The judge who knew too little
and was swayed by PATHA.
When the NZ government announced a ban on new prescriptions of puberty blockers for the treatment of gender dysphoria in minors, PATHA (Professional Association of Transgender Health Aotearoa) immediately launched a campaign to overturn the regulations. It sought an injunction to declare the regulations unlawful and to quash them and, in a two-hour hearing in the High Court, mustered the usual trans activist arguments to support its case.
The judge heard the same old discredited claims of puberty blockers being reversible, giving children time to think, improving their mental health, and being agreed best practice for ‘gender affirming care’ amongst experts.
What the judge didn’t hear
On the other hand, counsel for the Ministry of Health restricted their submission mainly to the process that was followed to reach the decision and the normal management of medicines used off-label. Almost none of the material in support of the government’s regulation was placed before the judge and she was not informed that the ‘expert’ evidence supplied by PATHA is nothing of the sort.
PATHA & WPATH – the activist organisations that sacrifice children’s health
PATHA and WPATH (World Professional Association of Transgender Health) are self-selected groups of activists and gender clinicians who support the belief that extreme body modification to ‘pass’ as the opposite sex is a human right, even for very young children.
PATHA has blown its child-protection credibility out of the water with its latest “Guidelines for Gender Affirming Healthcare” in which there are eight pages (73-81) of information on how to administer cross-sex hormones to those under 18, with no lower age limit. At the same time as acknowledging that cross sex hormones cause irreversible changes, including sterility, PATHA advocates for their early use, blithely sacrificing the health of children to validate their adult ideology.
Edit - replaced “from as young as Tanner Stage 2 - eight or nine years old” with “no lower age limit”. The PATHA guidelines assume that a child will first be prescribed puberty blockers but because there is no recommended age or Tanner stage to be reached before the initiation of cross sex hormones, the guidelines normalise their early use.
WPATH has similarly destroyed its credibility with its Standards of Care 8 (SOC8), published in 2022, which contains a whole chapter on ‘eunuch identities’ and supports castration as a valid “embodiment goal”. SOC8 also removed all lower age limits for ‘gender affirming’ treatment, emboldening PATHA to write guidelines for prescribing cross sex hormones to young children, something that was not included in its previous guidance (2018 & 2023). 1
No credence should be given to organisations that care so little for children that they will sacrifice their right to grow into healthy and whole adults on the altar of gender ideology.
Circular citation and suppression
In the High Court, PATHA listed several NZ medical organisations that had made statements opposing the government’s ban. However, the judge was not made aware that the statements are not based on membership surveys and do not reflect the wide range of opinion among medical professionals on this issue.
Both the Cass Review (2024) and the US Health and Human Services (HHS) Report (2025) concluded that an appearance of medical consensus has been manufactured through circular citations and committee capture.
“U.S. medical associations played a key role in creating a perception that there is professional consensus in support of pediatric medical transition. This apparent consensus, however, is driven primarily by a small number of specialized committees, influenced by WPATH. It is not clear that the official views of these associations are shared by the wider medical community, or even by most of their members. There is evidence that some medical and mental health associations have suppressed dissent and stifled debate about this issue among their members.” (HHS)
“The World Professional Association of Transgender Healthcare (WPATH) has been highly influential in directing international practice, although its guidelines were found by the University of York appraisal process to lack developmental rigour… [G]uidelines are also closely interlinked, with WPATH adopting Endocrine Society recommendations, and acting as a co-sponsor and providing input to drafts of the Endocrine Society guideline… The circularity of this approach may explain why there has been an apparent consensus on key areas of practice despite the evidence being poor.” (Cass)
The lack of medical consensus is acknowledged by the Royal Australasian College of Physicians which said in a letter to a member who supports the ban, “… this is a complex and sensitive area of medical practice, with considerable nuance and a range of differing views, including within the RACP membership.”
