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Journal articles on the topic 'Puberty blockers'

Author: Grafiati

Published: 5 June 2025

Last updated: 15 July 2025

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1

Jelsma, Tony. "On Gender, Gender Incongruence, and Gender-Affirming Care." Perspectives on Science and Christian Faith 77, no. 1 (2025): 2–25. https://doi.org/10.56315/pscf3-25jelsma.

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As the number of transgender individuals continues to rise, there is an urgent need to understand the nature of gender and the evidence supporting gender-affirming care. This article proposes the hypothesis that one’s gender is a perception, influenced by biological and social factors. Early-onset gender incongruence seems to be influenced but not wholly determined by the prenatal hormonal environment, while late-onset gender incongruence is associated with comorbidities, suggesting that one’s sense of gender can be impacted by a variety of psychological and social conditions that affect the mind-body connection. Puberty blockers have been used on children to buy time for them to decide whether to continue with their transition. However, most gender dysphoria desists at puberty, but this is prevented by puberty blockers. Moreover, puberty blockers have negative psychological and physiological consequences, and studies of puberty blockers and cross-sex hormones have not shown long-term improvements in mental health outcomes. Thus, while some gender incongruence does not resolve upon puberty and may be best treated by transitioning, the preponderance of evidence does not support a medicalized gender-affirming approach for children and adolescents.

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2

Geddes, Linda. "Puberty blockers recommended for transsexual teens." New Scientist 200, no. 2686 (2008): 8–9. http://dx.doi.org/10.1016/s0262-4079(08)63123-1.

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3

Gibelli, Filippo, Paolo Bailo, Anna Maria Caraffa, José López Guzmán, and Giovanna Ricci. "Medico-legal and bioethical controversies of the use of puberty blockers in adolescents with gender dysphoria: a comparative perspective between Italy and Spain." Medicina e Morale 73, no. 2 (2024): 149–76. http://dx.doi.org/10.4081/mem.2024.1294.

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Background: the administration of puberty blockers to adolescents with gender dysphoria has ignited significant bioethical controversy, especially in light of recent legislative changes in the United States, Australia and several European states, especially the UK, which in March 2024 permanently banned the administration of puberty blockers to children. Italy and Spain, with their distinct legal, cultural, and medical approaches to treating gender dysphoria in minors, serve as focal points for examining these complex issues. Aims: this article aims to explore the bioethical and medico-legal implications of using puberty blockers in adolescents with gender dysphoria, focusing on the regulatory frameworks in Italy and Spain. It seeks to contribute to the international dialogue on best practices for supporting adolescents with gender dysphoria by comparing these two countries’ approaches. Discussion: in recent years in many European states there has been an important evolution in the position on hormone blockade therapy for minors with gender dysphoria, having gone from open policies on puberty blockade treatment to decidedly more restrictive positions. In Italy, the debate on the legitimacy of authorising treatment has been lively for several years, and in the last year has become even more intense due to the decisions taken by countries such as Finland, Sweden, Norway and the United Kingdom. In Spain, a landmark law on trans rights was passed in 2023, but it did not directly regulate hormone-blocking treatment in adolescents with gender dysphoria, which only made an already intense debate even more heated. Conclusion: it is essential to recognise the complexity of gender identity in adolescents and adopt an inclusive approach that considers medical, legal, ethical and social implications. The dynamic nature of the debate on the use of puberty blockers requires ongoing international dialogue. Policy analysis from Italy and Spain can inform best practice globally, promoting inclusive guidelines that prioritise adolescent welfare by addressing the complex bioethical, medico-legal and scientific issues related to the use of puberty blockers.

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4

Adedeji, Olufunso. "After the Cass Report, what now for puberty blockers?" Journal of Global Medicine 4, no. 1 (2024): e243. http://dx.doi.org/10.51496/jogm.v4.243.

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5

Biggs, Michael. "Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria." Archives of Sexual Behavior 49, no. 7 (2020): 2227–29. http://dx.doi.org/10.1007/s10508-020-01743-6.

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6

Jorgensen, Sarah C. J., Patrick K. Hunter, Lori Regenstreif, Joanne Sinai, and William J. Malone. "Puberty blockers for gender dysphoric youth: A lack of sound science." JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 5, no. 9 (2022): 1005–7. http://dx.doi.org/10.1002/jac5.1691.

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7

Malone, William, Roberto D’Angelo, Stephen Beck, Julia Mason, and Marcus Evans. "Puberty blockers for gender dysphoria: the science is far from settled." Lancet Child & Adolescent Health 5, no. 9 (2021): e33-e34. http://dx.doi.org/10.1016/s2352-4642(21)00235-2.

