A very helpful summary of the current situation - thank you.
With Cass and now the HHS review NZ is now becoming an outlier in terms of "gender-affirming care". A big problem is the complete ideological capture of professional organisations, and the witch-hunts launched against any practitioners who dare speak out. I hope this ideological capture does not include Crown Law, whose job it will be to represent the Minister at the judicial review.
I'm astonished at the blasé attitude of PATHA to the threat to fertility from "gender-affirming care". Normally a medical treatment for children that caused infertility would be for an indication where the benefit from the treatment was overwhelming. The problem is that the focus on puberty blockers in isolation neglects the fact that this is the start of a pathway that almost always results in cross-sex hormones and hence infertility. I simply do not believe an 11-year old is able to make an informed decision on this.
There are several demonstrable factual errors and omissions in this post that undermine the argument:
1. False claim regarding hormones at Age 8 The article states: "PATHA advocates for their early use [cross-sex hormones]... from as young as Tanner Stage 2 – eight or nine years old." This is factually incorrect. Tanner Stage 2 is the clinical indication for puberty blockers (to pause puberty), not cross-sex hormones. No guideline in New Zealand or the world advocates for oestrogen or testosterone at age 8 or onset of puberty. This conflates two completely different stages of treatment.
2. Incorrect correction of the Judge regarding duration The article claims Justice Wilkinson-Smith was "the wrong way around" in stating that puberty blocker treatment can be longer for precocious puberty than for gender dysphoria. The Judge is correct. Treatment for central precocious puberty can begin in early childhood (e.g. age 4 to 6) and continue until age 11, a duration of 5 to 7 years. For gender dysphoria, blockers typically start later (age 11 to 12). Even if blockers are continued alongside cross-sex hormones until age 16, the Judge is factually correct that precocious puberty cases can involve "considerably longer" durations of suppression starting at a much younger age.
3. Legal error regarding Judicial Review The article states: "The judgment did NOT overturn the ban... as the Court has no jurisdiction to reverse government decisions." This is legally false. The High Court has the explicit power under the Judicial Review Procedure Act to declare regulations ultra vires (unlawful) and quash them. If a Minister acts outside their powers or follows an improper process, the Court absolutely has the jurisdiction to void that decision.
4. Contradiction on drug safety The article argues these drugs are unsafe for children, yet admits in the same paragraph they are approved by Medsafe for children with precocious puberty. The chemical safety profile of a drug (e.g. bone density, toxicity) does not change based on the child's diagnosis. If it is considered safe enough for a 9-year-old with precocious puberty, the "poison" rhetoric regarding an 11-year-old is scientifically inconsistent.
5. Misrepresentation of "exploratory" therapy and the Law The article claims regulators have declared "exploratory counselling to be an illegal conversion practice." This is false. Genuine exploratory psychotherapy remains legal. What is restricted is the specific Genspect model branded as "Gender Exploratory Therapy." This is a rebranding of Zucker and Bradley’s 1980s "reparative therapy", a model of endless non-affirming exploration on the therapists terms designed to delay transition. This fits the definition of a conversion practice under s5(a) of the Conversion Practices Prohibition Legislation Act (suppression of gender identity).
Professional bodies are not punishing therapists for exploring; they are upholding the law against suppressing. All four major mental health bodies in New Zealand (NZAC, NZPsS, NZAP, and RANZCP) consider the invalidation of trans gender identity and the pursuit of conversion practices to be unethical.
Ann Elborn (Footnote 2): The article cites her as a victim of a "witch hunt". In reality, she chose to resign from NZAC after ethics complaints were lodged regarding her promotion of prejudiced material.
Nelson Conference: Similarly, a key organiser faced an upheld complaint from the Psychotherapists Board (PBANZ). The Board sanctioned the practitioner for platforming hundreds of transphobic articles on the CATA website, ruling that this conduct harmed trans youth indirectly through the propagation of prejudice.
