In September 2022 the Ministry of Health removed the statement from its public website that puberty blockers were “safe and reversible” while "due diligence on evidence proceeds". (1)
Information on puberty blockers now appears on the Te Whatu Ora New Zealand Health website. The website currently states “Blockers are sometimes used from early puberty through to later adolescence to allow time to fully explore gender health options. This is done under the guidance of a clinician who specialises in their use.” (2)
An evidence brief of puberty blockers to manage gender dysphoria, commissioned by the Ministry of Health is, after several delays, now due for publication in early 2024. In April 2024, a few days after the Cass Report was released, the Ministry announced a further delay.(3)
New Zealand puberty blocker prescriptions
In New Zealand puberty blocker prescription is generally managed through GPs.
Originally developed for the treatment of precocious (very early) puberty, puberty blockers started being prescribed for gender dysphoria in New Zealand in around 2010.
In New Zealand 505 10-17 year olds were on puberty blockers in 2020. This is the age bracket likely to be being treated for gender dysphoria.
88 out of every 100,000 New Zealand adolescents (9-17 year olds) were on puberty blockers in 2020 compared to 7 out of every 100,000 in England and Wales. (4)
GnRH analogues or puberty blockers are approved by Medsafe for the treatment of precocious puberty. It is not approved for the treatment of gender dysphoria. (5) Section 29 of the Medicines Act 1981 allows for the prescription of approved or non-approved medicines by practitioners (6).
Pharmac funds puberty blockers for gender dysphoria up to the age of 16. (7)
Government positions on puberty blockers around the world
Australia: The provision and rules around gender services for young people, including puberty blockers, differs between states and territories. Puberty blocker prescriptions for gender dysphoria are not available through the country's Pharmaceutical Benefits Scheme which provides free medication.
England: In March 2024, after reviewing available evidence on safety and clinical effectiveness, England's National Health Service (NHS) stopped prescribing puberty blockers for children and young people suffering from gender dysphoria. (5,6) In April 2024, Hilary Cass released the final report of the Cass Review, an NHS commissioned investigation into gender-related care for children and young people and reported only weak and insufficient evidence to support the use of puberty blockers. (8)
Scotland: Following the release of the Cass Review, Scottish NHS's Young People Gender Service has paused new prescriptions of puberty blockers for young people.
United States: The Department of Health and Human Affairs' Office of Population Affairs says that gender-affirming care including puberty blockers is "crucial" to overall health and wellbeing. Decisions on the availability of puberty blockers is decided at a state level. Around 20 states have banned the prescription of puberty blockers. In 2022 President Biden signed an executive order stating "President Biden is charging HHS with taking steps to address the barriers and exclusionary policies that LGBTQI+ individuals and families face in accessing quality, affordable, comprehensive health care, including mental health care, reproductive health care, and HIV prevention and treatment. The President’s Order charges HHS to work with states to promote expanded access to gender-affirming care."(9)
Sweden: The Swedish government previously recommended hormonal interventions for youth gender dysphoria. A review of evidence in 2022 concluded that the evidence for puberty blockers for gender dysphoria in young people is low and that the risk of hormonal interventions (including puberty blockers) outweighs the potential benefits. Blockers are now only to be prescribed in exceptional circumstances.
Finland: The Finnish Health Authority recommends psychotherapy not puberty blockers or hormones as the first-line treatment for gender-dysphoric youth.