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8

Biggs, Michael. "Correction to: Puberty Blockers and Suicidality in Adolescents Suffering from Gender Dysphoria." Archives of Sexual Behavior 50, no. 4 (2021): 1845. http://dx.doi.org/10.1007/s10508-021-02056-y.

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9

Ashley, Florence. "Watchful Waiting Doesn’t Mean No Puberty Blockers, and Moving Beyond Watchful Waiting." American Journal of Bioethics 19, no. 6 (2019): W3—W4. http://dx.doi.org/10.1080/15265161.2019.1599466.

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10

Riggs, Damien W., Michelle Tollit, and Ashleigh Lin. "Refusing puberty blockers to trans young people is not justified by the evidence." Lancet Child & Adolescent Health 5, no. 9 (2021): e35-e36. http://dx.doi.org/10.1016/s2352-4642(21)00233-9.

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11

Richards, Christopher, Julie Maxwell, and Noel McCune. "Use of puberty blockers for gender dysphoria: a momentous step in the dark." Archives of Disease in Childhood 104, no. 6 (2019): 611–12. http://dx.doi.org/10.1136/archdischild-2018-315881.

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12

Knopf, Alison. "Most teens satisfied with gender‐affirming care." Brown University Child & Adolescent Psychopharmacology Update 26, no. 12 (2024): 5–6. http://dx.doi.org/10.1002/cpu30921.

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Gender‐affirming medical care includes puberty blockers, gender‐affirming hormones, and/or surgery, and is an important part of health care for transgender and nonbinary minors, according to the American Academy of Pediatrics and others. The interventions are associated with improvements in anxiety, depression, and body image. However, less is known about how satisfied or regretful the youth are about receiving such care when they were minors. There are reports that some individuals regret the care they received, creating complications for researchers and clinicians.

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13

MARTINS, Cassius Assunção. "A LITERARY REVIEW OF HORMONAL INHIBITORS TREATMENT IN GENDER-INCONGRUENT CHILDREN AND ADOLESCENTS." Boletim de Conjuntura (BOCA) 9, no. 25 (2022): 62–69. https://doi.org/10.5281/zenodo.5813252.

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<strong>Objective</strong>: to debate the impacts that current evidence may have on the use of hormonal blockers in minors diagnosed with Gender Incongruence. <strong>Data Source:</strong> a systematic review of the literature on “Gender Dysphoria” was carried out between 1961 to 2013, consisting of 11 journals taken from the PubMed digital repository, two literary sources and a dissertation. The method of analysis adopted was hypothetical-deductive and the systematic review, meta-analyses. <strong>Data Summary:</strong> it was found from a sample of 511 children and adolescents, for 52 years, only 98 (19%) persisted with dysphoric symptoms in adulthood without the administration of puberty blockers, while those based on hormonal suppression had a 100% rate. <strong>Discussion:</strong> the hormonal inhibitors administering by GNHRa may theoretically be inducing the persistence of gender incongruence and its long-term effects are unknown to science. Since there is no scientific consensus on the product in children and adolescents.

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Mills, Alex R., Kevin Astle, and Cheyenne C. Frazier. "A response to puberty blockers for gender dysphoric youth: A lack of sound science." JACCP: JOURNAL OF THE AMERICAN COLLEGE OF CLINICAL PHARMACY 5, no. 9 (2022): 1008–10. http://dx.doi.org/10.1002/jac5.1690.

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15

Lopez, Carla Marisa, Daniel Solomon, Susan D. Boulware, and Emily R. Christison-Lagay. "Trends in the use of puberty blockers among transgender children in the United States." Journal of Pediatric Endocrinology and Metabolism 31, no. 6 (2018): 665–70. http://dx.doi.org/10.1515/jpem-2018-0048.

