Genspect NZ Welcomes the Long-Awaited Evidence Brief on Puberty Blockers

[Wellington, 22 Nov 2024] – After a year’s delay, the Ministry of Health has finally released its long-anticipated evidence brief and position statement on puberty blockers. Genspect NZ welcomes the publication, which aligns with findings from other international systematic reviews. The evidence brief confirms there is insufficient evidence to support claims that puberty blockers are safe and reversible, or that they provide mental health benefits. The studies reviewed rely heavily on subjective self-reports from adolescents and most were rated by the Ministry as having “serious” or “critical” risk of bias. 

"The evidence for the benefits of puberty blockers is as bad, if not worse, than the evidence for homeopathy," said Genspect NZ spokesperson Jan Rivers. Reported benefits could simply be the placebo effect from a young vulnerable population convinced that they ‘need’ the treatment because they saw it promoted on social media. The Ministry’s current assessment directly contradicts claims made by leadership of the Professional Association of Transgender Health Aotearoa (PATHA), Health NZ, and the Ministry itself which proposed doing away with compulsory mental health assessments in 2021, and finally removed the “safe and fully reversible” claim from its website in 2022.

‘There must be accountability. For too long the Ministry and Health NZ have relied on supposed experts from PATHA who have pushed medical interventions and unsupported claims. The Ministry has finally taken steps to restore scientific integrity over activist demands,” said Rivers.

The Ministry has also issued a position statement outlining an interim policy shift. However, the policy does not square with the findings of the evidence brief. The Ministry specifies that “[c]linicians who initiate puberty blockers should be experienced in providing gender-affirming care”. While this removes the burden from GPs to prescribe puberty blockers, it places responsibility in the hands of the same self-selected clinicians who promoted the unscientific claim that puberty blockers are ‘safe and fully reversible.’ 

“The Ministry's decision to entrust this treatment to the very clinicians who have misrepresented the evidence for years raises serious concerns about accountability and patient safety,” said Rivers.

Additionally, the Ministry’s position statement contradicts a key recommendation of the Cass Review. Dr Cass advised that care for gender-questioning adolescents be integrated into general child and adolescent mental health services  where they would receive the same holistic mental health assessments as any child presenting with a problem, rather than kept separate under a "gender-affirming care" framework. This is important because “one of the key risks of the 'gender-affirming care' model, as identified by the Cass Review, is that labeling a child as 'transgender' can overshadow underlying issues and prematurely close off exploration ", said Rivers. “The Ministry has not addressed critical issues, such as the disproportionate representation of same-sex attracted youth in the patient group and the impacts of suppressing their emerging sexuality.”

There is however, a consultation period which will remain open until late January 2025, providing an opportunity to highlight these shortcomings. Genspect NZ will ask the Ministry to address the numerous contradictions and publish a submission guide to assist concerned individuals and groups.