In NZ, there is documented evidence that psychotherapy associations NZAC and APANZ have suppressed debate to adopt affirmative-only policies and declare exploratory counselling to be an illegal conversion practice.2
Therapists who raise concerns about ‘gender-affirming’ practices have been subjected to bullying and intimidation with one example being the media vilification of both organisers and speakers at the Child and Adolescent Therapists’ conference held in Nelson in 2022. The mere idea that psychotherapists might want to talk about this significant new phenomenon was enough to create a backlash that caused a keynote speaker to withdraw and, following threats to burn down the venue, the conference had to be moved to a secret location.
Downplaying the dangers
Puberty blockers are approved by Medsafe for the treatment of precocious puberty, but not for gender dysphoria. PATHA claims that using drugs off label for children is nothing of concern but the best source of information is surely what the manufacturers themselves say about the appropriate use of these drugs3:
Lupron – “The safety of long-term use in children has not been established. Not recommended for use outside the approved indication of central precocious puberty.”
Zoladex – “Zoladex is not recommended for use in children. Safety and effectiveness in children have not been established.”
Decapeptyl/Diphereline – “Long-term safety data in paediatric populations are limited. Use in children should be restricted to the treatment of central precocious puberty. Effects on future fertility are unknown.”
PATHA uses slippery language to make its demands seem moderate. In the High Court, puberty blockers were renamed as reversible puberty suppression to obscure the effects of the drugs and pre-pubertal children were referred to as young people.
The whole reason that the government imposed the regulations is because most children put on these drugs to treat gender dysphoria never have the opportunity to test their reversibility – more than 95% move on to opposite sex hormones and their normal sexual and reproductive development never takes place.
Puberty blockers are the first step in irreversible treatments. Even in the rare cases where they are discontinued and development of secondary sex characteristics according to their natal sex does resume, it is unknown what detrimental effect on cognitive maturation has already occurred.
“Earlier, this Report set out the very complex events that take place in the adolescent brain during puberty. Neuroscientists believe that these changes are driven by a combination of chronological age and sex hormones. Blocking the release of these sex hormones could have a range of unintended and as yet unidentified consequences. (Cass p178) (Emphasis added)
There is a lot more to puberty than just gaining secondary sex characteristics. Children on puberty blockers are also potentially forgoing brain development, sexual maturity, and future fertility. It is unconscionable for any adult to advocate for children to be given free access to such powerful drugs. They can’t possibly understand what they’re giving up.
Moving the goalposts
Originally, gender-affirming activists insisted that puberty blockers were essential, life-saving care because without them gender-distressed children were likely to commit suicide. Now that the evidence is crystal clear that there is no increased incidence of suicide in the absence of puberty blockers, the reason activists give for prescribing them has changed.
Instead of “necessary for mental health” we are now told that puberty blockers provide children with the opportunity to achieve the bodily changes they desire.
Puberty is presented as a pick’n’mix optional experience with blockers facilitating individual choice about “embodiment goals”.
Rather than providing treatment based on clinical evidence, PATHA advocates for life-altering drugs to be given to children simply on the basis of their subjective and changeable feelings and beliefs.
The ruling that went awry
On 17 December, Justice Wilkinson-Smith granted ‘interim relief’ from the government’s ban on new puberty blocker prescriptions, asking the Crown to take no steps to enforce the ban until the outcome of a judicial review sometime in 2026.
The judgment did NOT overturn the ban – it is still a gazetted regulation as the Court has no jurisdiction to reverse government decisions. All the Court can determine is whether the process for making the regulation was correctly followed and the judge has ordered that a Judicial Review should consider that question.
