A group challenging New Zealand’s puberty blocker ban has told the High Court at Wellington that the decision was never really about medication, but about the identity of the young people seeking care.
“This is self-evidently about the identity of these particular users. It’s about who this very small group of young people are,” Victoria Casey KC told the court.
“It’s about whether society will accept and affirm them as who they actually are, and allow them to access the wonders of modern medicine to help them realise their full potential.”
Casey is representing the Professional Association for Transgender Health Aotearoa (PATHA), which is seeking a judicial review of the Ministry of Health’s decision to ban new prescriptions of puberty blockers for young people with gender dysphoria or gender incongruence.
PATHA is an interdisciplinary professional organisation that promotes the health, wellbeing and rights of transgender people. It argues the ban “will cause immense harm, both directly and indirectly, to transgender children and their whānau”.
The group is seeking a declaration from the High Court that the regulations are unlawful and should be quashed.
The Government announced the regulations on 19 November 2025, restricting new prescriptions of gonadotropin-releasing hormone analogues, commonly known as puberty blockers, for people under 18 seeking treatment for gender dysphoria or gender incongruence. Existing patients can continue treatment, and puberty blockers remain available for other medical conditions, including early-onset puberty, endometriosis and prostate cancer.
“The politics of culture wars”
PATHA argues that prescribing decisions should sit with young people, their whānau and clinicians, rather than politicians.
“This is a political decision – the politics of culture wars, not a clinical decision. And it is shocking in its irresponsibility,” Casey said.
“No drug in New Zealand has ever had this level of Ministerial or political attention. No approved medicine in New Zealand has ever been subject to a ban of this kind.”
Casey told the court puberty blockers had been prescribed in New Zealand for more than 40 years without clinical problems, including over the past 15 years for gender dysphoria and gender incongruence.
She cited the Ministry of Health’s 2024 evidence review, which recommended a cautious approach, but argued that concerns around “low-quality evidence” should not be misunderstood.
Casey said low-quality evidence is common in medicine, particularly in paediatrics, and does not mean what campaigners or members of the public often assume it does.
She also said there was no evidence puberty blockers were being prescribed in New Zealand outside the recommended approach.
According to the Government’s own material, prescribing had already been declining since peaking in 2020, with fewer than an estimated 100 young people expected to start treatment in 2024.
Minister says ban is precautionary
Health Minister Simeon Brown has defended the decision as reasonable and appropriately cautious.
When announcing the restriction, Brown said the change was intended to ensure stronger safeguards so families could have confidence that any treatment was clinically sound and in the best interests of the child or young person.
The Ministry of Health said its review found a lack of high-quality evidence demonstrating the benefits or risks of puberty blockers for treating gender dysphoria or gender incongruence in young people. While that uncertainty persisted, the Government said it was taking a precautionary approach.
The Minister’s written submissions say PATHA overstates the Ministry’s position and that officials never advised there was “no basis” for regulation.
The Ministry had identified four policy options for the Minister. While officials preferred clinicians retaining prescribing discretion, the Minister argues that did not mean regulation was unavailable to him.
The Ministry has also removed from its website any suggestion that puberty blockers are “safe and reversible”.
PATHA says it was not consulted
PATHA says it was not consulted on the new regulations or draft regulations.
The Ministry says it undertook open public consultation on whether additional safety measures should apply to puberty blocker prescribing for young people with gender-related health needs.
In July 2025, the Ministry provided advice to the Minister identifying four policy options and advising that clinicians retaining prescribing discretion best met the policy objectives.
Banning new prescriptions was described as carrying a high risk of adverse health outcomes because of possible negative impacts on mental health.
However, in September, a Cabinet committee agreed to regulate to prohibit puberty blocker prescribing for new patients with gender incongruence or gender dysphoria, while making youth gender services more available.
In November, the Minister signed the regulations approving the ban, which was due to come into effect the following month.
Since then, the High Court has ordered the Ministry not to enforce the regulations while the judicial review is underway. PATHA confirmed in December that the High Court had granted interim relief, pausing enforcement of the ban pending the legal challenge.
NZ First comments raised in court
Casey also referred to the way NZ First announced the ban before Brown’s official media statement.
She read from a press release by Associate Health Minister Casey Costello, who was part of the Cabinet committee that made the decision.
“Today sanity won another battle on the war on woke,” the statement began.
“After years of dangerous ideological experimentation pushed by radical activists and rubber-stamped by weak politicians, the New Zealand government had officially banned puberty blockers for children.
“It’s a monumental victory for common sense and for every parent who’s been told to sit down, shut up, and let the so-called “experts” chemically sterilise their kids because they were “born in the wrong body”.
“No one is born in the wrong body.”
Casey also referred to a social media post by NZ First leader Winston Peters, who said the party had campaigned against puberty blockers and “never stopped fighting to make this happen”.
Casey told the court this amounted to NZ First claiming credit for the decision in unambiguous terms.
“These are not some random social media posts; these are posts from cabinet ministers who were at the cabinet committee that made the decision,” she said.
The Minister rejects the claim that he was driven by an improper purpose.
His submissions acknowledge that public discourse on the issue may be political and may include comments from political colleagues, but say he put those comments aside when exercising his statutory responsibilities.
Court hearing continues
The hearing is before Justice Dale La Hood and is set down for three days.
The case is being closely watched by rainbow communities, clinicians, human rights advocates and families of transgender young people.
For PATHA, the issue is medical autonomy, clinical judgement and the wellbeing of a small group of vulnerable young people.
For the Government, the issue is caution, uncertainty and safeguarding.
For trans young people and their whānau, the outcome could determine whether decisions about puberty blockers are made in a clinic with medical specialists, or blocked by regulation before that conversation can begin.
