Health professional bodies oppose restrictions on puberty blockers

Health professional organisations have come together in a public statement against the government’s proposal of further restrictions for access to puberty blockers.

Puberty blockers are a well-established component of gender-affirming healthcare, supported by the World Professional Association for Transgender Health (WPATH) Standards of Care version 8 and the Aotearoa New Zealand Guidelines for Gender Affirming Healthcare. Released today, the statement highlights that restricting access to puberty blockers would disregard established clinical guidance and international best practices, placing political interests above the wellbeing of young people.

The measures being considered, including limiting access to clinical trial participants, would impose unethical and discriminatory barriers to care. The professional bodies warn that requiring adolescents to enrol in research studies as a condition for receiving care endorsed by national and international professional bodies would be coercive and inconsistent with ethical healthcare practices. Evidence from the Ministry of Health’s Evidence Brief reveals that while claims of harm associated with puberty blockers are inconclusive, withholding this care risks exacerbating gender dysphoria and harming young people’s mental health.

“Decisions about puberty blockers must remain in the hands of young people, their whānau, and their healthcare providers,” says Dr Rona Carroll, Vice-President of the Professional Association for Transgender Health Aotearoa (PATHA). “These decisions are guided by professional training, clinical experience, clinical guidelines and the best available evidence—not by political agendas.”

The coalition of signatories, which includes PATHA alongside the Aotearoa New Zealand Association of Social Workers, Ara Taiohi, Auckland Sexual Health Service, AusPATH, the College of Child and Youth Nurses, the New Zealand College of Clinical Psychologists, the New Zealand Medical Students' Association, the New Zealand Paediatrics Society, the New Zealand Psychological Society, the New Zealand Sexual Health Society, the New Zealand Society of Endocrinology and the Society of Youth Health Professionals Aotearoa, calls on the government to uphold equitable and evidence-based access to this care.

We support the continued use of puberty blockers in gender affirming care in Aotearoa New Zealand, in line with the WPATH Standards of Care version 8 and the Aotearoa New Zealand Guidelines for Gender Affirming Healthcare. This is consistent with the Ministry of Health’s position statement, which specifies that clinicians who initiate puberty blockers should be experienced in providing gender-affirming care and have input from relevant multidisciplinary fields. As with any other specialty service, this care should be provided by professionals with appropriate expertise.

We do not support banning the use of puberty blockers for gender affirming care, or severely restricting access to this care, for example by limiting access to those enrolled in a clinical trial. Requiring adolescents to participate in a research project as a prerequisite for accessing care that is supported by major national and international professional bodies and has an evidence base comparable to other similar forms of paediatric care would be coercive and ethically inappropriate. The Ministry of Health Evidence Brief identified that any evidence of harm associated with providing puberty-blocking medication is limited and inconclusive, and withholding this care may exacerbate gender dysphoria and negatively impact mental health. Equitable and non-discriminatory access to this care should be provided and maintained throughout the country.

Decisions about prescribing puberty blockers should continue to be made collaboratively between young people, their families or support people, and the health professionals involved in their care. These decisions are individualised, based on informed consent, and guided by professional training, clinical experience, and the best available evidence. Any move to restrict access to puberty blockers would be a political decision and not one based on clinical guidance from health experts in New Zealand and international best practice. Medical decisions should remain free from political interference.

Signatories:

• Aotearoa New Zealand Association of Social Workers

• Ara Taihoi (Peak Body for Youth Development)

• Auckland Sexual Health Service

• Australian Professional Association for Transgender Health

• College of Child and Youth Nurses

• New Zealand College of Clinical Psychologists

• New Zealand Medical Students’ Association

• New Zealand Paediatrics Society

• New Zealand Psychological Society

• New Zealand Sexual Health Society

• New Zealand Society of Endocrinology

• Professional Association for Transgender Health Aotearoa

• Society of Youth Health Professionals Aotearoa