Justice Wilkinson-Smith gave three reasons for granting the injunction (Paragraph numbers in brackets are from the High Court Judgment):
Lack of consultation. “There was consultation about the potential for restrictions to be placed on the prescribing of puberty blockers by the passing of regulations. It does not appear from the evidence that there was consultation about a complete ban on new prescriptions for gender-based care. Whether the extent and nature of the consultation was sufficient, I cannot decide, but I agree that PATHA’s position is arguable.” [175]
The wrong person made the decision. “The Minister did not take a preferred position to Cabinet. Rather, he chaired a meeting at which strong views were expressed and appears to have accepted the views of Cabinet. The views of Cabinet do not reflect the medical advice set out in the RIS. Whether that suffices as an exercise of the Minister’s statutory power will need to be decided, but the factual picture is now quite clear, and it supports PATHA’s position that this was a political decision and contrary to advice from the Ministry which also feeds into the third cause of action.” [176]
Negative consequences are inevitable. “The total ban appears to make negative consequences inevitable for some transgender youth and there is an argument that it is discriminatory. That is because there is no doubt that puberty blockers are regarded as sufficiently safe to treat precocious puberty, and children begin puberty blockers earlier and remain on them for longer when used for that purpose.” [178]
PATHA’s flimsy complaints suggest that it is improper for a government to regulate to restrict a dangerous practice that is harming our children.
Lack of consultation
The public consultation form explained that the further measures being considered included the option to make regulations that could legally restrict prescribing of puberty blockers.
Comments on social media confirm that gender activists were not ‘blindsided’ as was claimed in the High Court, but were “putting together legal arguments ever since the public consultation was announced in November 2024” and that they had “prepared for this outcome.”
Not only did PATHA have an individual meeting with officials from the Ministry of Health in which they discussed a possible regulatory ban, but on 20 January 2025, the organisation made a written submission to the consultation, stating:
…that restricting access to puberty blockers through regulations would lead to consequences which are lifelong, irreversible and significantly harmful to transgender young people. PATHA said this applies whether that restriction is in the form of restricting who can prescribe them, who is eligible for them, or imposing restrictions through other means. [125]
PATHA is clutching at straws by now saying they didn’t understand the MOH was considering a ban on new prescriptions.
The wrong person made the decision
Under s105 of the Medicines Act the Minister of Health is ultimately responsible for making recommendations on regulations to the Governor-General. PATHA’s rather bizarre claim is that he must do that alone, without consulting Cabinet colleagues.
PATHA says that the material now provided, including the RIS, makes it clear beyond any doubt that the Minister was not the decision-maker in respect of the regulations. Rather, the Minister abdicated his decision-making power to Cabinet. That resulted in a purely political decision which is unlawful because the statutory power rests with the Minister and he is expected to exercise it. [163]
It was the Ministry of Health itself that advised the Minister to take four options for puberty blocker regulation to Cabinet for a final decision:
Option A: Current baseline of close monitoring and adjustment (status quo).
Option B: Baseline plus pre-planned trigger points for further action if required.
Option C: Combined option that establishes regulations to prohibit new prescribing while establishing alternative gender services.
Option D: New specific legislation.
In late 2024, the MOH’s evidence brief found “a scarcity of quality evidence on the impacts of puberty blockers in terms of clinical and mental health and wellbeing outcomes, both positive and negative.” [100] The Ministry thought that this cautionary brief would be enough to rein in NZ’s high rate of puberty blocker prescribing and was in favour of keeping the status quo - Option A.
However, after ruling out Option D because of the time it would take, Cabinet ulitmately chose Option C – a ban on new prescriptions for puberty blockers to treat gender dysphoria in minors.
According to Winston Peters (Minister of Foreign Affairs and a former lawyer), the decision was made to protect children but also to protect authorities from potential future legal claims as has happened, to date, in 28 cases in the US. 4
In a Newsroom interview, when asked what he hoped to achieve from the ban, Peters replied:
“That young people are not abused before they’ve had a chance to make up their mind at a mature age, and avoiding being sued in the future by those same young children when they say to us: ‘you had a duty of care to us and you didn’t exercise it, you didn’t fulfil your obligations, and now we’re suing you’.”
That a ban on new prescriptions was not the preferred option of the Ministry of Health does not negate the decision – the legal responsibility lies with the Minister, who made the decision based on international evidence and the government’s duty of care to our children.
Negative consequences
Here, Justice Wilkinson-Smith mistakes opinion for evidence.
