It’s the bitterest debate in modern politics. Fights over transgender rights have contaminated political debate in the US, UK and Australia but they’ve mostly passed New Zealand by. In 2021, a self-ID law making it easier to alter sex records on birth certificates and other documentation was passed unanimously. A small number of doctors and academics, including emeritus professor Charlotte Paul, have spoken up about the exponential growth rate of prescriptions for puberty blockers – allegedly 10 times the rate per capita of the UK. But in the past 10 years, the political, media and health establishments have generally taken the side of the transgender community and supported their right to healthcare and legislation that affirms their identity.
That bipartisan consensus is unravelling. The coalition government has agreed to “ensure publicly funded sporting bodies support fair competition that is not compromised by rules relating to gender”, a demand made by New Zealand First aimed at restricting trans-women athletes from competing in women’s sports categories. National’s coalition agreement with NZ First also contains a provision for “the removal and replacement of the gender, sexuality, and relationship-based education guidelines”. And after a series of poor poll results, NZ First leader Winston Peters recently announced his intention to introduce a member’s bill to “protect women’s spaces”.
It will ensure that every new non-domestic, publicly available building contains unisex and single-sex toilets, and introduce a new fine “for anyone who uses a single-sex toilet and is not of the sex for which that toilet has been designated”.
There’s a considerable constituency for such measures. A Talbot Mills poll released in November 2023 found 60% of respondents are opposed to biological males who identify as women competing in women’s sports, while only 14% support it. A total of 50% oppose allowing biological males identifying as women to use women’s bathrooms, versus 21% support.
Conservative states across the US are rolling back transgender rights and imposing bans on transgender healthcare for under-18s. These debates are divisive because everyone involved perceives themselves to be a victim, or acting on behalf of victims.
The trans community has long been a target of prejudice and persecution; the families of trans children and teenagers are determined to advocate for their rights and protect their dignity. Most of the modern Left sees the cause as an extension of the gay rights movement and a defining moral issue. All of this is opposed by conservatives (Peters, of course, eternally regards himself as a victim of unjust persecution by cruel and unscrupulous journalists) but also by traditional feminists. This group refer to themselves as gender critical feminists (their enemies call them TERFs, for trans-exclusionary radical feminists) and they dismiss the ideology adopted by much of the trans-rights movement which advances the notion that sex and gender are social constructs instead of biological categories.
They believe the blurring of boundaries for women’s health, sports, prisons, refuges and safe spaces – like bathrooms – constitutes an existential threat to the rights and safety of women. And they have grave doubts about the evidence base and clinical practices around transgender medicine.
Puberty blockers
Many trans and gender-nonconforming people experience dysphoria: psychological distress arising from a discrepancy between their bodies and “assigned” genders and their internal sense of who they are. This distress often becomes more acute during puberty, so one of the standard treatments for dysphoric children and adolescents is puberty blockers – drugs that suppress hormonal changes during puberty – until the patient is old enough to make informed choices about additional treatment. Most patients prescribed blockers proceed to cross-sex hormone therapy. Some also undergo mastectomies and genital surgery.
Advocates defend the practice of prescribing puberty-blocking drugs to minors on the grounds they’re safe, reversible and evidence-based. But the recent publication of the Cass Review – a mammoth report on gender identity services in the UK’s National Health Service – casts doubt on those claims. It found evidence for puberty blockers was surprisingly thin, and suggested possible side effects included menopausal symptoms, weaker bone density and the potential impact on fertility, sexual function and brain development. Transgender healthcare practitioners challenge the findings but the NHS has responded by halting the use of puberty blockers for minors. Sweden and Finland have adopted similar restrictions.
The review found roughly 20% of gender-dysphoric patients in England and Wales were prescribed blockers; NZ’s prescription rate has been cited as 60-70% of enrolled patients.
The Ministry of Health has requested an evidence brief on the clinical guidelines around gender dysphoria and the use of blockers. This was delayed until after publication of the Cass report and is now expected in August.
Officials and their advisers tend to endorse the status quo, but when they shift it’s usually because our peer nations have moved first. There’s pressure building in Australia for a national independent review into gender affirming healthcare. If they go, we’ll probably follow. A finding that affirms current clinical practices would be subject to intense scrutiny from the growing numbers of academics and physicians increasingly nervous about this branch of medicine.
Attention-seeking
If NZ First’s bathrooms bill is drawn from the members-bill ballot it will be killed at first reading. The chances of cross-party support for such ridiculous legislation are close to zero.
Regulation of trans athletes comes under the sports portfolio, currently held by Chris Bishop, a minister with an enormous workload who does not seem inclined to indulge NZ First’s agenda.
Peters’ coalition partners cringe with embarrassment whenever he raises transgender issues in the House. But the safety of distressed young people in the public health system is a separate and serious subject and it deserves attention from the other parties in Parliament, instead of just Peters’ unserious attention-seeking.
Danyl McLauchlan is the Voyager Media Awards 2024 best columnist, opinion or critique.
