Dr Diana Sarfati: Director-General of Health on the Ministry of Health brief examining the benefits and risks of puberty blockers

The Director-General of Health says she expects puberty blocker prescriptions to continue to fall. 

The Ministry of Health has released an evidence brief showing a lack of quality evidence backing their effectiveness and safety for gender dysphoria.

It says they should be prescribed by a clinician experienced in gender-affirming care, in a team offering wide support.

Dr Diana Sarfati says use was already declining. 

"The peak prescription for puberty blockers was around 2021- and in the last couple of years, we're already starting to see a drop-off."

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Episode Transcript

Speaker 1 (00:00):
Good afternoon. The Ministry of Health has finally released its
research on puberty blockers for kids. The review reckons there
is a lack of evidence to show that these things
are effective or safe for young people. Diana Sophati is
the Director General of Health. Hey Diana, Hi, Heather, So
have you guys basically come to the same conclusion as
the Cash report in the UK that found there's not
enough evidence that these things are safe or clinically effective

(00:21):
for kids.

Speaker 2 (00:23):
We've come to a very similar conclusion that the evidence
around puberty blockers is very poor, both on their potential
benefits and their potential risks.

Speaker 1 (00:33):
So if we've come to the same conclusion, do you
expect the outcome to be the same, which is that
in the UK the government then moved to basically ban
the routine use. Is that basically what's going to happen here.

Speaker 2 (00:45):
Look, all countries that have looked at this issue have
come to the same conclusion that the evidence is very poor,
and then the response to that has been quite different.
So in the UK and in some Scandinavian countries they've
moved to more or less ban the use of puberty blockers,
But in other countries like Australia and most of Canada,
they have the guidance and standards, but puberty blockers are

(01:08):
still available. So the way that countries are responding to
that varies.

Speaker 1 (01:12):
Right, So which way are we going to go?

Speaker 2 (01:15):
At the moment? What we've done is we have released
a position statement and what that does it ensures that
those medicines are used with appropriate caution, so only by
experienced clinicians and in the context of good wrap around
care for young people in their families. And then at
the same time, the government has asked us to go
out and consult on whether or not further restrictions would

(01:39):
be white in the New Zealand contract.

Speaker 1 (01:41):
All right, So these clinicians with experience and gender affirming care,
how many of them have we got in the country.

Speaker 2 (01:48):
I don't have a number specifically on that because they
come from various backgrounds. So they can be pediatricians for example,
they can be general practitioners with special interest in this area.
They can be psychologists or psychiatrist.

Speaker 1 (02:02):
How do they self nominate and say, yep, I feel
like I can do it. I've got some gender affirming
care experience, I'll do it.

Speaker 2 (02:09):
Yeah. They have to be able to demonstrate that they
have experience and gender affirming care, and we do have
some a number of clinics with a lot of experience
in this area. So what the standards do is they
set that expectation on commissions, which is is what we
normally do in relation to clinical standards, so that we
can then hold them into account if they.

Speaker 1 (02:32):
Do not say that, do they just go I think,
come up to it. I'm going to do it, or
do they have to come to you and say I
think I'm up to it and you go, yes, you're
allowed to do it.

Speaker 2 (02:40):
It's like other areas of medicine. There's no specific, you know,
process to determine that. But what it does mean is
that they can be held to account by, for example,
the Medical Council, and if they are unable to demonstrate
that they do have a whole level of experience to

(03:00):
gender affirming care, that would be problematic for them.

Speaker 1 (03:03):
Okay, so do you expect the number of puberty blockers
prescribed to drop off from now?

Speaker 2 (03:10):
Yeah, you know, we're already seeing it happening. So actually,
the peak prescription for puby blockers were at was actually
around about sort of twenty twenty one, around about then
in the last couple of years we're already starting to
see a drop off and the rate of prescribing, so
I would expect that that trend is likely to continue,
although of course we'll have to wait and see.

Speaker 1 (03:30):
Hey, thank you very much, Diana, appreciate it. Diana Safacei,
who's the Director General of Health. For more from Heather
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