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Access to publicly funded bariatric surgery in New Zealand is limited, but privileges patients who identify as New Zealand European or Other European. This example of institutional racism in the New Zealand health system further reiterates that Māori face inequitable access to gold standard medical interventions. This article analyses semi-structured interviews undertaken with Māori who had bariatric surgery at Counties Manukau Health which houses the largest public bariatric service. Thirty-one interviews were conducted, from which six themes were identified in relation to the stages of the bariatric journey. A thematic analysis of transcripts using an inductive approach was undertaken. Using Kaupapa Māori Research–aligned methodology, sites of racism, compassion, clinical barriers to positive health experiences and life-changing experiences were identified along the bariatric journey for Māori patients.

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Takatāpui (Māori LGBTIQ+) challenge static notions of relationality and belonging or whanaungatanga for Māori. Explorations of Māori and LGBTIQ+ identity can often polarise experiences of family as either nurturing spaces or sites comprised of actors of spiritual and physical violence. However, such framing ignores the ways in which cultural practices for establishing relationality for takatāpui extend beyond dichotomies of disconnection or connection within families and into spaces of new potential. In this paper we outline a bricoleur research praxis rooted in Māori ways of being which underpins the research. We engage in photo-poetry as an analytic tool, constructing poetry from our interviews with Waimirirangi, a twenty-year-old whakawahine (Māori term for trans woman or trans femme) and bring them into conversation with the images she provided as part of the broader research project. As the interface between her ancestors and future generations, Waimirirangi demonstrates the potentiality of whanaungatanga as a restorative practice for enhancing takatāpui wellbeing.

BackgroundHealth equity is a fundamental right afforded to all regardless of ethnicity. However, in New Zealand (NZ), health inequities are most compelling for Indigenous Māori who experience inadequate access to services, poorer quality of care and poor health outcomes as a result. Bariatric surgery is the most effective intervention for weight loss and remission of obesity‐related disease where all other interventions have been exhausted. This Kaupapa Māori qualitative study presents Māori perspectives of bariatric surgery from the largest public bariatric centre in NZ and offers solutions for enhancing bariatric service responsiveness to Māori.MethodsThis qualitative study was informed by Kaupapa Māori methodology and involved a general inductive thematic analysis of 31 semi‐structured interviews with Māori patients who had bariatric surgery at Counties Manukau Health in South Auckland, NZ.ResultsFour key themes were identified following analysis: (i) Kaupapa Māori standards of health; (ii) bariatric mentors; (iii) bariatric psychologists; and (iv) community‐integrated support. These themes offer four tangible solutions for optimizing bariatric pathways for Māori from the perspectives of Māori bariatric patients.ConclusionKaupapa Māori, community‐centred and greater non‐surgeon aspects of bariatric supportive mechanisms comprise key areas of opportunity for public bariatric pathways in NZ. Surgical leadership is required to advance health equity and service responsiveness to Māori.