BLOCKED: 'Lack of high-quality evidence'
There has been some contention as a result of the recent announcement from the Beehive, where Hon. Simeon Brown, stated:
‘The Ministry of Health’s evidence brief found that there is a lack of high-quality evidence that demonstrates the benefits or risks of the use of gonadotropin-releasing hormone analogues for the treatment of gender dysphoria or incongruence. While this uncertainty persists, the Government is taking a precautionary approach.’
This was immediately countered by various New Zealand based academics and Doctors in the Media and online platforms. The pause of Puberty blockers according to them “could cost lives.” Although provision was made for treatment to continue for children and young adults who had already been prescribed said medication.
On perusal of medical journals, published research & case studies an undeniable tapestry of uncomfortable truths began to emerge.
One of them being that there are strategies employed that have blind-sided Parents into believing that ‘death and life hang in the balance’ if they are hesitant about their Child being fast tracked down a medical pathway. It is a manipulative power play which some medical professionals have used to push frightened Parents and oppositional parties into agreeing to medical treatments for ‘at risk’ Children. Sadly, this strategy is even happening in New Zealand.
“The Counseller told me that the time you’re on the waiting list for is significantly sped up if they think that there is a danger to your life, or if they think that you’re going to kill yourself.’ Zara, New Zealand
“The “transition or suicide” narrative falsely implies that transition will prevent suicides. Clinicians working with trans-identified youth should be aware that although in the short-term, gender-affirmative interventions can lead to improvements in some measures of suicidality (Kaltiala et al), neither hormones nor surgeries have been shown to reduce suicidality in the long-term (Bränström & Pachank). Alarmingly, a longitudinal study from Sweden that covered more than a 30-year span found that adults who underwent surgical transition were 19 times more likely than their age-matched peers to die by suicide overall, with female-to-male participants’ risk 40 times the expected rate (Dhejne et al.). Another key longitudinal study from the Netherlands concluded that suicides occur at a similar rate at all stages of transition, from pretreatment assessment to post-transition follow-up (Wiepjes et al.). The data from the Tavistock clinic also did not show a statistically significant difference between completed suicides in the “waitlist” vs. the “treated” groups (Biggs,). Luckily, in both groups, completed suicides were rare events (which may have been responsible for the lack of statistical significance). Thus, we consider the “transition or die” narrative to be misinformed and ethically wrong.”
Strikingly amongst this calibre of New Zealand university academics, psychologists and Doctors is their alarming failure to notice that there has been an international shift in the medical aspect of gender affirming care for children under 18.
Are New Zealand Mental Health Professionals too casual about medicating people with mental health issues and too slow to change outdated care approaches?
”What the public may not be aware of, is that it is relatively common for treatments to be offered in health and mental health, where the research evidence is still emerging and/or limited.” Dr Paul Skirrow, (a strategic advisor to the New Zealand College of Clinical Psychologists)
Denmark, Finland, Sweden, and Norway, have shifted their approach to youth gender-affirming care by prioritizing psychological support over medical interventions like puberty blockers or hormones. This change is driven by concerns over the long-term outcomes of medical treatments and the high number of adolescents with overlapping mental health conditions seeking care. Many of these Nations have advanced levels of research and medical care due to the time, money, and commitment to their patient’s long-term well-being. In America and England lawsuits have begun to bring important changes to policy, care, and treatment as De-Transitioners speak up about their harrowing experiences with the medical care they received.
In a post Covid climate, there is no denying that in New Zealand we have a medical system under huge strain. General practitioners provide most of New Zealand’s mild to moderate treatment in mental health care. Beyond that patients are referred to specialist services. Approximately 30% of GP clinic visits have a mental health factor. In the ‘Counting Ourselves’ 2022 Survey participants on average said that Youth (30%) and disabled participants (28%) were more likely to have an unmet need for accessing counselling or psychological support. 57% of all survey participants said they could not afford counselling or psychological support. 47 % did not know where to go and 41% were afraid to go. Contrast that to the readily available and accessible medical form of treatment where 73% of survey participants accessed gender affirming hormones for the first time through their regular primary care provider. Only 4% astonishingly received hormones from a Mental Health Professional. What this clearly demonstrates is the ease of access to life altering drugs as opposed to ease of access to counselling and psychological support.
