[24] The United Kingdom has implemented a ban on prescribing puberty blockers to new patients under 18 for the treatment of gender dysphoria except for use in clinical research trials, as of May 2024.
[34] In terms of psychosocial markers, preadolescents and adolescents diagnosed with precocious puberty have shown body image concerns and demonstrated poor emotional regulation and high anxiety.
[39] Puberty blockers are sometimes prescribed to young transgender people with gender dysphoria to temporarily halt the development of secondary sex characteristics.
Another type of puberty blocker includes progestins, such as medroxyprogesterone acetate, which can be taken orally or by injection and work by reducing the body's production of sex hormones.
While many individuals experience relief from gender dysphoria, the delay in physical development might also cause anxiety or social difficulties in some cases, particularly in environments where peers are progressing through puberty.
It is crucial for healthcare providers to closely monitor the physical and emotional well-being of individuals on puberty blockers, ensuring that the benefits outweigh any short-term risks or discomforts.
[74][75][76] In 2016, the FDA ordered drugmakers to add warning labels to puberty blocker drugs that states: "Psychiatric events have been reported in patients", including symptoms "such as crying, irritability, impatience, anger and aggression."
[78] Morissa Ladinsky, a pediatrician with University of Alabama-Birmingham who works with transgender youth, said that "[Idiopathic intracranial hypertension] is an inordinately well-known side effect that can happen for many, many different medications, most commonly, oral birth control pills.
Since these medications suppress the production of sex hormones during a critical period of sexual maturation, their extended use may impact the development of reproductive organs and future fertility.
For instance, individuals assigned male at birth who take puberty blockers might experience underdeveloped testes, potentially affecting sperm production later in life.
These potential effects underscore the importance of careful, individualized medical counseling and consideration of fertility preservation options, such as sperm or egg banking, before initiating long-term puberty blocker treatment.
[107] According to pediatric endocrinology expert Brad Miller, pharmaceutical companies that make puberty blocker drugs for children with gender dysphoria have refused to submit them for FDA approval because doing so would cost too much money and "because (transgender treatment) was a political hot potato.
[116] A 2021 editorial adds a pragmatic perspective, claiming that "disproportionate emphasis is given to young people's inability to provide medical consent" and that "what matters ethically is whether an individual has a good enough reason for wanting treatment".
She claims that even in the absence of parental permission, the use of puberty blockers could mitigate any adverse effects on familial relationships within the home of a transgender child and that the psychological costs associated with untreated gender dysphoria in children are avoidable.
[125] In response to these bans, many Democrat-controlled states have gone in the opposite direction and enacted laws protecting access to gender affirming care for minors and adults.
[134] Puberty blockers in Canada: The British Columbia Infants Act of 1996 grants minors legal decision-making authority if they can consent to a clinical intervention and their healthcare provider believes it is in their best interest.
[136] A qualitative study investigating the experience of trans youth in seeking and receiving gender-affirming care at Canadian specialty clinics shows a mix of positive and negative outcomes.
[141][142][143][144][145] Access to puberty blockers for transgender youth in Australia is supported by: An independent review into gender-affirming care for minors commissioned by the New South Wales government and released in September 2024 found that puberty blockers are "safe, effective and reversible", while acknowledging that the evidence for this and other interventions "remains weak due to poor study designs, low participant numbers and single-centre recruitment", calling for more long-term research.
[146][147] According to the Canadian Pediatric Society in 2024, "Current evidence shows puberty blockers to be safe when used appropriately, and they remain an option to be considered within a wider view of the patient's mental and psychosocial health.
[154] In 2022, France's Académie Nationale de Médecine urged caution when considering puberty blockers due to potential side effects, including "impact on growth, bone weakening, [and] risk of infertility".
[154] In late 2024, the French Society of Pediatric Endocrinology and Diabetology released the country's first ever guidelines for medical care of trans youth, in which they recommended patients who have hit at least Tanner stage 2 to receive puberty blockers along with calcium and vitamin D supplements.
[159] Additionally, the use of puberty blockers in transgender youth is supported by: The Japanese Society of Psychiatry and Neurology (JSPN) published its updated guidelines in August 2024 on the treatment of gender dysphoria.
In addition to the guidelines, multiple Mexican states have modified their civil codes to recognize gender-affirming healthcare as a right for transgender people under the age of eighteen.
[164] The Dutch Ministry of Health, Welfare and Sport publishes guidelines recommending the use of puberty blockers in transgender adolescents of at least Tanner Stage II with informed consent and approval of an endocrinologist.
[173][174][154] In 2023, the Norwegian Healthcare Investigation Board, an independent non-governmental organization, issued a non-binding report finding "there is insufficient evidence for the use of puberty blockers and cross sex hormone treatments in young people" and recommending changing to a cautious approach.
[173] Sweden's Karolinska Institute, administrator of the second-largest hospital system in the country, announced in March 2021 that it would discontinue providing puberty blockers or cross-sex hormones to children under 16.
Additionally, the Karolinska Institute changed its policy to cease providing puberty blockers or cross-sex hormones to teenagers 16–18, outside of approved clinical trials.
[179][180][181] As of May 2024, prescription of puberty blockers to new patients under 18 for the treatment of gender dysphoria is banned for both private medical practices (by a law in parliament in May[182][25]) and the official state healthcare National Health Service (NHS) which stopped their use earlier, in the aftermath of the Cass Review except for use in clinical research trials.
"[197][198][199] The following day, the Health Secretary, Wes Streeting, announced in the House of Commons that the previously enacted ban on puberty blockers in England would be made indefinite and would be reviewed in 2027.
[207] To determine if you are experiencing precocious puberty and should receive treatment it is required your doctor take a medical history, physical exam, blood test, and x-rays.