TALKING POINTS FOR DOCTORS - ZEALAND PUBERTY BLOCKER POLICY (2025)
- AWW admin
- 13 minutes ago
- 3 min read
1. NZ Has Halted Puberty Blockers for New Cases
Key Message: The Government has placed a moratorium on prescribing puberty blockers (GnRH analogues) to new patients presenting with gender dysphoria or incongruence.
Quote from Beehive:
“New patients… can no longer be prescribed gonadotropin-releasing hormone analogues.”
Clinical implication: Doctors should not initiate puberty blockers for gender dysphoria outside a formal clinical trial. No such trial currently exists in NZ.
2. Government Recognises Lack of Evidence
Key Message: The decision is based on clear evidence gaps identified by the Ministry of Health and international systematic reviews.
Quote:
“There is a lack of high-quality evidence demonstrating the benefits or risks of puberty blockers for gender dysphoria or incongruence.”
Clinical implication: Doctors must communicate these evidence limitations during consultations and informed consent sessions.
3. The ‘Precautionary Principle’ Now Applies
Key Message: NZ is officially adopting the same precautionary framework as the UK, Finland, Sweden, and Norway.
Quote:
“While this uncertainty persists, the Government is taking a precautionary approach.”
Clinical implication: A cautious, exploratory, and holistic approach is now expected as the clinical standard — not automatic affirmation.
4. Medical Care Must Follow Evidence-Based Standards
Key Message: The Beehive explicitly states that all youth treatments must be clinically sound and in the best interests of the child.
Quote:
“We are putting in place stronger safeguards so families can have confidence that treatment is clinically sound and in the best interests of the young person.”
Clinical implication: Doctors must revert to normal child and adolescent care standards:
full assessment
screening for mental health conditions
developmental evaluation
family context
trauma history
ASD/ADHD where relevant
risk assessment
differential diagnosis
5. Psychological and Holistic Care Should Be First-Line
Key Message: Hormonal interventions are not the frontline treatment for gender distress.
International alignment:This matches Cass Review recommendations, NICE findings, and Nordic guideline changes.
Clinical implication: Offer or refer for:
psychological therapy
family therapy
broader mental-health support
support for school challenges, bullying, or social stressors
exploration-based care, not directive care
6. Blockers Are Only Available Within a Clinical Trial (UK Model)
Key Message: NZ is aligning with the UK, where puberty blockers are allowed only within a clinical research setting.
Quote:
“Pending completion of the United Kingdom’s clinical trial…”
Clinical implication: Doctors should inform families that:
puberty blockers are not available as routine care
any future use will follow formal research governance
long-term outcomes remain unknown
7. Existing Youth May Continue Treatment — With Oversight
Key Message: Current patients will not be forced to stop, but their care must be carefully monitored.
Quote:
“The new approach will not impact patients currently receiving puberty blockers…”
Clinical implication: Doctors should:
review ongoing treatment
reassess risk/benefit
ensure thorough documentation
discuss long-term uncertainties openly
ensure fertility and bone health monitoring is up to date
8. Suicide-Prevention Messaging Must Be Evidence-Based
Key Message: The government decision rejects activist claims such as “puberty blockers prevent suicide.”
Evidence base:No high-quality studies show blockers reduce suicide risk.The Cass and NICE reviews found no mental-health benefit.
Clinical implication: Doctors should use accurate, non-coercive language when discussing risk and ensure suicide risk is managed using established mental-health interventions.
9. International Consensus Has Shifted
Key Message: NZ is following a global movement away from the gender-affirming model for minors.
Countries taking the same approach:
United Kingdom
Finland
Sweden
Norway
Denmark (partial)
France (urgent caution guidance)
Australia now reviewing (post-Cass)
Clinical implication: Doctors can confidently inform families that NZ practice now aligns with international best evidence, not activist guidance.
10. Professional Obligations: Informed Consent Must Reflect Reality
Key Message: Doctors must ensure families are given accurate, complete information.
Informed consent should now explicitly include:
lack of long-term evidence
potential risks to fertility
impact on bone density
psychosocial factors influencing gender distress
the possibility of desistance
increasing awareness of detransition
alternative treatment pathways
the fact blockers do not “buy time”
the fact most youth on blockers progress to cross-sex hormones (96–98%)
Clinical implication: Clinicians can no longer rely on WPATH, PATHA or activist materials.Primary sources and government-approved guidelines should guide discussions. Download:
Comments