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Abstract Background: The objective of the study was to identify national trends in the utilization of histrelin acetate implants among transgender children in the United States. Methods: We analyzed demographic, diagnostic and treatment data from 2004 to 2016 on the use of histrelin acetate reported to the Pediatric Health Information System (PHIS) to determine the temporal trends in its use for transgender-related billing diagnoses, e.g. “gender identity disorder”. Demographic and payer status data on this patient population were also collected. Results: Between 2004 and 2016, the annual number of implants placed for a transgender-related diagnosis increased from 0 to 63. The average age for placement was 14 years. Compared to natal females, natal males were more likely to receive implants (57 vs. 46) and more likely to have implants placed at an older age (62% of natal males vs. 50% of natal females were ≥;13 years; p<0.04). The majority of children were White non-Hispanic (White: 60, minority: 21). When compared to the distribution of patients treated for precocious puberty (White: 1428, minority: 1421), White non-Hispanic patients were more likely to be treated with a histrelin acetate implant for a transgender-related diagnosis than minority patients (p<0.001). This disparity was present even among minority patients with commercial insurance (p<0.001). Conclusions: Utilization of histrelin acetate implants among transgender children has increased dramatically. Compared to natal females, natal males are more likely to receive implants and also more likely to receive implants at an older age. Treated transgender patients are more likely to be White when compared to the larger cohort of patients being treated with histrelin acetate for central precocious puberty (CPP), thus identifying a potential racial disparity in access to medically appropriate transgender care.

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16

Coleman, Doriane Lambelet. "Transgender Children, Puberty Blockers, and the Law: Solutions to the Problem of Dissenting Parents." American Journal of Bioethics 19, no. 2 (2019): 82–84. http://dx.doi.org/10.1080/15265161.2018.1557297.

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17

Pyne, Jake. "Arresting Ashley X: Trans Youth, Puberty Blockers and the Question of Whether Time is on Your Side." Somatechnics 7, no. 1 (2017): 95–123. http://dx.doi.org/10.3366/soma.2017.0208.

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In 2004, a young Seattle girl with significant disabilities known only by the pseudonym Ashley X, underwent a series of medical procedures without her consent. At the request of her parents, Ashley received a mastectomy, a hysterectomy and hormonal treatment, designed to arrest her development in a child-like state. In the eyes of her doctors, her family, and their lawyers, it was urgent that Ashley's body be aligned with her purported cognitive age. The temporal and ethical arguments used to justify her ‘Treatment’ turned Ashley's body into a site of international debate over disability and human rights, consent and medical science, eugenics and human engineering. Yet the similarities and differences between Ashley's non-consensual pubertal arrest versus that actively sought by trans youth are rarely mentioned. This paper uses the clinical and media discourses at work in both the ‘Ashley Treatment’ and the treatment sought by trans youth to think through this moment in which some bodies are treated to greater forms of autonomy while other bodies have none. I argue that the discourses used to secure transition for some trans youth ought to be weighed against the implications for others, in particular for trans youth with disabilities. While the availability of puberty suppression for trans youth can be narrated as a sign that things are getting better, the literatures of queer temporality and critical disability studies help to consider that it may also augur something else—a widening gap between those invested with the ability to stop time versus those who are stopped in time.

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18

Margasiński, Andrzej, and Agnieszka Marianowicz-Szczygieł. "„The Gender Reassignment” Controversy - Between Affirmation and Kind Restraining." Kwartalnik Naukowy Fides et Ratio 57, no. 1 (2024): 31–47. http://dx.doi.org/10.34766/fetr.v57i1.1254.

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The review article presents the phenomenon of transsexualism through the prism of the etiology, scale and dynamics of the phenomenon as well as the most controversial social consequences concerning "sex change" and the acceptance or non-acceptance of voluntary personal forms adopted by children and adolescents. Review of contemporary literature, analysis of positions on the issues of the so-called gender changes (gender reassignment, gender matching). The text shows the evolution of understanding of gender identity disorders in the ICD-10 and DSM-5 classifications as well as the controversy related to the tendencies depathologizing gender inconsistency in the ICD-11. Looking at the etiological issues we present an attempt of in-depth psychological analyzes as opposed to the dominant, reductive medical approach. In the text, we also recall the basic developmental regularities of children and adolescents, often overlooked in discussions on transsexualism. The basic developmental regularities of children and adolescents, often overlooked in discussions on transsexualism, were also reminded. As the review of the data shows the rapid increase in gender identity disorders in recent years, their pronunciation leads to emphasizing the growing role of pop culture influences on young people. There is also a lack of research on the use of puberty blockers in children/adolescents - their introduction appears to be an experiment with, in fact, unknown consequences. The analysis of developmental regularities, the transience of dysphoric tendencies and the lack of reliable scientific data on the use of puberty blockers and the consequences of taking hormones of the opposite sex lead to the conclusion that accepting voluntary personal forms proposed by children/teenagers is premature.

