Judge Stops Controversial Puberty Blocker Ban from Taking Effect

The High Court of New Zealand has intervened in the government's attempt to ban puberty blockers for transgender youth, declaring that the Crown must not enforce the new regulations while the legal challenge proceeds through the courts.

Justice Wilkinson-Smith granted an application for interim relief filed by the Professional Association for Transgender Health Aotearoa Incorporated (PATHA), preventing enforcement of the Medicines Restriction on Prescribing Gonadotropin-releasing Hormone Analogues Amendment Regulations that were scheduled to come into force on December 19, 2025. The regulations would have completely prohibited new prescriptions of puberty blockers for young people with gender dysphoria or gender incongruence.

Justice Wilkinson-Smith / Wikipedia

PATHA filed the application for judicial review on December 1, 2025, challenging the regulations on nine separate grounds. The judgment reveals significant concerns about how the government arrived at its decision to ban the medication. The Minister of Health presented multiple policy options to Cabinet in September 2025, with advice from the Ministry indicating that a complete ban carried a high risk of adverse health outcomes due to negative impacts on mental health. Despite this medical advice, Cabinet reached a consensus in favor of a total prohibition. The regulations were signed on November 17 and published on November 20, with the government publicly announcing the ban only on November 19.

The sudden and unannounced timing proved critical to the judge's reasoning. PATHA and the transgender community learned of the decision through social media rather than through official notification. This prevented PATHA from seeking interim relief under the normal judicial review procedures available when parties have advance notice of government actions. Justice Wilkinson-Smith found this timing problematic, as it gave the organization no opportunity to pursue standard protective measures before the regulations passed into law.

The judgment details extensive evidence regarding puberty blockers. Medical professionals explained that the medications pause the physical effects of puberty and are reversible. Young people can discontinue treatment and puberty restarts normally. The medications have been safely used for over 30 years to treat precocious puberty in children, often starting at younger ages and continuing for longer periods than use for gender-related care. Puberty blockers create time for young people to mature psychologically while delaying irreversible physical changes, reducing pressure to make permanent decisions before reaching full cognitive development.

The judge found compelling evidence about mental health impacts. Most health professional organizations in New Zealand opposed the ban, expressing concerns about increased anxiety, depression, and suicidal ideation among transgender youth facing denial of treatment. The Royal Australasian College of Physicians, Te Kāhui Korowai Rangatahi, the Royal Australian and New Zealand College of Psychiatrists, the New Zealand Nurses Organisation, the New Zealand Society of Endocrinology, and multiple other medical bodies released statements opposing the regulations.

The consultation process that preceded the ban revealed overwhelming public and professional opposition. The Ministry of Health received over 7,100 public submissions during the consultation period. The Regulatory Impact Statement provided to the Minister documented that most submissions and all affected groups supported continued access to puberty blockers where clinically appropriate. Groups consulted identified no clear rationale for restrictions and raised strong concerns about increased adverse mental health impacts and human rights implications.

The judge noted that New Zealand's ban is more restrictive than approaches taken in other countries. The United Kingdom restricted but did not completely ban access, making puberty blockers available only through clinical trials. Sweden, Norway, and Finland also imposed restrictions rather than outright bans, generally limiting access to clinical trials or requiring exploration of non-medical options first.

The court found significant weaknesses in the government's justification for a total ban. Puberty blockers are considered safe enough to prescribe to children with precocious puberty starting at even younger ages than for gender-related care. No evidence demonstrates immediate physical health risks from short-term use. The primary concern regarding bone density results from long-term use, and the judge noted that a delay of months for the judicial review would not create bone density issues.

The decision raised constitutional questions about decision-making authority. The Minister of Health holds statutory power under the Medicines Act to recommend regulations to the Governor-General. PATHA argued the Minister abdicated this responsibility by deferring entirely to Cabinet consensus rather than making an independent decision based on ministerial advice. The Regulatory Impact Statement makes clear the Minister presented options without a preferred position, then accepted Cabinet's decision which contradicted his own Ministry's advice about health risks.

Justice Wilkinson-Smith acknowledged the complexity of puberty blocker policy but found compelling reasons to preserve the status quo pending judicial review. The judge rejected PATHA's request for mandatory orders directing the Minister to advise the Governor-General to repeal or amend the regulations, finding such orders would be constitutionally inappropriate. Instead, the court issued a declaration that the Crown ought not enforce the regulations.

The judge emphasized that the decision must be revisited urgently, ordering that the judicial review hearing proceed with all possible speed. The interim declaration does not resolve the underlying legal challenges but prevents enforcement while the substantive claims of procedural impropriety, lack of consultation, and wrong decision-maker determination are heard.

The regulations would have affected approximately 100 young people per year who were newly prescribed puberty blockers, along with health professionals who would have been unable to provide what they consider best-practice medical care.