Blockers blocked, hormones not

New Zealand will halt new prescriptions of puberty blockers next month, but serious concerns remain about the welfare of gender-distressed minors

Photo by Sebastian Schuster on Unsplash

New Zealand will ban new prescriptions of puberty blockers for children who reject their birth sex, but minors will continue to have access to cross-sex hormone drugs with questionable legality.

On Wednesday, centre-right National Party Health Minister Simeon Brown announced the NZ Cabinet decision for the ban to operate from December 19, and cited the finding by his ministry’s 2024 evidence brief of “a lack of good-quality evidence to back the effectiveness and safety” of this “off-label” use of puberty suppression drugs.¹

The minister said the prohibition in the Medicines Act 1981 was modelled on the UK’s indefinite ban on puberty blockers for gender distress outside a clinical trial, after which NZ would revisit its position. That controversial trial and indefinite ban were inspired by the landmark UK 2020-24 Cass review of youth gender dysphoria care.

Brown said the NZ government’s “precautionary approach” also mirrored extra safeguards adopted in Nordic countries such as Sweden and Finland, and followed a consultation period in NZ after the ministry published its evidence brief last year.

Winston Peters, whose populist-right NZ First Party is a member of the country’s National-led governing coalition along with the libertarian ACT Party, said he had had to push successive health ministers and officials for action on puberty blockers following the 2024 report of UK paediatrician Dr Hilary Cass, who warned there was “remarkably weak evidence” for hormonal treatment of gender distress.

“I was saying to the National Party and ACT—stand back and watch, you’re going to get sued for a failure to exercise a duty of care on this matter, and you’ll have been the cause of it if we don’t do something,” Peters said on Thursday during an interview with Bob McCoskrie of the conservative Christian lobby group Family First NZ.

“Even now, we [are] exposed by the past administration [under Labour Party prime minister Jacinda Ardern] going down that pathway [of ignoring the risks of gender medicalisation of minors].

“There’ll be some young children growing up and a decent lawyer will say to them, look, you were owed a duty of care by parliamentarians, and they let you down. Why don’t you sue them?”

Meanwhile, Otago University’s emeritus professor of public health and medical epidemiology, Charlotte Paul, said the continued availability of cross-sex hormones in NZ is “a real problem here and arguably illegal for under 18-year-olds”.

Professor Paul said the question, which she first raised two years ago, is whether cross-sex hormones are legally non-routine treatment of the kind where minors cannot go ahead without parental consent.

Under the Care of Children Act 2004, she noted, “Parents are still guardians [of their children] until age 18 (unless their child marries earlier), and are responsible for helping their child determine ‘important matters’ including medical treatments that are not routine in nature”.

(GCN has sought comment from the NZ Ministry of Health on this issue.)

Professor Paul said: “Cross-sex hormones have been widely promoted in NZ, including in general practice [or primary care].”

“Because we have had such high rates of prescribing of [puberty blockers] I expect it of cross-sex hormones too, but we haven’t been able to collect figures.”

The health ministry was aware of the risk that its own past promotion of puberty blockers for gender distress—an off-label use without regulatory approval—might have been unlawful under the Medicines Act. Asked about this in 2023, the ministry said it was “satisfied that it has complied with the law at all times”.

“One of the most morally bankrupt and manipulative aspects to the ‘rainbow activism’ pushing child transition is how they have terrified parents with the utter bullshit that if their child doesn’t get puberty blockers, they will kill themselves. That is emotional blackmail. And there is absolutely no evidence or data to back it up.

“It has been a mass cruelty inflicted on parents by and large by dysfunctional screaming adults who don’t have children of their own.”—post, NZ commentator Ani O’Brien, 19 November 2025

Stealth edit

In 2022, after a similar 2020 manoeuvre by England’s National Health Service (NHS), New Zealand’s health authorities quietly abandoned their reassuring website claims that puberty blockers are “safe and fully reversible”.

International data suggests the vast majority of children begun on blockers proceed to cross-sex hormones, a combination with risks including sterilisation, sexual dysfunction, potential cognitive deficits, and other adverse health outcomes.

Multiple systematic reviews, independently conducted in several countries since 2018, have shown there is no good evidence to support claims that blockers and hormones confer mental health benefits. The drugs are often promoted as “lifesaving” by transgender activists.

On Wednesday, NZ First issued a statement saying the decision to ban blockers was—

“a monumental victory for common sense and for every parent who’s been told to sit down, shut up, and let so-called ‘experts’ chemically sterilise their kids because they were ‘born in the wrong body’.

