The Ministry of Health is urging clinicians to “exercise caution” in prescribing puberty blockers to young people experiencing gender incongruence and dysphoria, citing a “lack of good quality evidence” to justify their use.
The Ministry of Health released an evidence brief titled Impact of Puberty Blockers in Gender-Dysphoric Adolescents and a Position Statement on the Use of Puberty Blockers in Gender-Affirming Care on 21 November.
The position statement expects clinicians to take “a more precautionary approach”, beginning treatment with a “holistic assessment.” The assessment ought to reveal the “full spectrum of needs a young person may have, including social and mental health.”
A precautionary approach, the Ministry insists, “signals the need for clinicians to exercise caution in prescribing.” The expectation is that prescribing practitioners would be experienced in providing so-called “gender-affirming care,” would not be acting alone but as “part of an interprofessional team,” and that the team would be “offering a full range of supports.”
Evidence behind the decision
The Ministry of Health’s consultation page states, “We do not have good evidence to say that the medicines used improve the longer-term outcomes for young people with gender-related health needs – nor that the potential longer-term risks are low.”
Key concerns about the use of puberty blockers by young people were outlined in the Position Paper and include:
- A slower rate of increase of bone density than expected for the stage of development.
- The impact of hormone medication on organ systems.
- Poor quality evidence for an improvement in depression, anxiety, and suicidal ideation.
Use of puberty blockers in New Zealand for individuals suffering gender identity issues
Puberty blockers have been used for some time as part of what is referred to as “gender-affirming care” in young people aged between 11 and 17.
In 2021, the number of young people undergoing this interference in the natural function of puberty peaked at around 140 youth.
In 2023, the number had decreased to 113.
In contrast, in 2010 – just 14 years ago – the Ministry of Health reported that around 25 youth were taking the blockers.
Consultation
The Ministry of Health has been given the responsibility by the government of facilitating a consultation addressing “whether there should be additional safety measures for puberty blockers, such as regulations under the Medicines Act.”
Organisations who represent individuals who would be affected by regulations will be approached by the Ministry.
Public submissions are also sought via the Ministry of Health website and close on Monday 20 January 2025 at 5:00pm.
Consideration is being given to certain measures to ensure children and youth are not “unduly exposed to unknown risks.” These measures are:
- Updating clinical guidance.
- Increased monitoring of prescriptions.
- Regulatory measures.
What can the public and health practitioners expect over the coming months?
According to the press statement, over the coming months, the public and health practitioners can expect:
- Updated clinical guidelines on puberty blockers.
- Better monitoring of the usage of puberty blockers.
- Developing New Zealand’s knowledge to guide further advice and safeguards.
- The commissioning of research determining the long-term clinical and mental health and well-being impacts of puberty blockers.
FLI’s Response
“It is wonderful news that the Ministry of Health is beginning to objectively assess the dangers of puberty blockers on children and young people,” says FLI’s National Director, Michelle Kaufman.
“However, this is just a start,” she continued. “So-called gender-affirming care, whether supporting and facilitating social, chemical, or surgical transitioning, is still harmful to individuals who cannot possibly have the ability to give informed consent to the interventions.”
“Tens of thousands of de-transitioners attest to the psychological and physical damage they have endured and rightly believe they have been betrayed by the adults in their life who should have helped them navigate their confusion, rather than assist them to masquerade as a person of the opposite sex.”
“The team at FLI believe that replacing gender-affirming care with a listening and wait-and-see approach is the most prudent way forward.”
“Every person is made in the image of God. God made us male and female, and He does not make mistakes. There is a wide spectrum of what it looks like to be male, and the same goes for being female. As a society, we once understood this,” Kaufman explained.
“Young people must be assisted to discover who they are with genuine compassion and truth.”
“Congratulations to the Ministry of Health for taking the first step in protecting young people; however, the interventions need to go further so that the grave harms being perpetrated against the children and youth in this country completely cease.”
Take Action:
Public submissions to the Ministry of Health are now open until Monday, 20 January, 2024, 5pm.
• Complete the online survey here, or
• Email pbconsultation@health.govt.nz
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