The Ministry of Health has announced a more cautious approach to the use of puberty blockers for young people with gender identity issues, citing a lack of robust evidence on their safety and effectiveness.

This move could lead to stricter regulations under the Medicines Act 1981, following targeted consultation and public submissions.

A position statement released today, supported by an evidence brief, highlights concerns about the increasing use of puberty blockers without sufficient long-term data.

The evidence brief found that the evidence supporting the effectiveness and safety was limited and poor quality. There have been no significant New Zealand studies in this field. 

Studies found that for those on puberty blockers, bone density is lower than expected for the individual’s stage of development, when compared with other young people.  

Organ systems are often affected by hormone medication. However, for those on puberty blockers, there was no evidence of any potential significant effect on renal or liver function, or fertility or onset of diabetes.  

The Ministry said the treatment must now start with a holistic assessment, addressing the full range of a young person’s social and mental health needs.

The new guidelines set expectations for a more precautionary approach, requiring clinicians prescribing puberty blockers to be highly experienced in gender-affirming care and to work within interprofessional teams offering comprehensive support.

“Any additional safeguards in the form of regulations would be to protect against the risk of future harm to vulnerable individuals,” the Ministry said.

This shift comes amid growing international and domestic concern over the rapid rise in puberty blocker prescriptions. In New Zealand, the number of adolescents aged 11 to 17 starting treatment grew from around 25 in 2010 to 140 in 2021. While the number has declined recently, with 113 young people starting treatment in 2023, the Ministry is emphasising the need for tighter oversight.

The Ministry has been tasked with consulting stakeholders and the public to determine whether further safeguards are required.

The consultation, open until late January 2025, will invite feedback via a survey on the Ministry’s Health Consultation Hub website.

Other measures already underway include updated clinical guidelines being developed by Health NZ, improved monitoring of puberty blocker usage, and commissioning research to examine the long-term clinical and mental health impacts of the treatment.

The Ministry said the safety and appropriate care of adolescents with gender identity issues remain critically important. Material related to the consultation is available on the Ministry of Health’s website.

New Zealand First Leader Winston Peters released a statement on X saying “during the election campaign New Zealand First actively and consistently spoke on restricting the use of puberty blockers on children.

“We are pleased to see the first step has been taken by the ministry to restrict their use – once that feedback and consultation period has been completed our party will continue to be the voice of reason and commonsense when the next steps are taken.”

The Act Party also welcomed the news.

“Adolescence can be challenging and confusing, but using medication to deal with gender identity issues can have permanent effects that do real long-term harm. We should support young people to love themselves, not change themselves with experimental medication,” ACT MP Karen Chhour said.

“There was a day when we accepted that electric shock therapy was helpful for wellbeing of our young people. Look how that turned out.

“Internationally, there is increasing concern that there is not good evidence for the safety of puberty blockers for young people grappling with their gender identity. It’s great to see New Zealand now coming into line with countries around the world.

“New Zealand is moving toward a more precautionary approach that puts the safety of young people first, and Kiwis concerned about the role of puberty blockers in our health system have the chance to be heard in consultation that will inform future regulations.”