The Ministry of Health is today releasing an evidence brief and position statement on the use of puberty blockers for gender identity issues and outlining a more cautious approach to their use.

The evidence brief shows a lack of good quality evidence to back the effectiveness and safety of puberty blockers when used for this purpose.

A Ministry position statement underpinned by the evidence brief sets out expectations of a more precautionary approach for the care of adolescents with gender identity issues.

The Ministry’s assessment is that the starting point for treatment is a holistic assessment determining the full spectrum of needs a young person may have including social and mental health.

The new precautionary approach signals the need for clinicians to exercise caution in prescribing, including that prescribing should only be initiated by clinicians who are experienced in providing gender-affirming care, and are part of an interprofessional team offering a full range of supports to young people presenting with gender identity issues.

The Government has now tasked the Ministry with consulting on whether the new precautions should be backed by additional safeguards, such as regulations under the Medicines Act 1981 to strengthen changes in prescribing expectations.

These tighter controls reflect a level of concern both here and overseas about the increasing use of these medicines for the treatment of gender identity issues without sufficient evidence to support their safety and effectiveness both now and in the longer-term. 

The appropriate and safe care for this group of young people is critically important. 

Any additional safeguards in the form of regulations would be to protect against the risk of future harm to vulnerable individuals.

Other countries have also reported rises in recent years in the numbers of young people being treated for gender identity issues with puberty blockers.  In New Zealand, in 2010, around 25 young people aged 11 and 17 years were typically started on treatment with these medicines and by 2021 the number had grown to around 140. In the last two years that number had fallen and in 2023 was 113.

The Ministry will be undertaking targeted consultation with organisations that are representative of those who may be affected by any potential regulations.

In addition, the Ministry will invite public submissions via survey questions on its Health Consultation Hub web page.

The consultation, open until late in January 2025, will be asking if further precautions are needed.

Other steps already underway include updated clinical guidelines on puberty blockers being commissioned by Health NZ and expected in coming months, better monitoring of usage in New Zealand and developing New Zealand’s own knowledge in this area to guide any further advice or safeguards.

The Ministry of Health will also commission research to determine the long-term clinical and mental health and wellbeing impacts of puberty blockers.