, 2021).
30. Simmonds S, Carter M, Preval N, Wilson R. Baseline Data Capture: Cultural Safety, Partnership and Health Equity Initiatives - FINAL REPORT. Wellington: 2020.
31. Kerekere E. Part of the whānau: The emergence of takatāpui Identity - he whāriki takatāpui. Wellington: 2017.
32. Panelli R, Tipa G. Placing well-being: A Māori case-study of cultural and environmental specificity. n.d.;4:445–60. https://doi.org/10.1007/s10393-007-0133-1.
33. StatsNZ. 2018 Census ethnic group summaries | Stats NZ 2018. https://www.stats.govt.nz/tools/2018-census-ethnic-group-summaries/pacific-peoples (accessed January 14, 2021).
34. Ryan D, Grey C, Mischewski B. Tofa Saili: A review of evidence about health equity for Pacific Peoples in New Zealand. Wellington: Pacific Perspectives Ltd; 2019.
35. Ministry of Health. Tagata Pasifika in New Zealand. Ministry of Health NZ 2014. https://www.health.govt.nz/our-work/populations/pacific-health/tagata-pasifika-new-zealand (accessed January 14, 2021).
36. Ministry of Health. Obesity statistics. Ministry of Health NZ n.d. https://www.health.govt.nz/nz-health-statistics/health-statistics-and-data-sets/obesity-statistics (accessed January 14, 2021).
37. Ministry of Social Development. Pasefika Proud: The profile of Pacific peoples in New Zealand. 2016.
38. Health Quality Intelligence. A window on the quality of Aotearoa New Zealand’s health care 2019 – a view on Māori health equity. Health Quality & Safety Commission 2019. https://www.hqsc.govt.nz/our-programmes/health-quality-evaluation/publications-and-resources/ (accessed January 27, 2021).
39. Sorensen D, Jensen S, Rigamoto M, Pritchard M. Pasifika People in New Zealand: How are we doing? 2015.
40. Fa’alogo Lilo C. Barriers and Supports Pacific People Experience in Using Mental Health Services. Thesis. ResearchSpace@Auckland, 2012.
41. Pulotu-Endemann FK. Fonofale: Model of Health. Fonofale: Model of Health, 2001.
42. Lilo LS, Tautolo E-S, Smith M. Health literacy, culture and Pacific peoples in Aotearoa, New Zealand: A review. Pacific Health 2020; 3. https://doi.org/10.24135/pacifichealth.v3i0.4.
43. Disley B, Durie M, Paterson R, Rangihuna D, Tiatia-Seath J, Tualamali’i J. He Ara Oranga: report of the Government Inquiry into Mental Health and Addiction. 2018.
44. Oakley Browne MA, Elisabeth Wells J, Scott KM. Te Rau Hinengaro: The New Zealand Mental Health Survey. Wellington, New Zealand: Ministry of Health; 2006.
45. Elisabeth Wells J, Oakley Browne MA, Scott KM, Mcgee MA, Baxter J, Kokaua J. Te Rau Hinengaro: The New Zealand Mental Health Survey: Overview of Methods and Findings. Aust N Z J Psychiatry 2006;40:835–44. https://doi.org/10.1080/j.1440-1614.2006.01902.x.
46. New Zealand, Ministry of Health. Pacific peoples and mental health: a paper for the Pacific Health and Disability Action Plan review. Wellington, N.Z.: Ministry of Health; 2008.
47. Wise Group (N.Z.), Te Pou o te Whakaaro Nui, Le Va. FLO, Pasifika for life: Pasifika community perspectives on suicide prevention in New Zealand. 2014.
48. Minster J, Trowland H, New Zealand, Health Promotion Agency. Te Kaveinga - mental health and wellbeing of Pacific peoples: results from the New Zealand mental health monitor & health and lifestyles survey. 2018.
49. Yamada A-M, Vaivao DES, Subica AM. Addressing mental health challenges of Samoan Americans in Southern California: Perspectives of Samoan community providers. Asian American Journal of Psychology 2019;10:227–38. https://doi.org/10.1037/aap0000140.
50. Tiatia-Seath J. Pacific peoples, mental health service engagement and suicide prevention in Aotearoa New Zealand. Ethnicity and Inequalities in Health and Social Care 2014;7:111–21. https://doi.org/10.1108/EIHSC-10-2013-0023.
