Government Overreach in Healthcare with Puberty Blockers Decision

Statement - 20 November 2025

The Rainbow Support Collective objects to cabinet’s decision to ban puberty blockers for transgender children, and disputes their claims that this decision was made in the interests of protecting the wellbeing of young people.

The banning of puberty blockers is an example of government overreach and political attacks on healthcare. The announcement on 19 November that cabinet would be using the Medicines Act in order to put a restriction exclusively on young trans people seeking access to puberty blockers as treatment for gender incongruence, is described as a ‘precautionary approach’. In reality, it is an unprecedented and inherently discriminatory use of the Medicines Act to deny healthcare to a particular population on the basis of their sex (being transgender). The announcement also says that the decision will be in effect pending the outcome of the clinical trial in the UK, which is an extreme measure given that trial will not end until 2031, denying a generation of transgender young people crucial healthcare.

The evidence does not say what the government are claiming

To justify this decision, Healthcare Minister Simeon Brown cites the Ministry of Health’s evidence brief (which was finished in April 2024, but was delayed due to pressure from the Government to incorporate findings from the widely debunked Cass Report), and similar restrictions being imposed by the UK Government. The Minister has claimed that the evidence brief found a “lack of high-quality evidence that demonstrates the benefits or risks of the use of [puberty blockers]”. In practice, clinical guidance and evidence-based medicine are based on three tenets: the academic evidence, clinical experience, and the values and wishes of the patient. The limits of getting good quality evidence are due to the ethical and practical limitations, and it is always unethical to deny healthcare to a control group simply for the purpose of testing efficacy. Because of this limitation across all healthcare, it is extremely common for medicines to be used when there are limitations in the quality of evidence, and the fact that trans health is uniquely held to an impossible standard is political. Of further concern is that the Ministry of Health report focused solely on the mental health benefits of puberty blockers, which ignores that their primary medical purpose is simply to stop puberty.

While the quality of the evidence supporting the prescription of blockers is low, the evidence that exists shows a positive impact reducing depression, anxiety, self-harm and suicidal ideation. The position statement of the Ministry of Health, (informed by the results of the evidence review) recommend funding better research, and an approach where young people and their whānau are informed of the low quality of evidence when they make decisions about starting puberty blockers. The findings of the evidence brief do not justify a ban. At no point is a ban suggested, let alone recommended, which is an even more extreme response than the recommendations of the Cass report, which called for transgender children in that jurisdiction to still have access to puberty blockers, through a clinical trial.

The Cass report was not commissioned to be a clinical guideline, and should not be regarded as such. Critically, the Cass report goes well beyond its scope of investigating puberty blockers and leans into opposing gender affirming healthcare in principle. This is historically a failed and experimental approach to trans healthcare that goes against decades of medical consensus. When discussing puberty blockers, the Cass report encounters the same problems with its evidence as the Ministry evidence review. Even though it finds more evidence to support the ongoing use of puberty blockers than it does to prohibit them, the recommendations of the report are a direct contradiction to these findings. Researchers specialising in systemic reviews like those used for Cass and the Ministry of Health’s evidence brief have condemned using these studies for politically interfering with the provision of healthcare: 

“Following fundamental principles of humane medical practice, clinicians have an obligation to care for those in need, often in the context of shared decision making. It is unconscionable to forbid clinicians from delivering gender-affirming care.” 

The researchers urge clinicians to consider the autonomy of their patients, and their own capacity to be reliable narrators regarding their own bodies and needs. Every person and their whānau have a right to make informed decisions about their own healthcare, rather than have those decisions made for them by the government.

This is political, and it is discrimination

Policies that target transgender patients to reduce access to gender affirming healthcare are sex discrimination. Phrases such as ‘young people experiencing gender dysphoria or incongruence’ obscure that gender dysphoria is a diagnosis almost exclusively given to transgender patients. This announcement offered no restriction of access to these medicines for cisgender people - including five-year olds experiencing early-onset puberty, teenagers experiencing endometriosis, and adults with prostate cancer. There is also an assumption behind this language that puberty blockers can only cause harm in the case that a young person who accesses them may go on to find they are not transgender. What this decision ignores is the harm that is done by denying blockers to transgender young people, and therefore forcing them to go through an otherwise avoidable and irreversible puberty which causes them lifelong distress, increases the discrimination they will face throughout their life and will require them to undergo expensive surgery as adults.

Despite the claims made by the Minister of Health, it is not a precautionary approach and it is not about making sure that treatments are safe or carefully managed. It is a kneejerk reaction with political motivations that are not aligned with medical best practice, or the evidence he himself cites. Further contradicting the Minister’s claims, his coalition partners in New Zealand First have been open about their ideological opposition to gender affirming healthcare, which directly conflicts with their past claims to oppose government overreach in healthcare. 

This decision will cause significant harm

This decision was announced the afternoon before Transgender Day of Remembrance, when transgender communities worldwide remember those transgender people who have been killed by direct violence, and those who have died because of systemic discrimination. As a collective of community leaders, health promoters, counsellors, social workers, and others who work directly with young transgender people every year, we believe that this decision is dangerous and is likely to result in not only the suffering of transgender youth, but the names we will be remembering in the years to come.   

To the Ministers who made this decision: you are responsible for the weight of its consequences. 

To the transgender youth who will not be able to access these medicines: our member organisations will continue to fight for your rights. We will keep working with the many healthcare providers who want to make sure you get to choose the treatments that are right for you. We will continue to listen to you, to share information with you, and to respect your choices. We see you, we value you, and we want you to stay alive

The safety of trans children in this country requires us to put science and evidence first. This announcement intends to put politics above this.

This statement is written on behalf of the signing members of the Rainbow Support Collective. Our collective is made up of organisations doing the day to day work of providing support for rainbow people throughout Aotearoa, our membership includes both national and regional organisations, as well as organisations who specialise in supporting transgender, intersex and youth populations.

RainbowYOUTH - Intersex Aotearoa - Gender Minorities Aotearoa - Qtopia - Rainbow Hub Waikato - Te Ngākau Kahukura - Burnett Foundation Aotearoa - InsideOUT Kōaro - OutLine Aotearoa