These practitioners are not being "bullied"; they are facing the consequences of operating outside both the law and the ethical standards of their profession.
Try reading my comments again. You have misinterpreted me in several places:
The regulations will be in place until the JR rules them invalid - I agree.
Precocious puberty suppression would normally end at 9ish for girls and 11ish for boys - the age at which puberty normally starts, nothing to do with initiating an early puberty.
Informed consent is a nonsense when fertility preservative is impossible - agreed - yet the guidelines still have no lower age or Tanner stage limits. I accept that puberty suppression is supposed to precede cross sex hormones in young patients and have clarified that in the post.
“Massive cognitive changes” refers to the normal brain development in puberty, not any (as yet unproven) changes caused by PBs. I am advocating for children to be left to go through a natural puberty.
I do not agree that the professional standards have been reached through open and rigorous debate. That is the whole point of my remarks about “Circular citations and silencing”.
We fundamentally do not agree and there is no point in going over the same points repeatedly, so this will be my final response unless you have something fresh to say.
1. PATHA Guidelines (The "No Lower Limit" Fallacy) I appreciate that you have corrected your post regarding the syntax error in the table. However, you are now shifting your argument to claim that because there is no printed number, there is "no lower limit." This is factually incorrect. Medical guidelines rely on clinical markers, not just birthdays.
The Limit Exists: As we agreed, the guidelines require Informed Consent (competency to understand irreversible effects) and Fertility Preservation (usually Tanner Stage 3).
The Reality: It is clinically impossible to meet these criteria at age 8 or 9. Therefore, a lower limit does exist. Claiming the guidelines allow for hormones at age 8 because they don't explicitly print "Don't do this to a toddler" is a disingenuous reading of how clinical practice works.
2. Cognitive Changes (The Walk-Back) You state that "Massive cognitive changes refers to the normal changes in puberty". This is a significant retreat from your original implication that Puberty Blockers actively cause cognitive damage. If your position is now simply that "puberty involves change," then you are merely describing human development, not identifying a harm caused by the medication. As noted, the University of York systematic review (which you cited) found no evidence that pausing this process causes cognitive harm.
3. "Silencing" and Professional Standards You reject the consensus of the four major mental health bodies (NZAC, NZPsS, NZAP, RANZCP) by claiming they rely on "silencing." APANZ had a multi-year consultation with the entire membership including AGM votes before issuing this position statement: https://apanz.org.nz/apanz-formal-apology-to-rainbow-communities
This is a profound irony. You position yourself as a champion of "open debate" against a silencing industry. Yet, your immediate reaction to my factual corrections was a threat to delete my comments—a threat you included in your original reply but have since silently edited out:
"Mr Wilson and readers, please refrain from petty point-scoring arguments - I will delete conversations that descend into that."
I have the original email notification. You cannot credibly accuse an entire profession of "silencing" dissent when your own instinct, the moment you were challenged on facts, was to threaten censorship and then hide the evidence.
Thank you for retracting the lying accusation. No, I am not threatening to delete rebuttals, only pointless repetitive or abusive comments that don’t contribute to civil debate. That sort of commentary is a waste of everyone’s time.
I'm no longer accusing you of lying. It's a Substack display glitch as the images I provided show. The fact remains you are claiming others are 'silencing' while threatening to delete rebuttals of your claims due to 'point-scoring'.
I stand by the statements in my post but will respond to three of your criticisms:
Point 3 - Under the "Legal Principles" section of the High Court Judgment (from clause 146), Justice Wilkinson-Smith states [159] "The regulations are subordinate legislation which passed into law on 17 November 2025. As delegated legislation, the regulations are subject both to Parliamentary review and judicial review but unless declared invalid, they remain the law." My statement that the current judgment has NOT overturned the ban is correct - it is only an interim measure. The forthcoming Judicial Review has the power to declare that the process by which the decision was made was invalid but it cannot rule that the decision itself is incorrect. Basically, it can order the government to go through the decision-making process again but until that happens, the regulations are still gazetted and are still the law in NZ.
