Joint Statement on Puberty Blocker Ban in Aotearoa

The Professional Association for Trans Health Ireland, alongside other Irish trans health and LGBTQI+ organisations, stand with our colleagues in Aotearoa New Zealand and the young people, families, and clinicians affected by the Minister of Health’s decision—announced on the eve of Trans Day of Remembrance—to ban the prescribing of puberty blockers for trans and gender diverse (TGD) young people. This is an unjust and regressive step that will have harmful consequent impacts for TGD young people in Aotearoa and risks setting a dangerous precedent internationally.

For some TGD young people, delaying or pausing the progression of puberty is a crucial component of a gender-affirming care plan. Puberty blockers are a well-established, safe, and reversible treatment option that can significantly improve the mental health and wellbeing of TGD young people by providing them time to explore their gender identity and make informed decisions about future gender-affirming care without the added distress of physical development that conflicts with their gender. Denying access to this intervention ignores clinical expertise, research evidence, and lived experience, and risks causing preventable harm by leaving young people and their families without the timely, appropriate care they need. We know that withholding healthcare from vulnerable communities results in negative outcomes and widened health disparities, and TGD young people are already at heightened risk of mental health distress, including suicidality and self-harm. Revoking access to this care will only increase that distress and push some toward alternative pathways outside the healthcare system, such as self-medicating—patterns repeatedly observed whenever fundamental healthcare, including abortion care, is prohibited. 

The restrictions of prescriptions of GnRHa medications until the conclusion of the UK clinical trials will create a significant burden upon TGD young people, their families, and their clinicians. These trials have yet to begin and are not due to finish until at least 2031. While yet to start, the trials have already been critiqued by clinicians, researchers and organisations representing TGD communities in the UK, who claim that their design is unethical, coercive, and may cause undue distress and harm to the young people within it, and that considering the existing evidence, these trials are simply unnecessary—they do not meet the principle of clinical equipoise that provides the ethical basis for medical research. 

We do not accept that it is appropriate or ethical to pause vital treatments pending the results of a single clinical trial in a different country when there is clear evidence available proving their usefulness and success from around the world. Neither do those on the frontline of evidence-based medicine, who state that "forbidding delivery of gender-affirming care and limiting medical management options on the basis of low certainty evidence is a clear violation of the principles of evidence-based shared decision-making and is unconscionable." This decision will result in TGD young people, but not their cisgender peers, being unable to access life saving medication for at least five years. This act of discrimination in healthcare access would not be acceptable for any other vulnerable minority; it is not acceptable now.

Further, this ban on puberty blockers is an extension of the UK ban which resulted from a review study that has been repeatedly identified on a global scale by those with clinical and research expertise, professional organisations, and the TGD community as fundamentally flawed. In imposing these bans, the governments of the UK and Aotearoa have failed to recognise decades of research that show the safety and efficacy of puberty blockers, along with critiques of the Cass Report from sources such as the British Medical Association, McNamara et al. (2024), Noone et al. (2024), WPATH and USPATH, EPATH, PATHA, AusPATH, Endocrine Society, American Academy of Pediatrics, BAGIS, FGEN, and many others. Additionally, it is vital to recognise the harm of puberty blocker bans. 

Our position is that the current evidence base supports puberty blockers as safe, effective, and beneficial treatment for many TGD young people. This ban denies them and their families access to care that can be lifesaving. TGD young people and their clinicians must be free to engage in shared, evidence-informed decision-making, ensuring that care is guided by what is genuinely in the young person’s best interests rather than by restrictive or prescriptive policy barriers.

We encourage all governments to follow the evidence, listen to healthcare professionals who specialise in this area and have the confidence of their trans patients, and ensure that decisions and policies are co-produced with trans people, their families, and those with lived experience.

We agree with previous comments from the National Collective of Independent Women’s Refuges (NCIWR) that denying the use of medication to a particular group based on their gender and/or sex is sex-based discrimination which is illegal under the Human Rights Act (1993) in New Zealand.

We call upon the New Zealand Ministry of Health and Minister for Health Simeon Brown to reverse this decision, lift the ban on the prescribing of puberty blockers, and prioritise supporting the health and wellbeing of trans and gender diverse young people in Aotearoa. 

We urge the government of New Zealand to meet with the Professional Association for Transgender Health Aotearoa (PATHA), community organisations and others in Aotearoa with expertise and lived experience in this area for a review of this egregious ban. The government should not interfere in decisions that should be made between patients, their families, and their clinicians, based on the best available evidence.

On behalf of the organisations below signed:

• Professional Association for Trans Health Ireland
• AMACH! LGBT+ Galway
• Belong To – LGBTQ+ Youth Ireland
• Gender Rebels
• LGBT Ireland
• Mammies for Trans Rights
• Outhouse LGBTQ+ Centre
• ShoutOut
• Trans & Intersex Pride Dublin
• Trans Healthcare Action
• Trans* Research Association of Ireland
• Transgender Equality Network Ireland
• Transgress the NGS
• TRANSS UCC

Image credit: Ted Eytan