In an American study over 95% of youth treated with GnRH-analogs go on to receive cross-sex hormones.
By contrast, 61-98% of those managed with psychological support alone reconcile their gender identity with their biological sex during puberty. Let that sink in. More than half! This is consistent with other studies for example:
‘To date, the prospective follow-up studies on children with Gender Dysphoria for whom the majority would meet diagnostic criteria for gender identity disorder collectively reported on the outcomes of 246 children. At the time of follow-up in adolescence or adulthood, these studies showed that, for the majority of children (84.2%; n = 207), the Gender Dysphoria desisted’. (Steensma et al p. 582).
The precautionary approach allows Health Professionals to fairly treat each individual case with the necessary care & attention they deserve especially when such life altering (often irreversible) decisions are being made.
Zara a 20-year-old New Zealand ‘De-transitioner’ shared her experience of gender affirming care.
“When I was 13, I started socially transitioning. By the time I was 15, I was on puberty blockers. When I was 16, I was on testosterone. I had top surgery lined up for when I was 18 years old. If I said I was suicidal, that would get me through the system quickly, so I, I did exactly what they told me to do.”
Zara went onto share how speedily she gained access to life altering drugs whilst she transitioned into a trans male. “The side effects of puberty blockers for me were, I would get hot flashes… feeling quite unwell a lot of the time. It stopped my menstrual cycle. Mentally I think I was quite sad. Lacking in hormones definitely clouded my decision making.”
Zara shared that the process was quick without much questioning from the Health Professionals. Looking back she felt that she wished they had asked more questions. Once she reached 18 however, she made the decision not to cut off her healthy breasts and then to transition back to her biological sex; she said it was then that she was suddenly thoroughly questioned by her Health Professional, who was concerned that she may have been persuaded by others to detransition. Her health care provider informed her that the rate for detransition’s was very low. Unfortunately, Zara felt that after she had made it clear her detransition was her next course of action (& of her own volition) she was made to feel like a burden on the system.
Factors that drive Gender Dysphoria
‘The pathway to emerging adulthood, from early adolescence to young adulthood, is a time of significant biological, social, and personal change that has evolved over generations. This period is marked by major life milestones and transitions that coincide with the peak onset of mental disorders.’
It goes without saying that on the normative path of development from child to teen to adult, there are challenges as our bodies, hormones, and relationships in the World change. How much more challenging is navigating the World from the perspective of a person who is neurodivergent and often socially isolated. In this scenario self-diagnosing with information from Social Media influencers and online support groups certainly has played a role in what had seemed to be an international phenomenon.
Various international academics, doctors and health providers began to study data on the outstanding jump in young female transitioners.
‘Denmark one of the leading Countries in Transgender affirming care has been at the forefront of trans care research since 1951. With a long history of developing both medical and legal frameworks for gender-affirming care. They however began to change their strategies when in 2014, there were only 4 documented paediatric cases who requested gender reassignment. By 2022, the number of referrals grew by 8700% to 352, similar; to the several-thousand-percent increase in less than a decade witnessed by a number of Western countries, like Sweden whose Board of Health and Welfare confirmed a 1,500% rise between 2008 and 2018 in gender dysphoria diagnoses among 13- to 17-year-olds born as girls’.
“When rates of mental illness, smart phone and social media use, and transgender identification are traced, the graphs align with eerie precision. One particular year, in fact, stands out. 2013 was the first year most Americans owned a smart phone. It was also the year adolescent mental health problems began to noticeably climb. For example, rates of depression and anxiety rose by nearly 50% in the decade following 2013, and suicide among teen girls more than doubled. That same year, transgender identity among teenage girls also began its epidemic spread'.
