Puberty Blockers

There is a lot of false news about puberty blockers going around. One report says that bone density decreases in trans children that were on the blockers, but there is a major flaw in their research.

Refusing puberty blockers to trans young people is not justified by the evidence
The Lancet
By Damien W Riggs, Michelle Tollit, and Ashleigh Lin
September, 2021


We read with interest the Correspondences from Stella O’Malley and colleagues1 and Richard Armitage2 on the use of puberty blockers for transgender and gender diverse (trans) young people, and wish to address several of their comments, which we view as problematic.

O’Malley and colleagues1 assert that puberty blockers are “highly experimental”, and it is true that puberty blockers are not expressly licensed by relevant regulatory authorities, such as the US Food and Drug Administration and the European Medical Association, for the treatment of gender dysphoria in adolescents. However, what might be termed off-label use of medications is common in paediatrics, and the practice is not improper, illegal, or experimental.3 For example, 85% of more than 55 000 children admitted to paediatric intensive care units in the USA were treated with at least one off-label medication (the average number was 4·5), and these medications included neurological, antimicrobial, and cardiovascular drugs.4
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Moreover, there is substantive evidence demonstrating that puberty blockers have beneficial effects on emotional and behavioural problems, and Armitage—by focusing only on suicidality—“ignores decades of use of and research about puberty blockers and hormone therapy,” as the The Lancet Child & Adolescent Health's Editorial5 explicitly warned against. For example, one study compared the psychological welfare of trans adolescents who had been treated with puberty blockers to that of trans adolescents who had not yet received treatment, and reported fewer emotional and behavioural problems in the treated group.8 A study of 55 young adults who had received gender affirming medical care—including puberty blockers—as adolescents reported psychological functioning and quality of life on par with that expected of cisgender peers.9 And a 22-year follow-up of an individual who received blockers in adolescence found no net negative physiological side-effects and significant net positive psychological effects.10 Taken together, these findings, alongside many others, substantiate the position that puberty blockers are effective in “decreasing depressive symptoms and suicidality, and improving affective and psychological functioning”.11

One of the things I noticed in the studies that conservatives cite is they compare trans children who just came off of the blockers to children 5 years past puberty and the studies find difference in bone density with a child just off of of the blockers. Of course there is a difference, one child had five years for their bones to develop while the trans child is just starting to develop their bones. If you wait until the trans child is 5 years on Cross Gender Hormones therapy you see that their bones show no difference between trans children and cis-children.