Action on puberty blockers welcome, but why did it take so long?

A year ago the Ministry of Health announced it was considering additional safety measures and further restriction of puberty blockers (GnRH) to treat conditions related to "gender distress" in children.

This, in the wake findings of the damning final UK Cass Report, released in April 2024 after four years of study, which found young people had been given life‑changing, irreversible treatment despite "remarkably weak" evidence of safety or effectiveness.

The Ministry of Health consulted on safety measures for the use of puberty blockers in gender‑related health following the release of the evidence brief. This consultation closed 20 January.

At the time we said it was too little and too late, says Women's Rights Party Co‑leader Jill Ovens. "Here we are, after a further delay of almost a year, the Government has announced there will be no new prescribing of puberty blockers as of 19 December."

In response to all those commentators, including health professionals such as Dr Sue Bagshaw, saying politicians should not be making such decisions, the Women's Rights Party has been questioning for more than a year what is going on within the Ministry of Health?

"The Ministry's 'consultation' framing was very odd, given no safety measures had been in place, and the use of puberty blockers (GnRH) to treat conditions related to 'gender distress' is not a registered use of the hormones, and therefore isn't allowed."

Puberty blockers are licensed only for use in young children (for precocious puberty) or older adults (for certain cancers and endometriosis). Use of puberty blockers for gender incongruence or distress is not currently licensed, which means the safety and risk implications for use with gender dysphoria have not been assessed. Nor has the treatment's effectiveness been proven in this context.

Ms Ovens says the Ministry has failed to provide leadership, and the Government has had to step in to effectively ban the use of the hormones, pending a UK study that has yet to meet ethical approval and is looking at 2031 for completion.

"New Zealand health authorities have been held hostage to a vocal minority who have been putting our children's health at risk of lifelong irreversible damage," she says.

"The Ministry was not basing its advice on medical and professional evidence, despite the fact that its own review a year ago found a lack of good quality evidence for the effectiveness or safety of puberty blocking treatment in young people with gender dysphoria."

Ms Ovens says at one stage, the Ministry of Health quietly removed a claim from its website stating that puberty blockers were "safe and reversible", yet the Ministry continued to prevaricate on its duty to provide leadership across the health system. "So it is a bit rich for people who should know better to blame the Government for stepping up."

More than a year ago, Pharmac data that excluded young children and older adults (i.e. includes only 12‑17 year olds) showed an alarming increase in the use of such medicines from 2014 to 2022, which could only be off‑label to treat adolescents presenting with gender‑related distress.

The use of puberty blockers for such children is relatively new. Until the emergence of 'the Dutch Protocol', which set criteria for use of puberty blockers in gender medicine, treatment of a small number of mainly pre‑pubertal boys had been therapeutic.

From 2014, puberty blockers were given to a broader group of patients who would not have met the inclusion criteria of the original protocol; notably adolescent girls.

The Women's Rights Party says the unquestioning use of puberty blockers for the rapidly expanding cohort of adolescent girls already experiencing puberty was a dereliction of medical ethics akin to the 'Unfortunate Experiment' carried out on women with cervical cancer in the 1980s.

"This should have been of considerable concern in light of follow‑up studies dating as far back as 2008, showing that childhood criteria may 'scoop in' girls who are unlikely to persist with gender dysphoria into adulthood, and are more likely than the general female population to be lesbian or bisexual."

As Cass reported: "Puberty is an intense period of rapid change and can be a difficult process, where young people are vulnerable to mental health problems, particularly girls. Unwelcome bodily changes and experiences can be uncomfortable for all young people, but this can be particularly distressing for young neuro‑diverse people who may struggle with the sensory changes."

The Women's Rights Party supports a holistic approach that looks at other conditions often found in young people presenting with "gender distress", including ASD (Autism Spectrum Disorder), body dysmorphia (includes eating disorders such as anorexia), and sexual abuse.