“For years, activists told us to ‘trust the science’ while burying any study that didn’t fit their narrative. They have demonised parents who question medical transition. They have bullied doctors into silence, captured ministries and universities, and built an industry that profited from confusion.”

Genspect NZ, which advocates for non-invasive responses to youth gender issues, welcomed the blocker ban, saying it was “a decisive step toward safeguarding New Zealand children and brings us into line with a growing international consensus that these medicines are experimental, lack credible long-term safety data, and expose developing bodies to irreversible harm”.

“New Zealand has one of the highest prescribing rates of puberty blockers in the world, making us an outlier. This decision is an overdue correction.”

A 2024 analysis in the New Zealand Medical Journal by Otago University’s Professor Paul and colleagues showed a steep increase in puberty blocker prescriptions from 2014 to 2022, followed by a decline.

With prescribing expressed as cumulative incidence, NZ usage overtook the Netherlands, home of the puberty blocker-driven “Dutch protocol” for “juvenile transsexuals”, and in 2020 was up to 6.9 times higher than the prescribing at the UK Tavistock clinic, which was the world’s largest youth gender service before its closure as a result of the Cass review.

Genspect spokesperson Jan Rivers said the NZ government would have to see through its new restrictive policy “in the face of an alarmist disinformation campaign”.

One NZ physician, who spoke anonymously to be spared activist harassment, told GCN that the puberty blocker ban would inevitably generate pushback from clinicians practising “gender-affirming care”.

“Doctors who are in denial about the lack of evidence for prescribing puberty blockers are unlikely to accept this outcome,” this physician said.

“They will remain in denial that they have potentially been causing harm to these vulnerable young people. Many of these doctors are self-appointed specialists in this controversial area of medicine.

“Without being able to prescribe puberty blockers, their income will be affected. They will double-down to avoid losing their jobs and being accused of medical harm.”

Professor Paul said she supported the decision to ban blockers but told GCN she had some concerns.

“First, that being political—rather than medical and based on an independent review, which I long advocated—[this decision] is likely to stoke partisan opposition. This would be less of a risk if Labour also supported it. This bipartisan support happened in the UK,” she said.

Opposition MP Shanan Halbert, the “Rainbow Issues” spokesman for New Zealand’s centre-left Labour Party, objected to the November 19 blocker ban on the grounds that treatment decisions should be left to doctors, young people and patients.

The attitude of Green Party MP Ricardo Menéndez March, also in opposition, was that the government was “buying into imported culture wars”.

As yet, however, no opposition party has made an undertaking to overturn the puberty blocker ban if voted into power.

Meanwhile, the NZ First statement can be read as suggesting that the puberty blocker ban had to be forced upon a reluctant or divided National Party.

The ACT Party, also a member of the coalition government led by National Party Prime Minister Christopher Luxon, welcomed the new policy on blockers.

“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,” said Minister for Children Karen Chhour of ACT.

“We should support young people to love themselves, not change themselves with experimental medication.”

“Puberty blockers saved my son’s life. We fled from the US so he could continue to live his best life here. We cannot let this BS puberty blocker ban stand in Aotearoa [NZ]! We need to fight this now!”—post on the Bluesky social media platform, Lauren, 20 November 2025

“Zero surprises that the brainless transphobic health minister in NZ ignored all expert advice and evidence and banned puberty blockers for trans youth. Literal blood on his hands.”—Bluesky post by someone who identifies as Mikey Brenndorfer, a “youth health nurse practitioner”, 19 November 2025

The captured newsroom

Mainstream media coverage of Minister Brown’s November 19 statement was emotive and heavy on the politics, but weak on the scientific debate and international context.

“On the day of the announcement, online publication Spinoff ran a story on ‘The reality of raising a trans child in 2025’,” gender-critical NZ journalist Yvonne van Dongen told GCN.

She noted that one mainstream journalist had taken to Twitter/X to express his surprise at the sheer number of gender-critical groups sending him media releases in support of the ban.

She said groups such as Genspect NZ and Resist Gender Education had been largely ignored by mainstream outlets captured by gender ideology.

“Even the Science Media Centre press release only cited ‘experts’ that criticised the government’s actions,” van Dongen said.

“The [centre’s] remit is to ‘promote accurate, evidence-based reporting on research, science, and innovation by helping the media work more closely with the research community’.”

The prominent doctor and youth health specialist Dame Sue Bagshaw was widely quoted across the coverage, van Dongen said.

