Puberty blocker

Puberty blockers (also called puberty inhibitors or hormone blockers) are medicines used to postpone puberty in children. The most commonly used puberty blockers are gonadotropin-releasing hormone (GnRH) agonists, which suppress the natural production of sex hormones, such as androgens (e.g. testosterone) and estrogens (e.g. estradiol).[1][2][3] Puberty blockers are used to delay puberty in children with precocious puberty. They are also used to delay the development of unwanted secondary sex characteristics in transgender children,[4] so as to allow transgender youth more time to explore their gender identity.[5] The same drugs are also used in fertility medicine and to treat some hormone-sensitive cancers in adults.[6][7][8]

The use of puberty blockers is supported by twelve major American medical associations, including the American Medical Association,[9] the American Psychological Association,[10] and the American Academy of Pediatrics.[11] In Australia four medical organizations support them,[12] as does the Endocrine Society,[13] and the World Professional Association for Transgender Health (WPATH).[14] 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.[15]

In the 2020s, the provision of puberty blockers for gender dysphoria in children has become the subject of public controversy. A combination of shifts in public opinion, political lobbying, and rising scepticism in the field of medicine has led to the rolling back of the use of puberty blockers for transgender children in some countries, with the United Kingdom stopping the routine prescription of puberty blockers[16] and some states of the United States making their use a criminal offense.[17][18]

  1. ^ Hemat RA (2 March 2003). Andropathy. Urotext. pp. 120–. ISBN 978-1-903737-08-8.
  2. ^ Becker KL (2001). Principles and Practice of Endocrinology and Metabolism. Lippincott Williams & Wilkins. pp. 973–. ISBN 978-0-7817-1750-2.
  3. ^ "Pubertal blockers for transgender and gender diverse youth". Mayo Clinic. 16 August 2019. Archived from the original on 31 December 2022. Retrieved 15 December 2020.
  4. ^ Stevens J, Gomez-Lobo V, Pine-Twaddell E (December 2015). "Insurance Coverage of Puberty Blocker Therapies for Transgender Youth". Pediatrics. 136 (6): 1029–1031. doi:10.1542/peds.2015-2849. PMID 26527547.
  5. ^ Alegría CA (October 2016). "Gender nonconforming and transgender children/youth: Family, community, and implications for practice". Journal of the American Association of Nurse Practitioners. 28 (10): 521–527. doi:10.1002/2327-6924.12363. PMID 27031444. S2CID 22374099.
  6. ^ Helyar S, Jackson L, Patrick L, Hill A, Ion R (May 2022). "Gender Dysphoria in children and young people: The implications for clinical staff of the Bell V's Tavistock Judicial Review and Appeal Ruling". Journal of Clinical Nursing. 31 (9–10): e11–e13. doi:10.1111/jocn.16164. PMID 34888970. S2CID 245029743.
  7. ^ Watson SE, Greene A, Lewis K, Eugster EA (June 2015). "BIRD'S-EYE VIEW OF GnRH ANALOG USE IN A PEDIATRIC ENDOCRINOLOGY REFERRAL CENTER". Endocrine Practice. 21 (6): 586–589. doi:10.4158/EP14412.OR. PMC 5344188. PMID 25667370.
  8. ^ Panday K, Gona A, Humphrey MB (October 2014). "Medication-induced osteoporosis: screening and treatment strategies". Therapeutic Advances in Musculoskeletal Disease. 6 (5): 185–202. doi:10.1177/1759720X14546350. PMC 4206646. PMID 25342997.
  9. ^ "State Advocacy Update". American Medical Association. 26 March 2021. Archived from the original on 2 December 2022. Retrieved 18 May 2022.
  10. ^ "Criminalizing Gender Affirmative Care with Minors". APA. Archived from the original on 7 April 2022. Retrieved 20 June 2024.
  11. ^ Wyckoff AS. "AAP continues to support care of transgender youths as more states push restrictions". AAP. Archived from the original on 18 December 2022. Retrieved 20 June 2024.
  12. ^ Cite error: The named reference Parents of Gender Diverse Children was invoked but never defined (see the help page).
  13. ^ "Endocrine Society opposes legislative efforts to prevent access to medical care for transgender youth". Endocrine Society. 15 April 2021. Archived from the original on 23 October 2022. Retrieved 18 May 2022.
  14. ^ "USPATH Position Statement on Legislative and Executive Actions Regarding the Medical Care of Transgender Youth" (PDF). US Professional Association for Transgender Health (USPATH). 22 April 2022. Archived (PDF) from the original on 10 November 2022. Retrieved 18 May 2022.
  15. ^ Barnes H (30 May 2024). "The government's 11th-hour ban on puberty blockers". New Statesman. Archived from the original on 2 August 2024. Retrieved 20 August 2024.
  16. ^ Cite error: The named reference BBC_News_2024 was invoked but never defined (see the help page).
  17. ^ Choi A, Mullery W (6 June 2023). "19 states have laws restricting gender-affirming care, some with the possibility of a felony charge". CNN. Archived from the original on 4 August 2023. Retrieved 17 September 2023.
  18. ^ Alfonseca K (22 May 2023). "Map: Where gender-affirming care is being targeted in the US". ABC News. Archived from the original on 24 May 2023. Retrieved 14 August 2023.

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