In Court, Dr A anticipated an increase in distress, including self-harm, amongst those no longer able to access puberty blockers. [81]
Justice Wilkinson-Smith accepted that claim as fact, although there is no reliable data to support it. It is a poor argument, anyway, for retaining a practice that we know from five systematic reviews 5 does not provide the positive outcomes it claims. Threats of self-harm or self-medication are never justifications for continuing to do something we know is not supported by evidence. That would be caving into emotional blackmail. The answer is not to give children what they think they desire but to support them to accept and welcome their future in the healthy bodies they were born with.
In children with precocious or early-onset puberty, puberty blockers are used at an earlier age (typically under 10 years of age) than for puberty suppression in young people with gender dysphoria (typically 11 years or older). In both cases, treatment may continue for 2–3 years, although this may be considerably longer in the case of precocious puberty. [133]
It is a mystery where Justice Wilkinson-Smith found this information, which is the wrong way around. Children using puberty blockers to delay puberty until the same age as their peers are likely to be on them for 2-3 years (ages 7 to 10, for example). Those using them to bypass puberty altogether will need to be on them even after they start cross sex hormones, to ensure the full suppression of their natural hormones. This may be for 6-8 years or longer (perhaps ages 10 to 18). The longer normal hormone production is blocked, the higher is the risk of harm. There is also evidence that both very early and very late natural puberty are associated with adverse effects. 6
Are the regulations lawful?
The regulations are already in place. Justice Wilkinson-Smith’s ruling that doctors can ignore them and the Crown should not enforce them, pending the Judicial Review, is outrageous coming from a judge – it is like telling the police to ignore any speeding motorist while an investigation into changing the speed limit is undertaken.
The emotive evidence provided by PATHA is a red herring. It does not matter whether some children or clinicians will be aggrieved that they can no longer access puberty blockers – the Minister has exercised his right and his duty to protect children from medical harm.
As a judicial review does not look into the correctness of a government decision, only whether the process was correctly followed, it is puzzling why Justice Wilkinson-Smith spends half of her judgment repeating the views of PATHA, when they are irrelevant to a procedural review. Does that mean most of PATHA’s evidence was redundant?
Not from PATHA’s point of view. They were laying the groundwork for the Judicial Review which is likely to be presided over by the same judge. Having been swayed by PATHA’s injunction evidence, Justice Wilkinson-Smith is already inclined to believe:
that PATHA is a reputable organisation, “well placed to advocate for both health practitioners practising in this area and transgender young people”
that “puberty blockers are reversible”
that “allowing the regulatons to come into effect will cause direct and serious harm” and
that “preserving the status quo will not cause any harm”.
The Crown will start the Judicial Review on the back foot, having to counter those impressions as well as defend the process undertaken by the Minister in reaching the regulations decision.
Justice Wilkinson-Smith is correct in her assessment of what is at stake in the Judicial Review:
The broad public interest issue is whether the ability to prescribe puberty blockers for gender affirming care should be removed from doctors. The specific issue for judicial review will be whether that ability was lawfully removed in this case by way of secondary legislation. [172]
Counsel for the Crown needs to do a much better job at the Judicial Review in putting the whole picture of “gender-affirming care” in front of the judge. She needs to hear the up-to-date evidence about clinical overshadowing, irreversible changes to life trajectory and the reliance on ‘informed consent’ - an impossibility in minors. In addition, she must be informed of the unethical behaviour of WPATH in suppressing research that did not support its mental health benefit claims 7 and PATHA’s alarming advocacy for the use of cross sex hormones in very young children.
The puberty blocker ban is an ethical restriction on medications that target and disrupt children’s developing bodies and minds. All children should be given the same opportunity to grow up unhindered by drugs that are not proven to be safe or beneficial.
Puberty is a human right.
