By December, an urgent injunction filed by PATHA was granted by the High Court, stopping the regulations from coming into force until the judicial review was carried out.
The authors of the paper are Associate Professor Cindy Towns, Dr Rona Carroll, Dr Jemima Bullock, Professor Paul Hofman, Dr Richard Carroll and Dr Andrew Linton. Some work directly with gender-diverse young people, and Rona Carroll is a member of the PATHA executive committee.
“The Aotearoa New Zealand Government’s recent attempt to ban puberty blockers and the subsequent interim injunction granted by the Supreme Court has highlighted ethical concerns in the management of gender incongruence and gender dysphoria, particularly when a patient is under 16,” the authors say.
They acknowledge a rise in referrals for gender incongruence (when a person’s experienced gender and their assigned sex at birth do not match) and gender dysphoria (when a person’s gender incongruence has an adverse impact on their health and wellbeing), particularly in young people or children.
“The increase has resulted in an increased number of prescriptions for puberty blockers, which has, in some areas, resulted in criticisms.
“High-profile cases of detransition in those who have taken cross-hormone treatment (not puberty blockers) or undergone surgery have gained international media attention …”
The authors highlight a US Government decision to ban gender-affirming care, which continues to generate widespread concern among gender minorities and their advocates.
“Aotearoa New Zealand has not been immune to the debate, with the National-led coalition Government recently banning new prescriptions of GnRHa (Gonadotropin-Releasing Hormone Analogue) for people with gender incongruence or gender dysphoria.”
The paper talks about how puberty suppression, in the form of GnRHa or puberty blocker medications, can be used to benefit patients and reduce harm in young people with gender incongruence.
‘To deny treatment would be unethical’
The authors discuss how clinicians routinely assess the potential for harm with the potential for benefit to determine whether a specific treatment should be recommended for an individual.
They highlight a study that compared young people who had been on puberty blockers with those who had not at the time of assessment for gender-affirming hormone therapy.
That study found that those young people who had been on puberty blockers had lower rates of anxiety, depression and suicidality in comparison to those who had gone through a puberty that did not align with their experienced gender.
The authors recommend that more research be done, and they strongly believe it should be a long-term study, with regular reporting throughout adolescence and early childhood.
“There is clear evidence for puberty suppression clinically in children and youth with gender incongruence with dysphoria, and to deny them treatment with blanket bans would be unethical.”
Associate Professor Cindy Towns said puberty blockers are and should continue to be prescribed only by experienced doctors working within multi-disciplinary teams.
The medications are safe and reversible and have been used since the 1980s for a variety of conditions, not just gender incongruence, Towns said.
“We note that there has been no call to ban these medications in other conditions.
“In gender incongruent youth, they have been clearly demonstrated to provide benefit and decrease harm – primarily due to improved mental health and decreased depression, anxiety and suicidality. Given the evidence, it would be unethical to ban their use.”
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