New Zealand Health Ministry: ‘Lack of good quality evidence’ for puberty blockers

The New Zealand Ministry of Health released an evidence brief last week in which the government’s health regulator and watchdog urged caution regarding the prescription of puberty blockers due to a “lack of good quality evidence” to support their “effectiveness and safety.”

“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,” a press statement read, recommending that a “starting point” for treatment for young people is “a holistic assessment determining the full spectrum of needs a young person may have including social and mental health.”

The prescription of puberty blockers, the Ministry also stated, “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 Health Ministry announced that it will now weigh whether the new precautions “should be backed by additional safeguards, such as regulations” in order 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 Ministry highlighted. 

Bernard Lane, a journalist who covers the international debate over youth gender clinics and the author of “Gender Clinic News,” posted the news on X:

Australia’s public children’s hospitals still promote puberty blockers–which suppress the naturally timed sex hormones of puberty–as safe and reversible. Today, the NZ ministry has released the long-delayed results of its “evidence brief” on puberty blockers and has announced a “new precautionary approach” to treatment.

In an overview of the use of puberty blockers in New Zealand, the Ministry noted “a steady increase in the number of young people aged 12 to 17 receiving first-time prescriptions of [puberty blockers] between 2010 and 2023.”

Although the hormone-blocking drugs are not approved by the country’s Medsafe for gender distress in young people, clinicians are able to prescribe them “off-label.”

The Ministry observed that the “UK, Finland, Norway, and Sweden have recently decided to limit the initiation of new prescriptions of puberty blockers for young people seeking gender-affirming care to clinical trials.”

“These countries have all expressed concerns about the lack of high-quality evidence on outcomes in the use of puberty blockers for gender incongruence and gender dysphoria,” the Ministry further explained:

NHS England’s independent review also identified gaps in interprofessional approaches and variability in service access by patients. In Sweden there were concerns relating to the consent process, and a lack of data to understand the context in which puberty blockers have been used.

The Health Ministry referred to the UK’s acclaimed “Cass Review,” led by British pediatrician Dr. Hilary Cass.

Cass’ systematic review of guidelines and research pertaining to the so-called “gender-affirming care” treatment model ultimately concluded that evidence supporting the use of puberty blockers and cross-sex hormones for young people was “remarkably weak” and based on “poor quality of the published studies” and “misinformation.” The review observed as well that the “expectations of care” found in the evidence are “far from usual clinical practice.”

New Zealand’s push for a more “holistic” approach to treating children and teens with gender issues echoes a similar thrust found in the Cass Review, which called for an approach that would “include screening for neurodevelopmental conditions, including autism spectrum disorder, and a mental health assessment.”