Point 1 - Have you even read PATHA's new guidelines? There are 8 pages of instructions on how to prescribe cross sex hormones to under 18 year olds, with NO lower age limit. On p76 it recommends "Starting dose for those on puberty blockers started at Tanner stage 2–4". Yes, the patient supposedly has been given puberty blockers first, but with no recommended age or Tanner stage to be reached before starting opposite sex hormones, PATHA's guidelines do promote their early use. I will clarify that in the post.
Point 2 - I will concede that SOME children with precocious puberty might be on PBs longer than SOME for gender dysphoria but no one knows for certain because data isn't kept. However, we can agree that the longer a child is on these drugs, the bigger the risk of harm. In precocious puberty cases, doctors will stop PBs as soon as possible because there are recognised concerns over long term health effects. For girls that would usually be about the age of 9 and only boys would still be using them aged 11. Using PBs BEFORE normal puberty does not disrupt the typical brain development of the teen years, whereas blocking puberty from 10-18 years when there are massive cognitive changes that should be taking place ought to concern everyone.
Mr Wilson and readers, please refrain from petty point-scoring arguments - I will delete conversations that descend into that.
1. Regarding Legal Principles (Your Point 3) You are relying on a misunderstanding of Administrative Law. While you are correct that the Court does not substitute its own policy preference, you are fundamentally incorrect about the powers of Judicial Review and the status of unlawful regulations.
The Power to Quash: You claim the Court "cannot rule that the decision itself is incorrect." This is misleading. Under the Judicial Review Procedure Act, if a decision is found to be irrational (or Wednesbury unreasonable), made for an improper purpose, or based on a mistake of fact, the Court has the power to quash it.
Status of the Law: You claim that "until the government goes through the process again... the regulations are still gazetted and are still the law." This is false. If the Court grants a quashing order (certiorari) or declares the regulations ultra vires, the regulations are voided. They do not "remain the law" while the Minister tries again; they cease to have legal effect immediately.
The Interim Injunction: You cite Justice Wilkinson-Smith to argue the ban hasn't been overturned. Technically, the trial hasn't happened yet. However, the Interim Injunction explicitly prevents the Crown from enforcing these regulations against the plaintiffs. The Court would not have taken this extraordinary step against the Minister unless there was a serious case to be tried regarding the lawfulness of the decision.
2. You have misrepresented the PATHA Guidelines (Your Point 1) You ask if I have read the guidelines - I have. You are doubling down on a grammatical error to support a fabrication.
The Syntax Error: You cite Page 76: "Starting dose for those on puberty blockers started at Tanner stage 2–4". The word "started" is past tense. It refers to the patient's history (when they began blockers), not the instruction for current hormone prescription.
The "Precocious Puberty" Absurdity: Your interpretation requires us to believe that endocrinologists are advocating for the induction of Precocious Puberty (onset <8 in girls, <9 in boys). This is a medical absurdity. Doctors treat children to stop puberty at that age, not induce it.
Informed Consent: The guidelines explicitly require clinicians to ensure the youth understands the irreversible nature of cross-sex hormones. This level of cognitive understanding and consent is incompatible with an 8-year-old. Allowing time for that process is the entire point of puberty blockers.
Fertility: Your interpretation also contradicts page 101 of the same document, which states fertility preservation (sperm collection) usually requires Tanner Stage 3 (sperm production). You cannot claim the guidelines advocate hormones at Tanner 2 when the same document requires steps that are impossible at that stage.
Nowhere do the PATHA guidelines advocate for cross-sex hormones at age 8-9. That claim is false. Pivoting to claim 'no lower age limit' is a continuation of your misrepresentation.
3. Duration & Cognitive Claims (Your Point 2) You concede the duration argument but now pivot to "cognitive changes."
The Math: Treatment for central Precocious Puberty (PP) can begin at age 3 or 4 and run until age 11. That is a duration of 7 to 8 years. Gender dysphoria treatment typically begins at 12 and runs to 16 or 18. Therefore, the Judge was factually right to state that PP cases can involve "considerably longer" suppression.
