AAP

Minister for Health

Mark Butler .

Paul Smith THE NHMRC is to develop new national guidelines for transgender youth amid the ongoing debate about the prescription of puberty blockers and cross-sex hormones .

Announced by federal Minister for Health and Aged Care Mark Butler , he said : “ This process will be driven by evidence and conducted by our most eminent medical researchers and clinicians .”

It follows the Queensland Government ’ s decision to ban the

initiation of cross-sex hormones and puberty blockers in its public hospitals to children and adolescents diagnosed with gender dysphoria .

The ban will remain until it completes a formal review into the efficacy and safety of the treatments , which it says will take 10 months . Mr Butler said the NHMRC guidelines would be developed using the internationally recognised GRADE approach , with interim advice regarding the use

of puberty blockers expected to be completed by mid-2026 .

“ I ’ ve indicated to [ Queensland Health Minister Tim Nicholls ] that I don ’ t think it would be appropriate for Queensland to continue with their stated intention to undertake an evidence review in this area of care ,” Mr Butler added .

“ These issues should be nationally consistent and , in my view , should be driven by the pre-eminent authority , which is the NHMRC …

“ It is certainly best practice to ensure that state governments and private services are operating in accordance with national and consistent clinical guidelines that are issued , or at least approved , by the nation ’ s pre-eminent authority in this area .”

The guidelines currently used in Australia are based on a gender-affirming model and were developed by clinicians at the Royal Children ’ s Hospital in Melbourne .

PAGE 1 in a peer-reviewed journal , the research was based on MedicineInsight data for 37,000 patients initiating antihypertensive therapy between 2014 and 2016 , with a follow-up of 12 months .

Doctors were twice as likely to increase the dose of monotherapy than to add a second drug , it found .

Since 2008 , national guidelines have recommended adding a second therapy rather than increasing the dose of monotherapy if blood pressure remains uncontrolled .

Professor Anthony Rodgers , a Sydney epidemiologist who was involved in the research , said adding a second antihypertensive was 3-5 times more effective than increasing monotherapy doses .

“ Increasing the dose of monotherapy will only give you 1-2mm of extra systolic blood pressure reduction ,” he told Australian Doctor .

“ As you get to those maximal doses for monotherapy , you get very little efficacy , yet that is where the side effects really start to kick in , particularly for drugs like calcium-channel blockers and diuretics .”

He said changes to treatment were most common in the first few months after initiation .

“ A year in , you get into a situation where patients have a whole history of measurements — some within targets and some high ,” he said .

“ There is an innate human tendency to want to believe the low ones .

“ That is one reason why treatment inertia kicks in .”

Professor Garry Jennings .