51. Stang A, Earnshaw V, Logie C, van Brakel W, Simbayi L, Barre I, et al. The Health Stigma and Discrimination Framework: a global, crosscutting framework to inform research, intervention development, and policy on health-related stigmas. BMC Medicine 2016;388:412–36. https://doi.org/10.1016/S0140-6736(16)00684-X.
52. Crenshaw K. Demarginalizing the intersection of race and sex: A Black feminist critique of antidiscrimination doctrine, feminist theory and antiracist politics. University of Chicago Legal Forum 2015;1989.
53. Cooper B. Intersectionality. vol. 1. Oxford University Press; 2015. https://doi.org/10.1093/oxfordhb/9780199328581.013.20.
54. Carbado DW. Colorblind intersectionality. Signs: Journal of Women in Culture and Society 2013; 38:811–45. https://doi.org/10.1086/669666.
55. Coleman AL. What’s intersectionality? Let these scholars explain the theory and its history. Time 2019 https://time.com/5560575/intersectionality-theory/ (accessed January 27, 2021).
56. New Zealand, Statistics New Zealand, New Zealand, Ministry of Pacific Island Affairs. Health and Pacific peoples in New Zealand: Pacific progress. Wellington, N.Z.: Statistics New Zealand; 2011.
57. Health Research Council. Manalagi: Aotearoa Pacific Rainbow/Queer/LGBTIQA+ MVPFAFF Health and Wellbeing Project | Health Research Council of New Zealand n.d. https://hrc.govt.nz/resources/research-repository/manalagi-aotearoa-pacific-rainbowqueerlgbtiqa-mvpfaff-health-and (accessed January 26, 2021).
58. Doan PL. Queers in the American city: Transgendered perceptions of urban space. Gender, Place & Culture 2007;14:57–74. https://doi.org/10.1080/09663690601122309.
59. Saxton A. LGBTI homelessness: Auckland’s most vulnerable rough sleepers. Stuff 2020. https://www.stuff.co.nz/national/118792015/lgbti-homelessness-aucklands-most-vulnerable-rough-sleepers (accessed January 17, 2021)

60. Ministry of Health NZ. Expanding primary mental health and addiction support 2020. https://www.health.govt.nz/our-work/mental-health-and-addiction/primary-and-community-wellbeing/expanding-primary-mental-health-and-addiction-support (accessed January 26, 2021).
61. Alimahomed S. Thinking outside the rainbow: women of color redefining queer politics and identity. Social Identities 2010; 16:151–68. https://doi.org/10.1080/13504631003688849.
62. Kiesling E. The missing colors of the rainbow: Black queer resistance. European Journal of American studies 2017;11. https://doi.org/10.4000/ejas.11830.
63. Kelly-Hanku, A., Willie, B., Weikum, D.,A., Boli Neo, R., Kupul, M., Coy, K., Hou, P., Aeno. H., Ase, S., Gabuzzi, J., Nembari, J., Narakobi, R., Amos-Kuma, A., Gare, J., Dala, N., Wapling, J., Toliman, P., John, L., Nosi, S., Worth, H., Whiley, D., Tabrizi, S.N, Kaldor, J.M., Vallely, A.J, Badman, S.G. and Hakim, A. Kauntim mi tu : Multi-Site Summary Report from the Key Population Integrated Bio-Behavioural Survey, Papua New Guinea. Papua New Guinea Institute of Medical Research and Kirby Institute, UNSW Sydney: Goroka, Papua New Guinea. 2018
64. Han C. They don’t want to cruise your type: Gay Men of Color and the racial politics of exclusion. Social Identities 2007;13:51–67. https://doi.org/10.1080/13504630601163379.
65. Thomsen PS. Coming-Out in the intersections: Examining relationality in how Korean gay men in Seattle navigate church, culture and family through a Pacific lens. Journal of Homosexuality 2019; 1–22. https://doi.org/10.1080/00918369.2019.1695423.
66. Dudding A. Welcome to the rainbow world of gender and sexuality. StuffCo,Nz 2016. https://www.stuff.co.nz/life-style/life/81125652/welcome-to-the-rainbow-world-of-gender-and-sexuality (accessed January 27, 2021).