By Fern Hickson
Footnotes
In its previous guidelines PATHA stated: "In New Zealand young people aged 16 years and older are considered to be able to consent to medical care (Care of Children Act 2004), however it is increasingly recognised that there may be compelling reasons to initiate hormones prior to the age of 16 years for some individuals, although
there is as yet little published evidence to support this." (p31)NZAC = NZ Association of Counsellors. APANZ = Association of Psychotherapists Aotearoa NZ. See https://www.fsu.nz/blog/alarming-policy-from-association-of-psychotherapists-aotearoa-new-zealand-on-sexual-orientation-and-gender-identity, https://www.fsu.nz/blog/why-is-an-experienced-counsellor-under-fire and https://theplatform.kiwi/podcasts/episode/ann-elborn-on-the-witch-hunt-against-critics-of-trans-ideology
Research by Catherine Karena, Active Watchful Waiting Australia. https://37cb5b24-1f23-47e7-9fb4-da93b8e03532.usrfiles.com/ugd/37cb5b_39106adac1164e5f8012b388c58139dd.pdf
Benjamin Ryan on X, 2 Jan 2026.
Benjamin Ryan@benryanwriter@avidseries There are about 28 known detransitioner civil suits. The first to go to trial will start next week in New York State; I will be covering that trial. The second to go to trial will start in a couple of weeks, in Portland, Ore. Here is a spreadsheet I made of all the trials.
7:55 PM · Jan 1, 2026 · 142K Views72 Replies · 566 Reposts · 1.9K LikesFive systematic reviews of the safety and efficacy of puberty blockers have been carried out in the UK (Cass), the US (HHS), Sweden, Norway, and Finland. All have reached the same conclusion - there is no reliable evidence of the long term benefits of puberty blockers. All have regulated puberty blocker prescriptions in some way.
Suppression of research by WPATH. https://can-sg.org/2024/06/28/scandalous-suppression-of-research-on-transgender-health/
Justice Wilkinson-Smith’s explanation of the limits of the Court’s powers: The orders sought by PATHA would represent an extraordinary step and would likely be ineffective. The Minister has no power to direct the Governor-General. The Court, in granting injunctive relief against the Crown in ordinary circumstances, is limited to making a declaration that the Minister should not do something. I need not decide if an order of the type sought by PATHA would ever be available. I do not think that the circumstances here are so exceptional that I can or should make an order directing the Minister to advise the Governor-General to amend or repeal the regulations. Such an order would potentially pit the Court against the Executive Council, and I do not think it is constitutional. [183]
Interesting to read the precautionary statements by the drug suppliers themselves.
What an (insert expletive here) situation. I don't know about PATHA, but certainly for WPATH, the word "professional" does not mean what we usually believe it to mean, because becoming a member is as easy as signing up and giving them your credit card number. Try joining the professional societies for other careers and see how far you get, unless you can prove you have the requisite qualifications. The only qualification needed to be a member of WPATH is to have a belief system that overrides any critical thinking skills you might once have possessed.
As you correctly point out, it is necessary to go through puberty to be a healthy and whole adult; to do anything else actually removes the choice to be normal from children: https://lucyleader.substack.com/p/removing-the-possibility-of-normal
Queer theory, which is foundational to all of this crap, totally eschews anything "normal" as a site of oppression and privilege that needs to be destroyed, which of course goes down well with teens in particular, because this is the stage of human development where being contrary and rebellious is a tool to ultimate maturity. That's exactly why we have laws to prevent those with immature frontal lobes from making decisions that they haven't the capacity to safely make for themselves. If this weren't the case, why bother to have any age restrictions on alcohol consumption or driving?
The dangers of puberty blockers are long and complex, and as you say puberty is so much more than just the development of visible secondary sex characteristics. Most troubling to me is what doesn't happen to the adolescent brain that is stopped in its tracks: https://lucyleader.substack.com/p/time-critical-brain-development
One last comment: the actual research (as opposed to the unhinged cries of the cult members), demonstrates that the highest risk time for committing suicide for those who have been supported to have "gender affirming care" is about seven years after the very last procedure/treatment/surgery that one can have in the futile quest to change sex. This is how long it takes for hope to finally die and for the realization that nothing will ever work to make that sex change "feel real".