PATHA is seeking a judicial review of what it calls the "illegal and unethical decision". File photo. Photo: RNZ // Angus Dreaver
The ban on new prescriptions of puberty blockers to treat gender dysphoria in young people - which was due to come into effect this week - has been delayed, pending a judicial review.
In a decision just released, the High Court in Wellington has ruled in favour of the Professional Association for Transgender Healthcare Aotearoa (PATHA), which filed an application for an urgent injunction to prevent the ban coming into effect on 19 December.
The government announced last month it was banning new prescriptions of the drugs (gonadotropin-releasing hormone analogues), which are used to halt the unwanted physical changes that come with puberty, until the outcome of a major clinical trial in Britain, expected in 2031.
PATHA is seeking a judicial review of what it calls the "illegal and unethical decision", saying the use of puberty blockers should remain a decision made by doctors in consultation with affected families.
President Jennifer Shields told the court the organisation was not consulted or even given prior warning of the Cabinet decision.
"PATHA was only made aware that there had been a decision made about puberty blockers from an X post on the morning of 19 November 2025."
A community researcher on transgender health, Julia de Bres, said parents were deeply shocked by the government announcement and there was "widespread panic and distress".
In an affidavit for PATHA, a doctor said restricting access to this medication was likely to pose ethical challenges to health professionals who could no longer deliver what was "accepted to be best-practice care".
Judicial review should happen 'urgently' - judge
Justice Michele Wilkinson-Smith said it was not possible to make an order directing the Health Minister to ask the Governor General to amend or appeal the regulations, as PATHA had sought.
"Such an order would potentially pit the Court against the Executive Council and that is constitutionally inappropriate," she wrote.
"However, in this judgement I make a declaration that the Crown should take no steps to enforce the regulations pending the judicial review being determined."
There was a reasonable argument that the regulations were "unlawful in a judicial review sense".
"There is also no evidence of a particular need to act urgently to prevent new prescriptions because of some immediate risk to physical health if young people commence treatment."
The potential for a negative effect on mental health from banning them was "a far more immediate concern", she said.
Furthermore, the timing of the regulations, coupled with the lack of notice that a ban was contemplated "had the effect of taking PATHA and the whole transgender community by surprise".
"Standing back and looking at the overall justice of the situation, I am persuaded that a delay in enforcement of the regulations is the best option now available.
"The judicial review should be heard with all possible urgency."
Cautious approach required - Health Minister
Health Minister Simeon Brown declined to comment in detail while the matter remained before the courts, but said the government was seeking legal advice.
In his affidavit, Brown said he recommended to Cabinet that it agree to progress policy options to "respond to the issue of poor evidence either for or against any long-term benefits or risks from puberty blocker treatment".
While puberty blockers had been approved for many years to temporarily delay precocious puberty in very young children, their "off label" use to treat gender dysphoria increased markedly between 2010 and 2020, followed by a fall-off towards 2024, he noted.
The Health Ministry's evidence review in 2022 found "a scarcity of quality evidence" on the impacts of puberty blockers in terms of clinical and mental health and well-being outcomes.
"The evidence reviewed was found to be of low quality with studies presenting a high risk of bias and significant limitations."
Brown said the lack of evidence meant there was a risk of unintended consequences for gender dysphoric children and adolescents.
"After balancing the risk of restricting the medicine against the uncertainty and risk of potential harm for those patients, the Minister says he was satisfied that a cautious approach was required."
Consultation with PATHA and other groups and individuals on whether restrictions were necessary was carried out by the Health Ministry between November 2024 and January 2025.
A 'sensible' decision - Labour
Labour leader Chris Hipkins said the court's decision was "sensible," and called the original decision by the government "politically motivated."
Hipkins said Labour's position was that it was a matter for the young person concerned, their family, and their physician.
"I don't to buy into the identity politics argument, or culture war, frankly, that the current government are trying to provoke with these sorts of decisions. Because I actually don't think that's a good place for our very diverse rainbow community to find themselves."
Green Party co-leader Marama Davidson said the courts had come down on the side of people having access to gender-affirming healthcare.
"Well done to the communities, organisations out there who showed up for each other. Wish this government would listen," she said.
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