Changes to Prescribing gonadotropin-releasing hormone (GnRH) analogues for gender incongruence or gender dysphoria (puberty blockers)
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From 19 December 2025, new prescriptions for GnRH analogues for the purpose of puberty suppression for children or adolescents with gender incongruence or gender dysphoria will no longer be permitted for patients who have not been prescribed a GnRH analogue previously.
This follows Government regulations introduced on 17 November 2025. The new regulations are published online here: Medicines (Restriction on Prescribing Gonadotropin-releasing Hormone Analogues) Amendment Regulations 2025
Young people already receiving GnRH analogue treatment for gender incongruence or gender dysphoria can continue under their existing care plan with informed consent from both the patient and caregiver.
A change has been made to the new regulations to ensure that the restrictions on prescribing GnRH do not inadvertently apply to adults with gender incongruence or dysphoria. The new regulations apply only to new prescriptions for the purpose of puberty suppression in a person who is a child or adolescent with gender dysphoria or incongruence from 19 December 2025.
Please cascade this information as appropriate.
Context
The regulations follow the publication in November 2024 of the Ministry of Health’s Evidence Brief (Impact of Puberty Blockers in Gender-Dysphoric Adolescents: An evidence brief) which found significant limitations in the quality of evidence on the benefits and risks of puberty blockers for gender dysphoria. No new substantive evidence has emerged since. While this uncertainty persists, the Government is taking a precautionary approach. Following consultation, the Government has decided to take a similar approach to that taken in the United Kingdom.
Support for young people
Clinical and psychological support remains available. Health NZ will establish an online resource that will provide key information on approaches to gender affirming care and how to access services and support.
Key date
The new regulations take effect on 19 December 2025. From this date, no child or adolescent patients will be able to start puberty blockers for the purpose of puberty suppression for gender incongruence or gender dysphoria.
Puberty blockers use
Gonadotropin-releasing hormone analogues are medicines used to treat a number of conditions, including prostate cancer, some breast cancers, precocious puberty, endometriosis and uterine fibroids. They have been used off-label to delay puberty in treating gender incongruence and gender dysphoria as part of gender-affirming care. Prescribing for other indications remains unchanged.
Read the announcement on the Beehive website:
New Regulations
View the new regulations on the New Legislation website:
Frequently asked questions
What prescribing is included in this new regulation?
The regulations do not restrict adult treatment contexts and apply only to new prescriptions for puberty suppression for child or adolescent patients with gender dysphoria or incongruence. A prescriber must not prescribe a prescription medicine that is a gonadotropin-releasing hormone analogue for the purpose of puberty suppression in a person who is a child or adolescent with:
· gender incongruence; or
· gender dysphoria.
This restriction does not apply to any patient who has been prescribed a prescription medicine that is a gonadotropin-releasing hormone analogue before 19 December 2025.
Does the regulation only prohibit prescribing for young people under the age of 16?
The regulation does not apply only to specific age groups.
From 19 December 2025, the regulation prohibits prescribing prescription medicine that is a gonadotropin-releasing hormone analogue for the purpose of puberty suppression in a person who is a child or adolescent with:
· gender incongruence; or
· gender dysphoria.
What prescription medicines are subject to the restriction?
The prescription medicines subject to the restriction include buserelin, deslorelin, gonadorelin, goserelin, leuprorelin, nafarelin, and triptorelin.
Does the restriction apply to adult patients using goserelin as an anti-androgen if they can't tolerate oral options?
No. The restriction applies only to new prescriptions for puberty suppression in child or adolescent patients with gender dysphoria or incongruence.
What other support is available to young people and families who may be seeking care for gender dysphoria or gender incongruence?
Patients who are not able to access puberty blockers as part of their care can still access clinical support, including psychological support. In some specialised areas of healthcare, with only limited demand, it can be challenging to easily navigate through local services. To assist with this, Health New Zealand is developing an online hub of resources with links to existing support services for gender-affirming care around the country.
What does it mean to ‘bring together services through a central, accessible online resource’?
Health NZ will establish an online resource, referred to as an online hub, by ensuring key information on approaches to gender affirming care and how to access services and support is able to be found in one place by children, young people and their whānau. The online hub will be in place by March 2026.
Are other uses of GnRH analogues affected?
No. Prescribing for other indications, such as precocious puberty, endometriosis, and prostate cancer, remains unchanged.
Do the restrictions apply to patients who have had treatment initiated outside of New Zealand?
The restriction does not apply to a person who has been prescribed a gonadotropin-releasing hormone analogue for gender dysphoria or gender incongruence before 19 December 2025, whether that prescribing occurred in New Zealand or overseas.
If a patient leaves New Zealand for a period, for example, to live in another country where they start treatment with puberty blockers and then returns to New Zealand (as a child/adolescent) to live permanently in the future, will they be able to continue treatment?
Yes, but only if they were first prescribed a gonadotropin-releasing hormone analogue for gender dysphoria or gender incongruence before 19 December 2025.
If a patient has started treatment with puberty blockers in another country and immigrates to NZ (while still a child/adolescent), will they be able to continue treatment?
Yes, but only if they were first prescribed a gonadotropin-releasing hormone analogue for gender dysphoria or gender incongruence before 19 December 2025
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