The Inconsistency: You claim blocking puberty in a 12-year-old damages the brain ("massive cognitive changes"), yet imply blocking puberty in a 4-year-old for 7 years is safe. The chemical is the same and the brain development is equally critical. You cannot argue the drug is neurotoxic for one diagnosis but safe for another.
The Evidence: Your assertion of "massive cognitive changes" is not supported by the evidence. The University of York systematic review found very poor evidence of any cognitive impacts, noting that impact was only found in a single study (in a specific subgroup) and that no conclusions could be drawn about the effect on cognitive development. Stating "massive changes" as a settled fact contradicts the systematic reviews themselves.
4. Omissions regarding Professional Standards: I note you continue to ignore that all four major mental health bodies (NZAC, NZPsS, NZAP, RANZCP) consider the invalidation or suppression of trans identity to be unethical. Nor have you addressed that the CATA psychotherapist was sanctioned by PBANZ not for "debate," but for public misconduct regarding the platforming of a massive number of transphobic articles on the CATA website. These are the regulatory and ethical realities of the sector.
"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"
Been thinking about eunuch identities and kids… does anyone remember that Mengele castrated children to “learn” and for the “good” of the Reich? Amputated body parts, removed organs. The world was horrified and rightly so. Now some groups are saying castration, FGM, amputation of healthy body parts is “treatment “ for the social good.
Similarly, giving females huge doses of testosterone have numerous, known deleterious effects including associated with A/AS abuse have been identified: creating very low HDL cholesterol, hematological (polycythemia), as well as numerous psychiatric, cardiovascular and hepatic complications. We know this from examinations of female athletes given testosterone for doping purposes. The adverse - permanent health effects have been among the reasons anti-doping agencies have developed increasingly effective techniques for detecting doping.
Think about this concretely: we are being told that castration and FGM are a social “good”. That the dangerous practice of Andro doping is good. This should require pretty definitive evidence that castrating someone will save their lives.
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.
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".
Joining PATHA is just as easy as joining WPATH. The President of PATHA, Jennifer Shields, is a man who claims to be a woman who has no medical qualifications whatsoever.
Brilliant analysis Fern. I’m so grateful for your painstaking work unpicking the reasoning and implications of this judgement. Two questions: so the ban is still in place. Is that correct? And why do you say the same judge is likely to preside over the Judicial Review? You’re absolutely right though - the Crown will have to do a much better job countering PATHAs arguments.
So in a way this is just time wasting legal bs. It doesn’t alter anything. What would have to happen to lift the ban? Can the govt issue a retrospective order if the judgement goes against them?
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 of the judgment]
I’m not a lawyer, but my understanding is that if the JR rules against the ban, the government could appeal and/or could redo the process of consultation and decision-making. PATHA is using delaying tactics, knowing that an election is coming up. The JR itself may not happen until
Yes the regulations cannot be overturned by any judge- Justice Wilkinson-Smith confirms that in her judgment. All the High Court can do is say the process for making the regulations was not properly followed, in which case, the government would be obliged to redo the process. This happened with the JR into the Covid lockdowns - it was decided that due process wasn’t fully followed and the government announced a retrospective order. https://www.rnz.co.nz/news/national/423917/high-court-rules-some-of-covid-19-level-4-lockdown-was-unlawful
It is usual practice for the same judge who agreed to the JR to preside over it, although other court duties can sometimes preclude that and sometimes more than one judge presides, as in the lockdown JR.
A very helpful summary of the current situation - thank you.
With Cass and now the HHS review NZ is now becoming an outlier in terms of "gender-affirming care". A big problem is the complete ideological capture of professional organisations, and the witch-hunts launched against any practitioners who dare speak out. I hope this ideological capture does not include Crown Law, whose job it will be to represent the Minister at the judicial review.