Another very alarming factor in this ‘perfect storm’ became very apparent.
‘Multiple studies which corroborate previous research indicating an overrepresentation of Gender Dysphoria in children with autism spectrum disorder. The conclusion being further research is needed to understand the association and to demonstrate approaches to providing optimal care to these children and young adults.’
In the 2022 Counting Ourselves Survey more ‘than two-thirds of all participants (69%) were counted as disabled or identified as neurodivergent. Over a third of participants were both disabled and neurodivergent.’
'Three issues tend to obscure the salience of informed consent: conspicuous mental health problems, uncertainty about the minor’s personal capacity to understand the irreversible nature of the interventions, and parental disagreement. Physical and psychiatric comorbidities can contribute to the formation of a new identity, develop as its consequence, or bear no connection to it. Assessing mental health and the minor’s functionality is one of the reasons why rapid affirmative care may be dangerous for patients and their families. For example, when situations involve autism, learning disorders, sexual abuse, attachment problems, trauma, separation anxiety, previous depressed or anxious states, neglect, low IQ, past psychotic illness, eating disorders or parental mental illness, clinicians must choose between ignoring these potentially causative conditions and comorbidities and providing appropriate treatment before affirmative care (D’Angelo et al.)'
Let us state the obvious – in New Zealand there is a fair percentage of vulnerable people with differing mental conditions who are statistically more prone to gender dysphoria, and our answer is to go straight into medically transitioning them on request or (advised) threat of suicide in some cases.
Conversion Therapy Bill
Meaning of conversion practice
In this Act, conversion practice means any practice, sustained effort, or treatment that—
(A): is directed towards an individual because of the individual’s sexual orientation, gender identity, or gender expression; and
((B): is performed done with the intention of changing or suppressing the individual’s sexual orientation, gender identity, or gender expression.
Controversy has already ensued with a man by the name of Dave Riddell after the discovery was made that he intended to keep counselling people who came to him for help (out of their own volition) for treatment of sex and gender identity issues.
Which raised an important consideration…what if a Transgender person wants and seeks out counselling to detransition? What are their rights and what accessibility do they have in what could be a long lonely unsupported journey.
Issy a young 26year old De-transitioner in New Zealand gives some insight into that process.
“So, I’m just on a wait list to see the endocrinologist about that (*oestrogen replacement therapy). I went on the waiting list in April last year, and they told me it’s about a year wait list. So, the waiting list to see the endocrinologist in transition was five months. But as I’m wanting to detransition, the wait time is 12 months.
It was very easy to navigate the transitioning process through the healthcare system in our country, but I’m finding a bit of resistance and lack of care for the fact I want to detransition.”
She goes on to share about how difficult it is to talk about her detransition.
“ I can understand how you’d struggle to find people to talk about their detransition journey because it’s a touchy subject and yeah, to the queer community, it’s, it has almost seemed like a betrayal, so I get it.
But it’s also important stuff that’s not talked about enough.
I will also say that, um, that we are not born trans. It is a choice. Um, even from the, the very moment I made the choice to transition, like, I knew that this was a decision that I was making, that I didn’t have to. I just thought life would be better.”
Is the Conversion Therapy bill a sentence of isolation and suffering for people who realise Transgenderism is not for them after all? Surely, it a human rights issue - if you are not allowed to get professional help to detransition. Where is compassion & care now New Zealand? This is the part where I begin to suspect an ideological element instead of sincere professional care – if a person leaves an identity group or trans patient care – their need for professional support is suddenly ignored, resisted or they are made to feel like burdens or made to wait longer. Every Health care professional has a responsibility to give COMPETENT CARE that is not driven by ideology. They also have the responsibility to change an outdated approach to standards of best practice. When Nation’s at the forefront of gender affirming care give reliable research results that are in the best interests of children and young adults long-term health – we should do everything in power to adapt for best outcome for every patient!