“She said that puberty blockers are safer than aspirin, which is available over the counter. She believed puberty blockers were safe and reversible and warned against any ‘moral panic’,” van Dongen said.

“Even our Human Rights Commission put out a release that banning puberty blockers is an infringement of human rights.”

Fortunately, van Dongen said, NZ also has “a thriving alternative media scene” and representatives of gender-critical groups ignored in the mainstream coverage were interviewed by outlets such as The Platform and Reality Check Radio.

At a media conference on Friday, Peters of NZ First responded to one question by asking if the journalist had read the Cass report; the answer was no.

“I’m actually astonished that you people here haven’t read the Cass report [and] don’t know what’s in it…” Peters said.

The group Family First urged media editors to listen to the stories of two young NZ detransitioners, Issy and Zara.

Bagshaw v Bagshaw

Dame Sue Bagshaw, founder of the 298 Youth Health centre in New Zealand’s South Island city of Christchurch, has a history of difficult-to-reconcile claims on puberty blockers.

NZ media often quotes her as a disinterested “youth health expert” without acknowledging she has been one of the country’s most active prescribers of blocker drugs to interrupt the normally timed puberty of children distressed by their sex.

Here’s a list of some of the claims she has made since 2021. They are ordered by relevance, not date—

What we don’t know is the effect [of puberty blockers] on the brain development.” Newshub, March 2021

“[Puberty blockers] are totally reversible, so that when you stop them, your own hormones grow up again.” Stuff, July 2021

“The issue that we need to do more research into is the long-term effect [of blockers] on brain development.” The Platform, November 2025

“These medications allow young people the time to explore their identity—and you know, this is the job of adolescence. Finding out who you are, exploring your identity. This is where you start to be able to think in abstract thinking, and you’re able to actually explore who you are.” RNZ, November 2025

“I think a child of 12 or 13 definitely knows their mind.” Newshub, 2021, via Bob McCoskrie’s Family First McBlog

“[The vast majority of children begun on blockers go on to cross-sex hormones, meant to be taken lifelong] because most kids know what they want, most kids know who they are. And that’s confirmed with time, so they do carry on with the hormones. It sets them on a pathway that they have already chosen by saying they have gender dysphoria.” RNZ, April 2024

“If you actually discuss and explore with young people properly, many of them do not go on to hormones [from blockers]. But the point being, that [puberty suppression] gives them a delay so they don’t give up hope and just kill themselves.” The Platform, November 2025

“Dr Sue Bagshaw reports that 65 per cent of her [Youth 298] clinic’s 100 patients receive [blockers]. The [London-based] Tavistock GIDS clinic prescribed blockers to about 6 per cent. About 80 per cent of Youth 298 patients on puberty blockers went on to hormone therapy as adults.” Stuff, March 2021

“[On psychosocial support being no substitute for blockers] “It’s actually quite difficult to help them to understand that they’re being listened to without doing something, and that’s the nature of brain development and it’s also the nature of short appointment times.” RNZ, September 2022

“We have had no disasters so far [with puberty blockers], compared with things like aspirin, which is pretty unsafe, and you can buy that over the counter.”—NewstalkZB, November 2025

“Dame Sue Bagshaw, who has many transgender patients at her Christchurch youth practice, conceded there were some unknowns about the long-term effects of puberty blockers, particularly on bone density.” RNZ, September 2022

“[The adverse effect of blockers on bone density] is reversible once hormones start again.” RNZ, November 2025

Beyond blockers

Otago University’s Professor Paul said the end of puberty blockers in itself did not allay her concerns about the more general “care and support for gender dysphoric children and young people”.

She said Dr Cass’s 2024 report for the NHS “recommended mental health services for those young people—to provide assessment and appropriate care of mental health problems and autism, etc. The UK has also developed and are testing psychological interventions for gender dysphoria.”

“Cass recommended these services should be outside the gender clinics. The plan in NZ is to have these types of services in the gender clinics. Given the hostile reaction of [the gender-affirming lobby] PATHA to the new announcement, I think that is unlikely to be successful here.”

Genspect NZ director Simon Tegg wondered whether gender clinics “may feel justified in ‘fighting back’ against the government’s regulation by doubling down on the medical model and treating even younger children with other drugs that everyone acknowledges have irreversible impacts”.

“Will clinicians at these services simply put a 14-year-old straight on to [cross-sex] hormones now that the government has taken away the puberty blocker option?”

As for those young patients “who would have received blockers [but] will now receive mental health support, what kind of support will this be, and who will provide it?”

