Medical gender transition in New Zealand: How common is it really?
Guest Post by Laura López. Laura is the mother of two girls and holds a graduate degree in psychology. She writes about gender at Arguments With Friends on Substack. Comprehensive sources for the findings highlighted in this article can be found in Laura’s full-length report here.
Many New Zealanders now know that the UK’s gender clinic for children is being closed down (The Times) and sued for criminal negligence. A damning independent review by paediatrician Hillary Cass found that the clinic was “not a safe or viable long-term option” (PDF) for the treatment of gender questioning youth. The families harmed by the clinic say that patients were “rushed into taking life altering puberty blockers without adequate consideration or proper diagnosis”, resulting in “physical and psychological permanent scarring”.
Is the practice of gender medicine in New Zealand better or worse than the appalling situation Dr Cass discovered in the UK? Some people claim that New Zealand has taken a more conservative approach to medical gender transition than our international peers. Others dispute this, claiming that New Zealand has been particularly incautious (PDF). Our mainstream media seem reluctant to provide balanced or critical reporting on transgender issues, making it difficult for people to know exactly what is happening in our country.
Facebook comment claiming that New Zealand has taken a conservative approach to medical gender transition
I decided to explore and analyse the available evidence on medical transition in New Zealand. What I found was shocking:
- There has been a huge rise in the number of New Zealanders seeking medical transition. This rise has been largest among natal females. The chart below shows that between 1990 and 1995, only one person sought female-to-male gender transition at Wellington Endocrine Service. By 2016, 41 people were seeking female-to-male gender transition in a single year.
Number and median age of people seeking female-to-male gender transition at Wellington Endocrine Service. Adapted from Delahunt et al. (2018), New Zealand Medical Journal
- Available data suggest that New Zealand’s rates of medical transition continued to climb until at least 2018, and have now reached remarkably high levels. Roughly 42 per 100,000 people served by Capital and Coast DHB started ‘gender affirming care’ in 2018. To put this into context, 46 out of every 100,000 people served by this DHB were hospitalised for traffic injuries in the same year. There is reason to believe that rates of medical transition may have risen further since 2018, and may continue to rise in the future.
- Puberty blockers are prescribed over ten times more frequently in New Zealand than in the UK. One prominent Christchurch medical practice appears to be prescribing puberty blockers to about 13% of all its patients.
- In some regions, medical transition is available without a mental health assessment. Even where a mental health assessment is required, it seems unlikely that this screens out many patients, since New Zealand’s Guidelines for Gender Affirming Healthcare state plainly that “having… mental health concerns does not mean gender affirming care cannot be commenced”.
- Increasingly young patients are being medically transitioned. The chart above shows that between 1990 and 2016, the average age of people seeking female-to-male transition in Wellington fell from 30 to 22 years old. The researchers note that children as young as 11 years old have started presenting to Wellington Endocrine Service.
- Some doctors appear to be prescribing cross-sex hormones to patients in their early teens. New Zealand’s Guidelines for Gender Affirming Healthcare suggest this practice may be acceptable if needed to prevent patients from growing up to be the wrong height. The New Zealand medical website Family Doctor suggests that it is sometimes acceptable to prescribe cross-sex hormones to under-16s without parental consent.
- There appears to be very little proactive monitoring of the frequency, safety, or effectiveness of youth medical transition in New Zealand. Our Ministry of Health has said that it does not track statistics on gender transition or transition regret.
- Medical transition is a journey that often ends in chronic pain, or high-risk surgeries in poorly-regulated gender clinics in Thailand. Trans activists argue that these physical health costs are outweighed by supposed mental health benefits. In reality, increased medical transition has occurred in concert with a tripling in youth psychological distress. This suggests that the social influences driving increased medical transition are not entirely beneficial.
Percent of New Zealanders aged 15 to 24 reporting significant psychological distress, compared with the number of first appointments for ‘gender affirming care’ at Wellington Endocrine Service (WTN) and across Capital and Coast District Health Board as a whole (CCDHB). Based on data from multiple sources; see full report for details.
In short, the available evidence suggests that medical transition is even more poorly overseen here in New Zealand than it was until recently in the UK. One probable reason for this failure is the lack of critical media scrutiny of this area of medicine in Aotearoa.
As mentioned earlier, the UK government eventually took notice of public outcry, and organised an independent review of how their health system was managing the medical transition of children. We are in desperate need of a similar independent review in this country. I have every confidence that this will happen eventually. The scale of the damage to our children will one day be revealed to all New Zealanders.
Further information can be found in Laura’s full-length report.