133 Molesworth Street
PO Box 5013
9 December 2024
Wellington 6140
New Zealand
T+64 4 496 2000
Yasir Shaikh
By email: [FYI request #29139 email]
Ref:
H2024055740
Tēnā koe Yasir
Response to your request for official information
Thank you for your request under the Official Information Act 1982 (the Act) to the Ministry of
Health – Manatū Hauora (the Ministry) on 11 November 2024 for information regarding puberty
blockers.
On 15 and 18 November 2024, you were advised that the following parts of your request have
been transferred to Health New Zealand – Te Whatu Ora in accordance with section 14(b)(i) of
the Act:
The total amount of taxpayer money allocated for the procurement and distribution of
puberty blockers in New Zealand over the past five years.
A breakdown of annual expenditures on puberty blockers during this period.
Are puberty blockers administered or distributed within educational institutions, including
primary and secondary schools, as well as colleges? If so, please provide details on the
policies and protocols governing their administration in these settings.
What clinical guidelines does the Ministry of Health follow regarding the prescription and
administration of puberty blockers to minors? What oversight mechanisms are in place to
monitor the use of puberty blockers among youth?
You can expect a response from that agency in due course. Should you wish to follow up,
Health New Zealand can be contacted at:
[email address]. Turning to the
remainder of your request:
Have there been any reported adverse effects or complications associated with the use of
puberty blockers in minors over the past five years? If so, please provide a summary of
these reports and any actions taken in response.
Puberty blockers are a group of medicines that have other uses but are being used ‘off-label’ to
prevent puberty in people with gender dysphoria. Medsafe has not approved any medicines for
this use in New Zealand. The approved medicines that we are aware may be being prescribed
‘off-label’ contain the active ingredients goserelin or leuprorelin.
The approved indications and known side effects are in the data sheets, which can be found on
Medsafe’s website at the following links:
•
www.medsafe.govt.nz/profs/Datasheet/z/Zoladex10implant.pdf.
•
www.medsafe.govt.nz/profs/Datasheet/l/LucrinDepot1-month3month6monthDUALinj.pdf.
It is important to note that anyone who thinks they may have experienced an adverse reaction
to a medicine can report this to the Centre for Adverse Reactions Monitoring. A summary of
these reports can be found at:
www.medsafe.govt.nz/Projects/B1/ADRDisclaimer.asp. Please note that not all adverse reactions to medicines are reported and, when they are
reported, the indication for use of the medicine is not required to be reported. The Ministry is
unable to answer this part of your request, in accordance with section 18(g)(i) of the Act, as we
do not know why the medicine was being taken, given that these medicines are approved for
other uses.
What processes are in place to ensure that minors and their guardians provide informed
consent before initiating treatment with puberty blockers?
Under New Zealand Law, people 16 years and over are able to make treatment decisions on
their own behalf. Children under the age of 16 are able to make some treatment decisions,
based on their competence to make the particular decision with higher levels of competence
needed for more complex treatments. When a child is deemed competent, parents cannot
overturn their decision. Where they are not deemed competent and their parent or guardian
decides on their behalf, they are still involved in discussions about their treatment to the extent
they are able to.
Prescribers have obligations and duties relating to informed consent set out under the Code of
Health and Disability Services Consumers' Rights. This includes discussing with the person
evidence to support the use and any potential safety concerns including an assessment of the
expected risks, side effects, benefits, and costs. It is also expected that informed consent
discussion and outcomes are documented in the patient’s clinical record.
Since which year have puberty blockers been legally administered to the public in New
Zealand? Under which laws or regulations are healthcare providers authorized to
prescribe and administer puberty blockers?
The Medicines Act 1981 and the Medicines Regulations 1984 enable health practitioners to
prescribe medicines in New Zealand. The legislation does not differentiate between conditions
being treated. Prescribers’ prescribing practice must be consistent with their scope of practice
and their specialty (area or practice) as specified by the prescribers’ responsible authority (for
example, the Medical Council for medical prescribers and the Nursing Council for Nurse
Practitioners).
Puberty blockers are not used exclusively for gender affirming care and are typically brought to
the New Zealand market for other uses. It is therefore not possible to state when these
medicines may have been first used as puberty blockers. Goserelin was first approved in New
Zealand in 1987 and leuprorelin in 1985.
If you wish to discuss any aspect of your request with us, including this decision, please feel
free to contact the OIA Services Team on:
[email address]. Under section 28(3) of the Act,
you have the right to ask the Ombudsman to review any decisions made under this request.
The Ombudsman may be contacted by email at:
[email address] or by calling
0800 802 602.
Please note that this response, with your personal details removed, may be published on the
Manatū Hauora website at:
www.health.govt.nz/about-ministry/information-releases/responses-
official-information-act-requests.
Page 2 of 3
Nāku noa, nā
Dr Joe Bourne
Steve Barnes
Chief Medical Officer
Associate Deputy Director-General
Clinical, Community and Mental Health
Strategy, Policy and Legislation
Page 3 of 3
