High Court decision reinforces importance of individualised care for gender-diverse young people

The Royal Australian and New Zealand College of Psychiatrists (RANZCP) says the New Zealand High Court’s decision to set aside regulations restricting new prescriptions of puberty blockers reinforces the importance of individualised, evidence-informed healthcare and meaningful consultation with those affected by healthcare policy.

Consistent with Position Statement 103: The role of psychiatrists in working with trans and gender diverse people, the RANZCP supports respectful, person-centred and non-judgemental mental healthcare for children and adolescents experiencing gender incongruence or gender dysphoria.

Chair of RANZCP Tū Te Akaaka Roa, A/Prof Hiran Thabrew, emphasised that being trans or gender diverse is not itself a mental health condition, and that stigma, discrimination and trauma can contribute to the higher rates of mental health difficulties experienced by this population.

“Young people and their whānau deserve compassionate, accessible healthcare that responds to their individual needs and circumstances,” A/Prof Thabrew said.

“Clinical decisions should be informed by comprehensive assessment, the best available evidence, careful consideration of potential benefits and risks, and appropriate informed consent.”

When the restrictions were first put in place in November last year, Tū Te Akaaka Roa warned that people newly seeking support were already navigating a maze of confusion and distress, and that removing a treatment option without clarifying alternative avenues for support could cause significant additional harm to their mental health.

Evidence regarding medical interventions for gender dysphoria in children and adolescents continues to evolve. Decisions regarding appropriate modes of care and medical prescribing should be made by the patient and relevant medical specialists together, following careful consideration of the available treatment options, the risks associated with both providing and withholding each mode of treatment, and informed consent.

Psychiatrists may contribute to this multidisciplinary care by assessing and supporting a young person’s mental health and wellbeing, including any co-occurring mental health concerns.

“Healthcare policy must be informed by robust evidence, clinical expertise and meaningful consultation with the young people, families and whānau whose lives are directly affected,” A/Prof Thabrew said.

The College continues to support the development of national guidelines and clear service models in Aotearoa New Zealand, alongside further research into safe, effective and accessible multidisciplinary modes of care, guided by the strongest clinical evidence and with input from people with lived experience, their whānau and clinicians, with long term monitoring of outcomes.

The College remains committed to ensuring that all young people can access respectful, culturally safe and appropriate mental healthcare, regardless of the treatment pathway they pursue.

For media inquiries, please contact: Dishi Gahlowt 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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