I'm astonished at the blasé attitude of PATHA to the threat to fertility from "gender-affirming care". Normally a medical treatment for children that caused infertility would be for an indication where the benefit from the treatment was overwhelming. The problem is that the focus on puberty blockers in isolation neglects the fact that this is the start of a pathway that almost always results in cross-sex hormones and hence infertility. I simply do not believe an 11-year old is able to make an informed decision on this.
There are several demonstrable factual errors and omissions in this post that undermine the argument:
1. False claim regarding hormones at Age 8 The article states: "PATHA advocates for their early use [cross-sex hormones]... from as young as Tanner Stage 2 – eight or nine years old." This is factually incorrect. Tanner Stage 2 is the clinical indication for puberty blockers (to pause puberty), not cross-sex hormones. No guideline in New Zealand or the world advocates for oestrogen or testosterone at age 8 or onset of puberty. This conflates two completely different stages of treatment.
2. Incorrect correction of the Judge regarding duration The article claims Justice Wilkinson-Smith was "the wrong way around" in stating that puberty blocker treatment can be longer for precocious puberty than for gender dysphoria. The Judge is correct. Treatment for central precocious puberty can begin in early childhood (e.g. age 4 to 6) and continue until age 11, a duration of 5 to 7 years. For gender dysphoria, blockers typically start later (age 11 to 12). Even if blockers are continued alongside cross-sex hormones until age 16, the Judge is factually correct that precocious puberty cases can involve "considerably longer" durations of suppression starting at a much younger age.
3. Legal error regarding Judicial Review The article states: "The judgment did NOT overturn the ban... as the Court has no jurisdiction to reverse government decisions." This is legally false. The High Court has the explicit power under the Judicial Review Procedure Act to declare regulations ultra vires (unlawful) and quash them. If a Minister acts outside their powers or follows an improper process, the Court absolutely has the jurisdiction to void that decision.
4. Contradiction on drug safety The article argues these drugs are unsafe for children, yet admits in the same paragraph they are approved by Medsafe for children with precocious puberty. The chemical safety profile of a drug (e.g. bone density, toxicity) does not change based on the child's diagnosis. If it is considered safe enough for a 9-year-old with precocious puberty, the "poison" rhetoric regarding an 11-year-old is scientifically inconsistent.
5. Misrepresentation of "exploratory" therapy and the Law The article claims regulators have declared "exploratory counselling to be an illegal conversion practice." This is false. Genuine exploratory psychotherapy remains legal. What is restricted is the specific Genspect model branded as "Gender Exploratory Therapy." This is a rebranding of Zucker and Bradley’s 1980s "reparative therapy", a model of endless non-affirming exploration on the therapists terms designed to delay transition. This fits the definition of a conversion practice under s5(a) of the Conversion Practices Prohibition Legislation Act (suppression of gender identity).
Professional bodies are not punishing therapists for exploring; they are upholding the law against suppressing. All four major mental health bodies in New Zealand (NZAC, NZPsS, NZAP, and RANZCP) consider the invalidation of trans gender identity and the pursuit of conversion practices to be unethical.
Ann Elborn (Footnote 2): The article cites her as a victim of a "witch hunt". In reality, she chose to resign from NZAC after ethics complaints were lodged regarding her promotion of prejudiced material.
Nelson Conference: Similarly, a key organiser faced an upheld complaint from the Psychotherapists Board (PBANZ). The Board sanctioned the practitioner for platforming hundreds of transphobic articles on the CATA website, ruling that this conduct harmed trans youth indirectly through the propagation of prejudice.
These practitioners are not being "bullied"; they are facing the consequences of operating outside both the law and the ethical standards of their profession.
Try reading my comments again. You have misinterpreted me in several places:
The regulations will be in place until the JR rules them invalid - I agree.
Precocious puberty suppression would normally end at 9ish for girls and 11ish for boys - the age at which puberty normally starts, nothing to do with initiating an early puberty.
