A big bit of the rhetoric used to push the regulations of puberty blockers is the medical angle. “There just isn’t enough long-term research about the benefits and risks involved with supplying these drugs to young people with gender dysphoria” is the angle that this government went with. Is this really valid? I reached out to Dr. Steven Lillis to get a second opinion.
1. Is the government right in calling for more long-term research?
It is reasonable for the government to call for more research. Evidence in gender-affirming care, like many areas of youth mental health and developmental medicine, continues to evolve. Ongoing high-quality research should always be encouraged. However, uncertainty alone is not sufficient grounds to restrict access to established clinical interventions, particularly where withholding care carries foreseeable harms. Puberty blockers have an established safety profile from decades of use in paediatric endocrinology under specialist supervision. In gender-affirming care, they are prescribed cautiously, following comprehensive assessment and multidisciplinary input.
Equity must also be considered. Māori and Pacific rangatahi already experience disproportionate mental health burdens and barriers to specialist care. If calls for “more research” function in practice as barriers to care, inequities may widen. Research should strengthen services and governance, not suspend access without clear evidence of unique or serious harm.
2. How helpful are puberty blockers, and what would losing access to them mean for Trans youth?
Puberty blockers temporarily suppress further pubertal development, allowing time for careful assessment and ongoing discussion. They are not irreversible and are not a commitment to future medical transition. For some young people with significant gender dysphoria, unwanted pubertal changes can intensify distress. In those cases, delaying puberty can reduce acute psychological harm and allow supported, developmentally appropriate decision-making.
If access were removed, the impact would not be theoretical. Transgender and gender-diverse youth already experience higher rates of acute psychological issues. Removing one component of clinically supervised care may heighten those risks. The impact would also be uneven. Families with resources may seek expensive alternatives, while those without means would have fewer options. In a publicly funded system committed to equity, withholding care is not a neutral act. It alters the balance of risk.
3. Who should get the final say?
The government has a legitimate role in funding services, regulating medicines, commissioning research, and ensuring safety. Individual clinical decisions belong with young people, their whānau, and qualified clinicians, guided by professional standards and evidence-informed practice. The balance should be clear: the government ensures systems are safe, equitable, and evidence-informed; clinicians, young people, and whānau make individual decisions within those systems. That balance matters most when evidence is still evolving. Imperfect long-term data does not automatically justify prohibition. It calls for specialist oversight, informed consent, transparent discussion of risks, and ongoing research.
The responsible response is not to ban care outright, but to regulate it carefully while continuing to strengthen the evidence base. Unless there is clear proof of serious harm, uncertainty should lead to stronger governance, not substitution of clinical judgement. Protecting that principle preserves the integrity of managing uncertainty across the health system as a whole.
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All of this is pretty in line with the High Court’s decision that the restriction shouldn’t be enforced. Thankfully, it seems like we have a legal system that can pump the breaks.
Unless we can also take feet off the accelerator, though, all we get are donuts – our democracy going round in circles – maybe this is better than flooring it to the worst endpoint, but it’s also not getting us anywhere.
We have to seize the wheel, and we try to vote for capable hands that can do that on our behalf every three years. One of these possible drivers are the Greens, so Aoife had a chat with Danielle Marks to see where politics and queerness intersect.
