While Associate Health Minister Matt Doocey continues to delay the release of expert ministerial advice about the prescription of puberty blockers to trans children and adolescents, Craig Young looks at what information exists about current medical practice in this area.
According to a recent New Zealand Medical Journal paper written by Charlotte Paul, Simon Tegg and Sarah Donovan (27 September), puberty blocker prescription in Aotearoa/New Zealand is relatively unconstricted compared to other jurisdictions, although it has dropped recently. The paper’s authors report that nearly four hundred teenagers (12-17) started puberty blocker courses during the last year. Comparative figures indicate this is twice as high proportionately as the Netherlands, four times as high as in Denmark and three and half to seven times as high as England and Wales.
The NZMJ study is long-term and notes that puberty blocker prescriptions initially increased slowly (2010-2014), then more steeply (2014-2022), but now seems to have plateaued off or slightly decreased. For adolescents, there was a particularly steep increase after 2016, while those under twelve only started to increase significantly after 2018.
As for media coverage of the NZMJ article, regrettably, Stuff referred to the UK Cass Report without reference to the abundant criticism of its conclusions from senior professionals in pediatric practice, developmental psychology and endocrinology. It also featured a photograph of anti-trans detransitioner Keira Bell without mentioning that her case against gender-appropriate medical care was overturned by the UK Court of Appeal.
The New Zealand Herald’s coverage did incorporate feedback from appropriate professional senior medical figures, two of whom noted that it was commendable that Aotearoa/New Zealand trans adolescents apparently had unconstricted access to appropriate and timely medical care, unlike the United Kingdom, and that the situation that the NZMJ authors highlighted was not necessarily ‘overprescribing.’ Additionally, NZH’s Isaac Davison did his homework when it came to the controversy over the Cass Report within professional circles in the United Kingdom and elsewhere.
In the Christchurch Press (28 September), it was noted that the Cass Report had emboldened ardent gender-critical thinking like the libertarian Spiked magazine, Julie Birchall and J.K. Rowling. Charlotte Paul, an Emeritus Professor at Otago University, is referred to as a ‘high-profile New Zealand defender of the Cass Report.’ It was also noted that New Zealand’s administration of puberty blockers is less centralised than was the case in the United Kingdom and that the abrupt truncation of puberty blocker access in the latter produced an inflated perception of the extent of New Zealand liberalism in this context.
In contrast with Charlotte Paul’s conservative perceptions, there was coverage of Christchurch Otautahi’s Te Tahi Gender Youth Clinic, and its director, Dr Sue Bagshaw. Dr Bagshaw argued that as the use of medication is standardised, its use tends to reach a plateau or slightly decline as other treatment options appear. It also noted that the British Medical Association continues to be ambivalent about the report and that the Yale Law School and School of Medicine and US Endocrine Society had rejected the Cass Report’s findings due to poor methodology and research design.
It is good to see that some New Zealand media outlets are taking due diligence and accuracy as professional practice in this context. The Christchurch Press is to be especially commended for highlighting the Destiny Church’s presence in anti-transgender activism. As for Dr Paul and her colleagues, one must at least credit them for trying to provide some statistical evidence to buttress the debate. However, as media coverage has noted, her co-authored paper has met with some criticism from her professional peers.
It also raises some questions about those jurisdictions in which puberty blocker access has been abruptly halted and the possible harmful consequences that might ensue. One hopes that if medical studies disclose that self-harm, suicidality, severe depression and other negative indicators have risen and can be verified, then advocates of puberty blocker restrictions will recognise this and abandon their campaign against the medication.