“If the same clinicians continue to reinforce the child’s belief that they are the opposite sex while intimating that the government has taken away a ‘necessary’ treatment, this could cause a huge amount of distress in a vulnerable population,” Tegg told GCN.

Despite such misgivings Tegg welcomed the government’s ban on blockers.

“The announcement will be a huge relief to parents who previously faced teachers and other unlicensed professionals ‘suggesting’ puberty blockers to their gender non-conforming child and setting him or her up for a lifetime of medical treatment,” he said.

On the public broadcaster RNZ, Jennifer Shields, the president of PATHA, the Professional Association for Transgender Health Aotearoa, claimed that children denied puberty blockers face a bleak prospect.

“The outlook for them looks like, you know, a significant deterioration in quality of life, because this government [in NZ] has done essentially what the UK has done,” Shields said.

“We’re able to look at the impacts of that ban over there, and we are seeing increased rates of suicidality, a reduction in, like, young people’s ability to participate in public life,” Shields said.

“They stop going to school, they stop engaging with their social engagements. It really is just a huge limit on trans young people’s ability to thrive, and again, based purely on politics, not on medical expertise.”

Shields is self-described as “a queer and trans artist, activist, advocate and educator”.²

In the UK, following trans activist claims of a spike in self-harm after restrictions were imposed on puberty blockers, Labour Health Secretary Wes Streeting commissioned an independent review by suicide prevention expert Louis Appleby.

In his report Professor Appleby debunked the suicide narrative and said: “The way that this issue has been discussed on social media has been insensitive, distressing and dangerous, and goes against guidance on safe reporting of suicide”.

In NZ, PATHA president Shields is managing director of Qtopia, an “LGBTQIA+” advocacy group which boasts it is accredited by the NZ Ministry of Education as a provider of “professional learning and development for teachers”.

Under the heading of “hormones and puberty blockers” for under-18s, the Qtopia website says—

“Previous pathways to accessing this care have been arduous and seen as ‘gate-keeping’—lots of us in the community have seen these assessments as a test to see if we’re ‘trans enough’ for treatment.

“It’s important to know that a lot has changed—now, these assessments are an opportunity to talk with a mental health professional with a good understanding of gender diversity about you, your life, your gender, and your goals …

“The pathway after a readiness assessment is currently being re-developed. Previously, you might have been referred to endocrinology, or paediatric endocrinology. Work is underway to bring this care into primary care, through a GP practice.”

As recently as last month, activists were agitating for the government to release “gender-affirming” treatment guidelines updated by PATHA under a 2023 contract with NZ health authorities.

The current 2018 NZ guidelines—endorsed by PATHA—were rated 12/100 for the rigour of their development during an evaluation of international treatment guidelines commissioned by the Cass review.

These 2018 guidelines make claims at odds with the state of the evidence base. For example, they assert: “Puberty blockers are considered to be fully reversible and allow the adolescent time prior to making a decision on starting hormone therapy.”

---

GCN does not dispute that gender-affirming clinicians believe their interventions benefit vulnerable young people

1. Puberty blockers—known as gonadotropin-releasing hormone analogues (GnRHa)—are used “off-label” to treat minors distressed about their birth sex. They are prescribed off-label because they do not have regulatory approval for that use. The ban to operate from December 19 will not affect the approved use of GnRHa drugs to treat children with central precocious puberty whose sexual development begins prematurely. This hormone suppression continues until the child is at an age to go through puberty in sync with his or her peers. In gender clinics, however, GnRHa drugs are used to interrupt normally timed puberty.

Trans activists have conflated these two distinct uses to suggest that any restriction of puberty blocker use by gender clinics is discriminatory because “trans” children are being denied the same treatment allowed for “cis” children.

This conflation also enables gender clinicians to enlist in a reassuring way the longer track record of GnRHa use with precocious puberty. In fact, the use of these drugs to suppress normally timed puberty is relatively new, and in many countries they were not prescribed at scale until the mid-to-late 2010s.

In her 2024 report, UK paediatrician Dr Hilary Cass directly addresses the misleading claim that drugs approved as safe for precocious puberty can be judged equally safe when given to minors who reject their birth sex and are distressed at the prospect of their normal puberty. See pages 173-174.

2. PATHA’s official statement quoted not Shields but the group’s vice-president, Dr Elizabeth McElrea, a primary care doctor described as a “GP specialist in gender-affirming care”. Dr McElrea was quoted as saying: “The prescribing of puberty blockers is always undertaken with the utmost care and consideration”. No evidence was offered for this blanket claim.