More delays in action on use of puberty blockers with children
More than four years ago, questions were being raised both in New Zealand and internationally about the safety and long-term use of puberty blockers to treat children experiencing “sex-related distress”.
Today [Thursday, 21 November], the Ministry of Health announced it had been instructed by the Government to consult on whether there should be additional safety measures around prescribing these drugs to children and adolescents to treat “gender incongruence”.
Two years ago, in September 2022, the Ministry quietly dropped the assertion on their website that use of puberty blockers in cases relating to “gender” was safe and effective.
This followed an Interim Report of the Cass Review, an independent UK report of “gender identity” services for children and young people, released in February 2022.
The Ministry completed an evidence brief in September 2023, but this was not released at the time, pending publication of the final report of the Cass Review in April this year.
The Cass Report recommended a pause on prescribing blockers in light of the short and long-term side effects, including menopausal symptoms, weaker bone density and the potential impact on fertility, sexual function and brain development.
The Cass Report found that that existing studies were of poor quality and lacked evidence on the long-term impact of taking hormones from an early age.
Cass concluded that the research has let all those involved down, and most importantly children and young people. Far from giving children “time to think”, the Cass Report found that puberty blockers effectively locked them into a medical pathway leading to cross-sex hormones and surgeries that are irreversible.
Women’s Rights Party Co-leader Jill Ovens says the Ministry has put New Zealand children at risk by continuing to allow “off-label” prescribing of puberty blockers at far higher rates than other similar countries.
“The Ministry’s announcement today of a consultation period through to 20 January 2025 is just a further delay on safeguarding our children,” she says.
The Women’s Rights Party is calling for a ban on the use of puberty blockers and cross-sex hormones to treat children and adolescents under the age of 18 who are presenting with “sex-related distress”, and to restrict Government-funded masculinisation or feminisation cosmetic surgery to those aged over 25 (currently aged over 18).
Ms Ovens notes that the Ministry says it wants to hear through its consultation process “particularly from organisations representing people who may be affected by safety measures or which may be involved in how safety measures are used in practice”.
“This is like asking the fox for advice on how to guard the chickens. Our health authorities have remained hostage to a vocal minority who have vested interests and have put our children’s health at risk of lifelong irreversible damage,” Ms Ovens says.
She notes from the position statement that the Ministry has already established an external advisory group, without stating who is on that group, and that Health NZ is currently developing updated guidance to support clinicians providing “gender-affirming care”, including the use of puberty blockers.
Ms Ovens says the Women’s Rights Party has been calling for an inquiry into the contracting of PATHA (the Professional Association for Transgender Health Aotearoa) by Health NZ to update its guidelines for “gender-affirming care” for healthcare professionals, given that the Cass Report assessment of guideline quality put the New Zealand PATHA guidelines second to last – a very low score of 149/600.
Says Ms Ovens: “While our health service has been dodging questions about the safety and long-term use of puberty blockers to treat children, limitations have been placed on their use in the UK, Finland, Norway and Sweden.”
In its position statement, the Ministry acknowledges that these countries have all expressed concerns about the lack of high-quality evidence on use of puberty blockers.
The Canadian province of Alberta is currently considering banning the use of puberty blockers for young people aged under 16, in light of the NHS decisions in England and Scotland.
And in most Australian States, the prescription of puberty blockers for people under 18 years requires consent of the young person, treating clinician, and all those with parental responsibility for the child. Because use of puberty blockers for this purpose is “off-label”, it is not publicly funded in Australia.