Australian and New Zealand governments must take a careful, clinically grounded approach to decisions about puberty blockers, with the mental and physical health of children and adolescents placed at the centre of all policy and service decisions. 

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) supports rigorous, independent examination of the evidence relating to gender-affirming care and recognises the importance of recent reviews in strengthening clinical understanding. At the same time, the College is urging governments to ensure that such reviews inform, rather than replace nuanced, individualised clinical decision-making. 

Removing or pausing treatment options without clear alternative pathways for assessment, ongoing mental health and related care, and broader psychosocial support risks causing significant additional harm, particularly for young people who are already experiencing distress and vulnerability. 

On Friday, the Queensland Government extended its pause on puberty blocker treatments until 2031 as it released an Independent Review of Stage 1 and Stage 2 hormone therapies in Queensland's public paediatric gender services.  

Over the weekend, the Northern Territory government announced a similar halt to the use of puberty blockers for young people in public health care.These decisions follow a comparable move in Aotearoa New Zealand last month to pause new prescriptions of puberty blockers for young people with gender incongruence. 

RANZCP President Dr Astha Tomar said high-quality, independent reviews that carefully examine an evolving area of clinical practice were critical to informing safe, ethical and effective care for children and adolescents.  

She said governments have a responsibility to meaningfully engage with the evidence presented in these reviews when developing policy, and to ensure that policy settings do not outpace or distort the clinical realities they are intended to address. 

“This is a complex and evolving area of clinical practice where decisions must be informed by the best available evidence and applied carefully to the individual circumstances of each young person,” Dr Tomar said.  

“Independent reviews should actively inform policy and support clinical decision-making, alongside professional expertise and person-centred care. 

"The College reaffirms our commitment to the fundamental principles that transgender and gender diverse people must be provided with person-centred, evidence-informed mental health care that is ethical, supportive, non-judgmental and culturally safe.  

“While The RANZCP does not advocate for a particular model of care, any assessment or treatment for children and adolescents who identify as transgender or gender-diverse must be developmentally appropriate, evidence-informed, person-centered, and underpinned by dignity, empathy and respect.  

“These decisions have profound implications for young people, their families, carers and whānau, as well as the clinicians supporting them. 

“Meaningful consultation must occur before blanket restrictions that directly affect health and wellbeing are put in place.” 

The RANZCP notes that Queensland’s independent review, led by Professor Ruth Vine, appropriately reflects established principles of evidence-based medical practice - namely the integration of research evidence, clinical expertise, and the preferences and values of patients and families in individual clinical decision-making.  

Importantly, the report’s strong focus on comprehensive, person-centred assessment, including the early identification and management of co-occurring mental health conditions and psychosocial risk factors, aligns with core psychiatric practice and reinforces the need for coordinated care pathways within the public health system to reduce fragmentation and prevent young people from falling through service gaps. 

Where governments choose to pause or restrict access to treatment while awaiting further evidence, including the findings of the UK PATHWAYS trial expected in 2031, Dr Tomar said it was critical that these decisions do not unfairly limit access to the broader care, assessment and support pathways transgender and gender diverse young people rely on, particularly within the public health system.  

Policy settings must remain responsive to new and emerging evidence and guidance, including that arising from the forthcoming National Health and Medical Research Council (NHMRC) review. The NHMRC review and development of Australian standards and guidelines for transgender and gender diverse children and adolescents is expected to deliver interim recommendations on puberty suppression in mid-2026.  

“For Australian governments, this presents an opportunity to consolidate evidence, reflect on critical and rigorous reviews, and move towards a nationally consistent, clinically sound framework of care,” Dr Tomar said. 

“Such a framework must also prioritise timely and equitable access to appropriate public mental health and specialist services when people need them and where they need them. This includes children and adolescents in rural, regional and remote communities, where access to care is often most limited and delays can compound risk and distress. 

”Ultimately, this is a vulnerable population of young people and their families. Every decision about access to care must be made carefully, compassionately, and with a clear focus on mental health and wellbeing.” 

The RANZCP looks forward to engaging constructively with governments across Australia and New Zealand, and contributing to ongoing discussions about how best to support the mental health and wellbeing of transgender and gender diverse young people. 

ENQUIRIES: For more information, or to arrange an interview call Dishi on +61 437 315 911 or email media@ranzcp.org.   

The Royal Australian and New Zealand College of Psychiatrists is a membership organisation that prepares medical specialists in the field of psychiatry, supports and enhances clinical practice, advocates for people affected by mental illness and advises governments and other groups on mental health care. For information about our work, our members or our history, visit www.ranzcp.org.

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