Family First has written to the Director-General of Health Dr Diana Sarfati requiring the Ministry of Health to remove the reference to the PATHA Guidelines in the Position Statement on the Use of Puberty Blockers in Gender-Affirming Care issued by the Ministry on 21 November 2024.

Family First has been legally advised that such a reference may be illegal.

The Guidelines for Gender Affirming Health care for Gender Diverse and Transgender Adults in Aotearoa New Zealand written by activists from PATHA makes statements on puberty blockers which are not supported by the findings from the Ministry’s own evidence brief, as summarised in the Position Statement on the Use of Puberty Blockers in Gender-Affirming Care, nor by other probative evidence.

The consent forms in the appendices to the PATHA guidelines also state: “Blockers are a reversible medication used to stop the physical changes of puberty. It can be started in early puberty (Tanner stage 2–3). This position is reinforced by the reference in the Health NZ website to PATHA under “Resources for transgender New Zealanders and their whanau”.

Not removing the reference to the independent PATHA Guidelines is also inconsistent with the Position Statement stating that “Clinicians will continue to provide careful guidance to and follow up for people and families considering gender-affirming care.”

Family First has advised the Director General that there are four reasons why failure to remove reference to the PATHA Guidelines may be illegal:

• the findings of the Evidence Brief mean that the PATHA Guidelines include fundamental mistakes of fact. Those Guidelines confidently state that puberty blockers are safe and reversible (and effective). Yet the Position Statement found that there is no quality evidence to support any of these findings. This leads to a lack of informed consent
• the Ministry of Health is effectively advising Doctors, parents, and young people over 16 that the PATHA Guidelines are safe and factually accurate guidelines to use in the interim while the Ministry works with Health NZ to devise clinical guidelines.
• the consent form does not set out the risks of harm due to the lack of quality research about lack of harm and reversibility. The PATHA Guidelines say puberty blockers are safe and reversible as does the consent form you sign to start “treatment.” The potential breaches of sections 8-10 of the Bill Of Rights Act (BORA) must be viewed in the factual context that the Court of Appeal in the UK has found regarding puberty blockers: “the clinical interventions involve significant, long-term and, in part, potentially irreversible long-term physical, and psychological consequences for young persons.
• the reference to the PATHA Guidelines in the Ministry’s Position Statement breaches the United Nations Convention on the Rights of the Child (UNCROC). The misinformation in the PATHA Guidelines and included consent forms are not in the best interests of children under UNCROC.

Family First believes for these legal reasons alone, it is critical that the Ministry act immediately and make regulations under the Medicines Act to stop the prescribing of puberty blockers for delaying puberty in gender incongruent or gender dysphoric young people because there is insufficient quality evidence that puberty blockers are both safe and reversible and efficacious in the treatment of gender dysphoria.

The letter has also been sent to the Minister of Health Dr Shane Reti and Associate Ministers of Health Matt Doocey, Casey Costello and David Seymour.

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