Health Minister Simeon Brown. Photo: RNZ / Mark Papalii
The government is halting new prescriptions of puberty blockers for young people with gender dysphoria, saying "a precautionary approach" is needed while evidence remains uncertain.
In a statement published on Wednesday afternoon, Health Minister Simeon Brown said Cabinet had agreed to the new settings until the outcome of a major clinical trial in the United Kingdom, expected in 2031.
The drugs - known as gonadotropin-releasing hormone analogues - would remain available for people already using them for gender dysphoria, as well as for medical conditions such as early-onset puberty, endometriosis, and prostate cancer.
Brown said the new rules - taking effect on 19 December - would give families confidence that any treatment was "clinically sound and in the best interests of the young person".
"These changes are about ensuring treatments are safe and carefully managed, while maintaining access to care for those who need it."
Existing youth gender services would stay in place, with information brought together into one national online hub, Brown said.
In a post on social media website X, New Zealand First leader Winston Peters said his party was the only one to campaign on stopping the use of puberty blockers in children.
"It is commonsense to put a pause on these unproven and potentially damaging drugs for children until we assess the results of the clinical trials in the UK once it's completed."
The ACT party's children's spokesperson Karen Chhour also issued a statement, declaring a victory for science, evidence, and the safety of children.
"I believe young people should be supported to love themselves, not change themselves with experimental medication."
Green Party MP Ricardo Menéndez March told RNZ the government was "buying into imported culture wars" and targeting trans people on the eve of Transgender Day of Remembrance.
"We know from queer people that gender affirming healthcare can be life-saving," he said. "The government should focus on addressing the core issues that our health system faces... rather than waging culture wars on trans people."
The coalition's move mirrors a major shift in the UK following the Cass Review - a four-year investigation commissioned by the National Health Service (NHS).
That review, spearheaded by paediatrician Dr Hilary Cass, concluded that the evidence base for gender-affirming medicine was "remarkably weak", with study results misrepresented by people on all sides of the debate.
Cass also recommended a formal clinical trial to properly test whether puberty blockers, which delay the onset of puberty by suppressing oestrogen and testosterone, were safe and effective for young people. That trial was due to run until 2031.
In response, the NHS stopped routine access to puberty blockers for new patients. Other countries, including Sweden, Finland and Norway, had already tightened access and guidelines.
The Cass Review split opinion among clinicians and academics worldwide. While some endorsed the call of higher evidence standards, others criticised the report's methodology and warned it downplayed the risk of denying treatment to young people.
At the time, the Professional Association for Transgender Health Aotearoa (PATHA) criticised the review as irrelevant to New Zealand and said it ignored the global medical consensus.
"The final Cass Review did not include trans or non-binary experts or clinicians experienced in providing gender affirming care in its decision-making, conclusions, or findings," PATHA president Jennifer Shields said.
"Instead, a number of people involved in the review and the advisory group previously advocated for bans on gender affirming care in the United States, and have promoted non-affirming 'gender exploratory therapy', which is considered a conversion practice."
PATHA has condemned today's decision, saying it was an ideologically driven ban that will have a "devastating impact on the lives and wellbeing of our transgender and gender diverse young people".
Dr Elizabeth McElrea, GP specialist in gender affirming care and PATHA vice president said children, young people and their whānau will be highly distressed by this decision.
"We also acknowledge health professionals' frustration at the way their expertise has been ignored and disregarded.
"The ban will lead to a deterioration in mental health, increased risk of suicidality and increased dysphoria in gender diverse children and young people, and will put them at a higher risk of experiencing marginalisation and discrimination.
"The prescribing of puberty blockers is always undertaken with the utmost care and consideration. They have been prescribed safely for decades for transgender children and banning their use will lead to profound distress in this already vulnerable group."
Dr McElrea said the decision was not supported by the Ministry of Health's November 2024 evidence brief on this care.
"While the evidence brief identified some limitations in the academic quality of evidence regarding the risks and benefits of GnRH analogues, limitations in evidence quality are common across a number of areas of medicine, especially within paediatric medicine, and do not justify a ban on access.
"PATHA supports evidence-based medicine, which consists of three key components: academic evidence, clinical experience, and patient preferences and values," said Dr McElrea.
PATHA also criticised the fact that the new restrictions will be in place until the conclusion of clinical trials in the UK, which are not due until at least 2031.
"In no other area of care would life-saving medication be withheld from a vulnerable population for six years. This will have a traumatic impact on a generation of transgender children," said PATHA Executive Committee member Avery Zavoda.
"That New Zealand First announced this news three hours before the Minister of Health shows the way this care has been politicised, and how politics have been prioritised over the wellbeing of New Zealand children."
Youth health specialist Dame Sue Bagshaw also said she believed puberty blockers were safe and reversible and warned against any "moral panic".
However, public health expert and Otago University emeritus professor Charlotte Paul said the British approach should give New Zealand clinicians "pause for thought", saying some had abandoned "normal standards of informed consent for children".
New Zealand's Health Ministry last year also released a report finding "a lack of high-quality evidence" on the benefits or risks of puberty blockers for gender dysphoria.
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