Informed consent is a nonsense when fertility preservative is impossible - agreed - yet the guidelines still have no lower age or Tanner stage limits. I accept that puberty suppression is supposed to precede cross sex hormones in young patients and have clarified that in the post.
“Massive cognitive changes” refers to the normal brain development in puberty, not any (as yet unproven) changes caused by PBs. I am advocating for children to be left to go through a natural puberty.
I do not agree that the professional standards have been reached through open and rigorous debate. That is the whole point of my remarks about “Circular citations and silencing”.
We fundamentally do not agree and there is no point in going over the same points repeatedly, so this will be my final response unless you have something fresh to say.
My response to your clarifications:
1. PATHA Guidelines (The "No Lower Limit" Fallacy) I appreciate that you have corrected your post regarding the syntax error in the table. However, you are now shifting your argument to claim that because there is no printed number, there is "no lower limit." This is factually incorrect. Medical guidelines rely on clinical markers, not just birthdays.
The Limit Exists: As we agreed, the guidelines require Informed Consent (competency to understand irreversible effects) and Fertility Preservation (usually Tanner Stage 3).
The Reality: It is clinically impossible to meet these criteria at age 8 or 9. Therefore, a lower limit does exist. Claiming the guidelines allow for hormones at age 8 because they don't explicitly print "Don't do this to a toddler" is a disingenuous reading of how clinical practice works.
2. Cognitive Changes (The Walk-Back) You state that "Massive cognitive changes refers to the normal changes in puberty". This is a significant retreat from your original implication that Puberty Blockers actively cause cognitive damage. If your position is now simply that "puberty involves change," then you are merely describing human development, not identifying a harm caused by the medication. As noted, the University of York systematic review (which you cited) found no evidence that pausing this process causes cognitive harm.
3. "Silencing" and Professional Standards You reject the consensus of the four major mental health bodies (NZAC, NZPsS, NZAP, RANZCP) by claiming they rely on "silencing." APANZ had a multi-year consultation with the entire membership including AGM votes before issuing this position statement: https://apanz.org.nz/apanz-formal-apology-to-rainbow-communities
This is a profound irony. You position yourself as a champion of "open debate" against a silencing industry. Yet, your immediate reaction to my factual corrections was a threat to delete my comments—a threat you included in your original reply but have since silently edited out:
"Mr Wilson and readers, please refrain from petty point-scoring arguments - I will delete conversations that descend into that."
I have the original email notification. You cannot credibly accuse an entire profession of "silencing" dissent when your own instinct, the moment you were challenged on facts, was to threaten censorship and then hide the evidence.
Thank you for retracting the lying accusation. No, I am not threatening to delete rebuttals, only pointless repetitive or abusive comments that don’t contribute to civil debate. That sort of commentary is a waste of everyone’s time.
Paul, if you continue to accuse me of lying, you will be banned from commenting on this substack. Civil debate is required.
I'm no longer accusing you of lying. It's a Substack display glitch as the images I provided show. The fact remains you are claiming others are 'silencing' while threatening to delete rebuttals of your claims due to 'point-scoring'.
I stand by the statements in my post but will respond to three of your criticisms:
Point 3 - Under the "Legal Principles" section of the High Court Judgment (from clause 146), Justice Wilkinson-Smith states [159] "The regulations are subordinate legislation which passed into law on 17 November 2025. As delegated legislation, the regulations are subject both to Parliamentary review and judicial review but unless declared invalid, they remain the law." My statement that the current judgment has NOT overturned the ban is correct - it is only an interim measure. The forthcoming Judicial Review has the power to declare that the process by which the decision was made was invalid but it cannot rule that the decision itself is incorrect. Basically, it can order the government to go through the decision-making process again but until that happens, the regulations are still gazetted and are still the law in NZ.