The suicides in New Zealand
"I kept saying, why isn't anyone monitoring her? Why isn't anyone coming in? If you were in Auckland they'd do it, but since you're in Kaitaia you can't do it."
Rakich says after the suicide attempts he pushed for Zahra to see another mental health specialist. This time, she was diagnosed with borderline Asperger's syndrome, a mild form of autism.
"That's when everything clicked," Zahra says. "And that's when I started doing some deep thinking."
On the internet, she learned Asperger's people commonly struggle with gender identity issues. Experts say this is because of a tendency to think in black and white, to have a very fixed idea of the rules, and therefore look for reasons why they do not fit in - often landing on gender dysphoria as an answer.
Zahra Cooper stopped taking testosterone and de-transitioned. Her partner at the time said she was less angry, “stopped lying” and overall Zahra seemed happier.
In 2022, 19-year-old Sung Ig Choi confided of feeling suicidal and was not followed up. Sung-ig committed suicide a week later. According to the article the coroner had dealt with another suicide of a male to female transitioner.
In a 2025 case, the parents of a 17year old teenager (who is referred to as ‘Vanessa’) believe her death alone in emergency accommodation is as the result of multiple agencies failing her in their care.
”Their only child was able to keep them at a distance on the grounds they did not accept the teen was transgender - an identity the parents say the teen later abandoned.
However, the couple allege that while attentive to their child's gender identity, various care professionals failed to adequately respond to the threat from a long-standing eating disorder.”
This propensity for people in the Transgender care realm to push concerned Parents away from their Children (sometimes legally) and to encourage said kids to break away – can lead to isolation from the people who care about them the most.
"I definitely got the message that you don’t need your family if they cause you distress. And that if they do not say yes to everything, then you don’t need your family". Zara
The complete disregard for grieving Parents who are also processing the loss of a Child’s former identity is cruel -to say the least.
Ultimately nobody should have the power to guide someone else’s vulnerable child into medical treatments and then mismanage their well-being to the point of the Child’s suicide.
It should be criminal.
Will it take Parents and De-transitioner’s suing the New Zealand Medical System to bring about change? Time will tell.
I leave you with the words of Yarden, an American kid -whose life tragically ended too soon.
"I wish I never listened to the medical and psychiatric community when they told me it was possible to change my sex. What a lie. Very dangerous and unethical. Sex reassignment surgery is a hit and miss type of surgery, but they don't tell you that. They never do. And maybe if I didn't have autism, maybe if my brain wasn't so defective, I would have caught on before it was too late. I wish there was a cure for autism, but that is unlikely. It's endless suffering on top even more suffering. I also wish voluntary euthanasia was legal. My death, likely painful, has proven that ethics are not universal and are otherwise non-existent. No one is truly there for me. There's no need to pretend. I have a gaping hole in my genital area with my colon spilling out(disgusting) and a ring of scar tissue blocking most of the entrance. If the colon can't discharge, that leaves it with severe blockage, which could turn (and likely expected to) into blood clots, followed by death. I have already reached the stage of blockage".
Pilleus Project
*Disclaimer: Extracted direct quotes and excerpts from studies, open access medical journals, and articles. Precaution taken in attempt to cite all information shared.
Kwong ASF, Manley D, Timpson NJ, Pearson RM, Heron J, Sallis H, Stergiakouli E, Davis OSP, Leckie G. Identifying Critical Points of Trajectories of Depressive Symptoms from Childhood to Young Adulthood. J Youth Adolesc. 2019 Apr;48(4):815-827. doi: 10.1007/s10964-018-0976-5. Epub 2019 Jan 22. PMID: 30671716; PMCID: PMC6441403.
Zupanič S, Kruljac I, Šoštarič Zvonar M, Drobnič Radobuljac M. Case Report: Adolescent With Autism and Gender Dysphoria. Front Psychiatry. 2021 May 26;12:671448. doi: 10.3389/fpsyt.2021.671448. PMID: 34122187; PMCID: PMC8187799.
