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Speaker 1: Now on another subject altogether, We've got a bit of

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Speaker 1: an insight today into the use of puberty blockers for

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Speaker 1: transgender kids in the country. Analysis in the Medical Journal

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Speaker 1: shows that New Zealand doctors have been prescribing these puberty

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Speaker 1: blockers up to seven times more than in other comparable countries.

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Speaker 1: And comparable countries we're talking about are the Netherlands, England, Wales,

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Speaker 1: Denmark and so on. Now. Professor Paul Hoffman is a

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Speaker 1: pediatric endocrinologist at Auckland University.

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Speaker 2: Hey, Paul, Hi, does that.

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Speaker 1: Surprise you how often these things have been prescribed here?

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Speaker 2: Not particularly, it's there has been a trend in New

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Speaker 2: Zealand probably to use more pupil suppressive therapy than other

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Speaker 2: parts of the world. I am surprised at the absolute amount,

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Speaker 2: but I have to say we have to be a

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Speaker 2: bit careful because the study wasn't precisely looking at pubertal

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Speaker 2: suppressive therapy per se, but at the number of prescriptions

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Speaker 2: drived for pupil suppressive therapy. And that's not just transgender.

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Speaker 2: There's other conditions involved in that as well, So.

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Speaker 1: That tends to be in the under twelves right in

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Speaker 1: the twelve to seventeen or twelve to eighteen category that

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Speaker 1: will mainly be transgender, won't.

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Speaker 2: It will mainly, but there are a number of particularly

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Speaker 2: for males, not so much females, who will be still

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Speaker 2: beyond on therapy during that stage. So I do agree

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Speaker 2: that the rapid increase is almost certainly related to transgender.

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Speaker 2: It would be really nice so to have that accurately defined.

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Speaker 1: Now, why has it been happening at such a rate

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Speaker 1: in New Zealand? Do you have any idea?

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Speaker 2: Well, I think two things first before we get to that.

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Speaker 2: First there, we've just got to be careful the rates overseas.

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Speaker 2: They are probably closest to accurate in the Dutch. But

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Speaker 2: when you're doing things one hundred thousand adolescents and it's

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Speaker 2: not national data, which it is in this country, you

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Speaker 2: are approximating the background population, so the denominator may not

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Speaker 2: be entirely accurate, so there is potential bias both could

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Speaker 2: make it higher or lower. So I think we had

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Speaker 2: to be a little careful as well. But yes, I

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Speaker 2: think overall it's definitely higher compared to you just looking

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Speaker 2: at what's happened in New Zealand over the last decade,

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Speaker 2: and it probably is a lot higher than what's happened

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Speaker 2: in Europe, at least two to three European countries. Now, well,

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Speaker 2: that's a good question. I think it reflects the approach

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Speaker 2: to transgender in New Zealand, which goes on a human

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Speaker 2: rights perspective where it's a human right to decide what

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Speaker 2: your gender is, as opposed to an evidence based approach

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Speaker 2: where we're looking at evidence that the therapy is effective

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Speaker 2: and making sure we're using it appropriately. And that's what's

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Speaker 2: been happening, particularly in Europe and the UK, where there

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Speaker 2: have been a number of problems and older youth and

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Speaker 2: young adults which who wanted to wanted to change back

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Speaker 2: and they've already had permanent surgery. So I think there

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Speaker 2: has been a concern that it's been overused whereas and

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Speaker 2: so they've gone down a more evidence based approach, and

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Speaker 2: I have to say the efficacy of the actual hard

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Speaker 2: evidence that it has benefit is not as strong as

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Speaker 2: we'd like to think it is. There are clear cases

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Speaker 2: where it does, but it's not as clear colors as

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Speaker 2: we as we used to think.

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Speaker 1: So quite interesting in that data, it appears that the

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Speaker 1: use of the puberty blockers prescriptions have started to decline

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Speaker 1: in the last couple of years. Now, do you think

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Speaker 1: that is because we have increasingly in the last couple

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Speaker 1: of years talked about this stuff and talked about the concerns,

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Speaker 1: and so parents and perhaps doctors are sort of just

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Speaker 1: getting a bit worried about prescribing.

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Speaker 2: Yeah. Look, I think there has been increasing data internationally

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Speaker 2: and concern those in the scientific media but also in

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Speaker 2: the press expressing the worries about using this therapy, and

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Speaker 2: so I think there has been reduction. It's also possible,

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Speaker 2: of course, that we've saturated the number of kids with

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Speaker 2: transgender and use of transgender out there, so that there

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Speaker 2: the population is now stabilizing. Well, I suspect as you

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Speaker 2: say that, it's more likely it's there is a negative

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Speaker 2: or concerning impact on the effect of pupil suppressor therapy

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Speaker 2: and it's and its benefits.

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Speaker 1: Paul, do you think that we should go down the

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Speaker 1: same path as Britain and ban the use of puberty

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Speaker 1: blockers for under eighteen's the routine use.

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Speaker 2: My personal feeling is no, that's basically partner on some

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Speaker 2: of the clinical cases I've been involved in. I don't

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Speaker 2: generally do transgender children look after transgender children myself, but

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Speaker 2: I have been involved in several cases where I have

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Speaker 2: seen benefit. This is a very vulnerable group and I

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Speaker 2: think those who are self harming or doing high risk behaviors,

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Speaker 2: if you have a therapy which can reduce those reduce

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Speaker 2: some of that stress, then I think that it's not

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Speaker 2: unreasonable to look at it. So whilst I don't think

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Speaker 2: it should be banned, I think that close supervision and

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Speaker 2: careful use of it, particularly with the use of a

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Speaker 2: psychologist and a multi discipline team, is very important.

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