Point 1 - Have you even read PATHA's new guidelines? There are 8 pages of instructions on how to prescribe cross sex hormones to under 18 year olds, with NO lower age limit. On p76 it recommends "Starting dose for those on puberty blockers started at Tanner stage 2–4". Yes, the patient supposedly has been given puberty blockers first, but with no recommended age or Tanner stage to be reached before starting opposite sex hormones, PATHA's guidelines do promote their early use. I will clarify that in the post.
Point 2 - I will concede that SOME children with precocious puberty might be on PBs longer than SOME for gender dysphoria but no one knows for certain because data isn't kept. However, we can agree that the longer a child is on these drugs, the bigger the risk of harm. In precocious puberty cases, doctors will stop PBs as soon as possible because there are recognised concerns over long term health effects. For girls that would usually be about the age of 9 and only boys would still be using them aged 11. Using PBs BEFORE normal puberty does not disrupt the typical brain development of the teen years, whereas blocking puberty from 10-18 years when there are massive cognitive changes that should be taking place ought to concern everyone.
Mr Wilson and readers, please refrain from petty point-scoring arguments - I will delete conversations that descend into that.
A response to your specific replies:
1. Regarding Legal Principles (Your Point 3) You are relying on a misunderstanding of Administrative Law. While you are correct that the Court does not substitute its own policy preference, you are fundamentally incorrect about the powers of Judicial Review and the status of unlawful regulations.
The Power to Quash: You claim the Court "cannot rule that the decision itself is incorrect." This is misleading. Under the Judicial Review Procedure Act, if a decision is found to be irrational (or Wednesbury unreasonable), made for an improper purpose, or based on a mistake of fact, the Court has the power to quash it.
Status of the Law: You claim that "until the government goes through the process again... the regulations are still gazetted and are still the law." This is false. If the Court grants a quashing order (certiorari) or declares the regulations ultra vires, the regulations are voided. They do not "remain the law" while the Minister tries again; they cease to have legal effect immediately.
The Interim Injunction: You cite Justice Wilkinson-Smith to argue the ban hasn't been overturned. Technically, the trial hasn't happened yet. However, the Interim Injunction explicitly prevents the Crown from enforcing these regulations against the plaintiffs. The Court would not have taken this extraordinary step against the Minister unless there was a serious case to be tried regarding the lawfulness of the decision.
2. You have misrepresented the PATHA Guidelines (Your Point 1) You ask if I have read the guidelines - I have. You are doubling down on a grammatical error to support a fabrication.
The Syntax Error: You cite Page 76: "Starting dose for those on puberty blockers started at Tanner stage 2–4". The word "started" is past tense. It refers to the patient's history (when they began blockers), not the instruction for current hormone prescription.
The "Precocious Puberty" Absurdity: Your interpretation requires us to believe that endocrinologists are advocating for the induction of Precocious Puberty (onset <8 in girls, <9 in boys). This is a medical absurdity. Doctors treat children to stop puberty at that age, not induce it.
Informed Consent: The guidelines explicitly require clinicians to ensure the youth understands the irreversible nature of cross-sex hormones. This level of cognitive understanding and consent is incompatible with an 8-year-old. Allowing time for that process is the entire point of puberty blockers.
Fertility: Your interpretation also contradicts page 101 of the same document, which states fertility preservation (sperm collection) usually requires Tanner Stage 3 (sperm production). You cannot claim the guidelines advocate hormones at Tanner 2 when the same document requires steps that are impossible at that stage.
Nowhere do the PATHA guidelines advocate for cross-sex hormones at age 8-9. That claim is false. Pivoting to claim 'no lower age limit' is a continuation of your misrepresentation.
3. Duration & Cognitive Claims (Your Point 2) You concede the duration argument but now pivot to "cognitive changes."
The Math: Treatment for central Precocious Puberty (PP) can begin at age 3 or 4 and run until age 11. That is a duration of 7 to 8 years. Gender dysphoria treatment typically begins at 12 and runs to 16 or 18. Therefore, the Judge was factually right to state that PP cases can involve "considerably longer" suppression.