Hisle-Gorman E, Landis CA, Susi A, Schvey NA, Gorman GH, Nylund CM, Klein DA. Gender Dysphoria in Children with Autism Spectrum Disorder. LGBT Health. 2019 Apr;6(3):95-100. doi: 10.1089/lgbt.2018.0252. Epub 2019 Apr 2. PMID: 30920347.
Puberty Blockers for gender dysphoric youth: Lack of sound science. Sarah C. J. Jorgensen Pharm.D., MPH, Patrick K. Hunter M.D., M.Sc. Bioethics, Lori Regenstreif M.D., M.Sc., Joanne Sinai M.D., M.Ed., William J. Malone M.D. American College of Clinical Pharmacy/A.C.C.P
McGorry P, Gunasiri H, Mei C, Rice S, Gao CX. The youth mental health crisis: analysis and solutions. Front Psychiatry. 2025 Jan 21;15:1517533. doi: 10.3389/fpsyt.2024.1517533. PMID: 39906686; PMCID: PMC11790661.
Stephen B. Levine, E. Abbruzzese & Julia W. Mason (2022) Reconsidering Informed Consent for Trans-Identified Children, Adolescents, and Young Adults, Journal of Sex & Marital Therapy, 48:7, 706-727, DOI: 10.1080/0092623X.2022.2046221
Betsi G, Goulia P, Sandhu S, Xekouki P. Puberty suppression in adolescents with gender dysphoria: an emerging issue with multiple implications. Front Endocrinol (Lausanne). 2024 Jun 14;15:1309904. doi: 10.3389/fendo.2024.1309904. PMID: 38988996; PMCID: PMC11235884.
The influence of social media on mediating gender identity and psychosocial values in the student population of Kazakhstan. Tusupbekova Serikovna Bakhyt, Aliya Saktaganovna Mambetalina,Kehinde Clement Lawrence,. Snezhana Evlogieva Ilieva,Nuradinov Almat Sabitovich.
Zahra Cooper detransitions 2017. https://www.nzherald.co.nz/nz/from-girl-to-boy-and-back-again-zahra-cooper-shares-her-journey-everyone-is-different/NLBTDG4M7LDUBZQF57V7K76JU4/?fbclid=IwY2xjawOVeD1leHRuA2FlbQIxMABicmlkETFwbmFmTVhqelBsNXF2T0Vsc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHjvuQMLebA_1itMa1ZdvXnNaCnFwx0TK2Km2FygllprOJDKRmRB_P0yDArAi_aem_1AzoGGpqTGGfqFI5R8XkUw
Vanessa dies 17 https://www.stuff.co.nz/nz-news/360720926/teenager-starves-death-alone-emergency-accommodation
Sung-Iy Choi dies 19 https://www.stuff.co.nz/national/health/128796764/transgender-teen-disclosed-suicide-plan-to-community-careworker-days-before-death?rm=a&fbclid=IwY2xjawOVdmFleHRuA2FlbQIxMABicmlkETFwbmFmTVhqelBsNXF2T0Vsc3J0YwZhcHBfaWQQMjIyMDM5MTc4ODIwMDg5MgABHl1pnHYhDesqhRRhCqAEepGbHYg7WFnJAfA3mX44PwTYrX1x2Dd-Py9MLvNA_aem_urtqtNVcKw4ydfk6mmGlzA
Zara De-transitions https://familyfirst.org.nz/2025/11/18/the-untold-stories-of-kiwi-detransitioners-meet-zara/
Issy De-transitions 26 https://familyfirst.org.nz/2025/11/18/the-untold-stories-of-kiwi-detransitioners-meet-issy/
J.M. Twenge Social Contagion Data https://www.generationtechblog.com/p/transgender-identity-how-much-has
Counting Ourselves Survey Report https://countingourselves.nz/2022-survey-report/