Age of uncertainty

Other countries have reviewed their use of puberty blockers for children and young people. New Zealand should too, argues Charlotte Paul.

I am writing this article because my colleagues pleaded with me to do so. My younger col-leagues, in particular, know they can’t speak out because it could potentially damage their reputations.

I’m a medical epidemiologist and my relevant background is in research on sexual and reproductive health, the safety of medicines, and the ethics of research. My colleagues approached me because they’re concerned about the rapid increase in the use of hormones to suppress normal puberty in children and young people who express discomfort with their biological sex. They’re especially concerned that the grounds for accessing these hormones have widened greatly. How do we know this is doing more good than harm?

My colleagues are seeing in their clinics young people who have changed their minds about wanting to transition away from their biological sex and who also have serious mental health problems that have been left unaddressed. They doubt whether there is sufficient psychological assessment for children with gender dysphoria before they are prescribed puberty blockers – to help distinguish those who will remain transgender from those for whom it is a phase. They also question the capacity of children to consent to the intervention. They are worried about the lack of knowledge of long-term harms and benefits.

We all know that gender issues are highly contentious. The question has become polarised, and much commentary is written from a partisan perspective. That means there is extraordinarily little balanced information available to the public. Frank and fair discussion is surely necessary if we are to protect children and adolescents.