The Inconsistency: You claim blocking puberty in a 12-year-old damages the brain ("massive cognitive changes"), yet imply blocking puberty in a 4-year-old for 7 years is safe. The chemical is the same and the brain development is equally critical. You cannot argue the drug is neurotoxic for one diagnosis but safe for another.
The Evidence: Your assertion of "massive cognitive changes" is not supported by the evidence. The University of York systematic review found very poor evidence of any cognitive impacts, noting that impact was only found in a single study (in a specific subgroup) and that no conclusions could be drawn about the effect on cognitive development. Stating "massive changes" as a settled fact contradicts the systematic reviews themselves.
4. Omissions regarding Professional Standards: I note you continue to ignore that all four major mental health bodies (NZAC, NZPsS, NZAP, RANZCP) consider the invalidation or suppression of trans identity to be unethical. Nor have you addressed that the CATA psychotherapist was sanctioned by PBANZ not for "debate," but for public misconduct regarding the platforming of a massive number of transphobic articles on the CATA website. These are the regulatory and ethical realities of the sector.
Great analysis, Fern, thanks.
Shame the Ministry of Health didn't put up a proper fight.
Maybe an intervener is required? Now who might that be???
Have cross posted
https://dustymasterson.substack.com/p/the-jungle-book-the-bare-necessities
Dusty
Shouts from the rooftops...!!!
"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"
Been thinking about eunuch identities and kids… does anyone remember that Mengele castrated children to “learn” and for the “good” of the Reich? Amputated body parts, removed organs. The world was horrified and rightly so. Now some groups are saying castration, FGM, amputation of healthy body parts is “treatment “ for the social good.
Similarly, giving females huge doses of testosterone have numerous, known deleterious effects including associated with A/AS abuse have been identified: creating very low HDL cholesterol, hematological (polycythemia), as well as numerous psychiatric, cardiovascular and hepatic complications. We know this from examinations of female athletes given testosterone for doping purposes. The adverse - permanent health effects have been among the reasons anti-doping agencies have developed increasingly effective techniques for detecting doping.
Think about this concretely: we are being told that castration and FGM are a social “good”. That the dangerous practice of Andro doping is good. This should require pretty definitive evidence that castrating someone will save their lives.
And, worst of all PATHA is advocating that these things be done to children.
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".
Joining PATHA is just as easy as joining WPATH. The President of PATHA, Jennifer Shields, is a man who claims to be a woman who has no medical qualifications whatsoever.
Brilliant analysis Fern. I’m so grateful for your painstaking work unpicking the reasoning and implications of this judgement. Two questions: so the ban is still in place. Is that correct? And why do you say the same judge is likely to preside over the Judicial Review? You’re absolutely right though - the Crown will have to do a much better job countering PATHAs arguments.
So in a way this is just time wasting legal bs. It doesn’t alter anything. What would have to happen to lift the ban? Can the govt issue a retrospective order if the judgement goes against them?
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 of the judgment]
As the ban was made by Order in Council it can be cancelled by a new Order in Council or by legislation in the House, I believe.
I’m not a lawyer, but my understanding is that if the JR rules against the ban, the government could appeal and/or could redo the process of consultation and decision-making. PATHA is using delaying tactics, knowing that an election is coming up. The JR itself may not happen until
May or June.
Yes the regulations cannot be overturned by any judge- Justice Wilkinson-Smith confirms that in her judgment. All the High Court can do is say the process for making the regulations was not properly followed, in which case, the government would be obliged to redo the process. This happened with the JR into the Covid lockdowns - it was decided that due process wasn’t fully followed and the government announced a retrospective order. https://www.rnz.co.nz/news/national/423917/high-court-rules-some-of-covid-19-level-4-lockdown-was-unlawful
It is usual practice for the same judge who agreed to the JR to preside over it, although other court duties can sometimes preclude that and sometimes more than one judge presides, as in the lockdown JR.
Interesting to read the precautionary statements by the drug suppliers themselves.