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19

Dunne, Peter. "CHILDHOOD IN TRANSITION: CAN TRANSGENDER AND NON-BINARY MINORS PROVIDE LAWFUL CONSENT TO PUBERTY BLOCKERS?" Cambridge Law Journal 80, no. 1 (2021): 15–18. http://dx.doi.org/10.1017/s0008197321000179.

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20

Miah, Faria, Caroline Brereton, Erin Kelley, and Kathryn Eckert. "ODP619 Trends in Obesity in Gender Diverse Adolescents in Northern Nevada." Journal of the Endocrine Society 6, Supplement_1 (2022): A609. http://dx.doi.org/10.1210/jendso/bvac150.1264.

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Abstract Obesity in the pediatric population is increasing with 19.3% of adolescents having a body mass index (BMI) at or above 95th percentile. Childhood obesity impacts physical and psychological health, increasing the risk of developing various diseases. Studies show that prevalence of gender diverse (GD) adolescents is increasing and is estimated to be 7 per 1000 in the US. GD adolescents are at increased risk for cardiovascular disease and mental health disorders. GD adolescents who are diagnosed with obesity are at an increased risk for poor health outcomes. There is a lack of research regarding the prevalence of obesity and the impact of hormone therapy in GD adolescents. A retrospective chart review was conducted at Renown Regional Medical Center in Reno, NV. A total of 119 adolescents, aged 8-21, diagnosed with gender dysphoria prior to June 2021, were enrolled using ICD-10 codes. Patient demographics including age, sex assigned at birth, gender identity, BMI, and use of puberty blockers or hormone therapy were retrieved. Patients were categorized into two groups - no treatment and treatment with puberty blockers and/or testosterone. Average change in BMI was calculated. Fisher exact tests were conducted using SAS version 9.4. Nineteen of the 119 GD patients enrolled were classified as obese using age and sex appropriate BMI charts (15.9%). Thirteen participants were assigned female at birth (AFAB) and six were assigned male at birth (AMAB). Of these participants, 12 had no medical interventions and 7 were treated with puberty blockers and/or without testosterone. No participants received estrogen therapy. The average change in BMI was +1.84 (no treatment group) and + 3.70 (treatment group). The average change in BMI for AFAB participants was +2.24 and +3.16 for AMAB participants. Association of obesity with treatment compared to no treatment was not found to be statistically significant (p=0.4125). The prevalence of obesity in this population was similar to the prevalence of obesity in non-GD adolescents regionally. In Nevada, obesity in adolescents age 10-17 increased from 12.9% to 16% from 2018-2021. We expected to observe a higher prevalence of obesity in the adolescent GD population compared to the non-GD pediatric population. Additionally, we expected to see a greater increase in BMI in the group of GD patients receiving treatment. Although the results were not statistically significant, patients undergoing treatments did experience a greater average increase in BMI compared to those who had no medical intervention. The lack of statistical significance is likely due to having a small sample size. Further research is needed to observe obesity trends in adolescent GD populations, as well as the effects of hormone therapy on BMI. Presentation: Saturday, June 11, 2022 1:00 p.m. - 3:00 p.m.

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Ashley, Florence. "Thinking an ethics of gender exploration: Against delaying transition for transgender and gender creative youth." Clinical Child Psychology and Psychiatry 24, no. 2 (2019): 223–36. http://dx.doi.org/10.1177/1359104519836462.

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Youth explore their genders – both theirs and those of others. Exploration is not only a vessel of discovery and understanding but also of creation. Centring the notion of gender exploration, this article inquires into the ethical issues surrounding care for transgender youth. Arguing that exploration is best seen not as a precondition to transition-related care but as a process that can operate through transitioning, the article concludes that the gender-affirmative approach to trans youth care best fosters youth’s capacity for healthy exploration. Unbounded social transition and ready access to puberty blockers ought to be treated as the default option, and support should be offered to parents who may have difficulty accepting their youth.

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22

Ashley, Florence. "Puberty Blockers Are Necessary, but They Don’t Prevent Homelessness: Caring for Transgender Youth by Supporting Unsupportive Parents." American Journal of Bioethics 19, no. 2 (2019): 87–89. http://dx.doi.org/10.1080/15265161.2018.1557277.

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23

Hero, M., S. Maury, E. Luotoniemi, E. Service, and L. Dunkel. "Cognitive effects of aromatase inhibitor therapy in peripubertal boys." European Journal of Endocrinology 163, no. 1 (2010): 149–55. http://dx.doi.org/10.1530/eje-10-0040.

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ObjectiveAromatase inhibitors, blockers of oestrogen biosynthesis, have emerged as a new potential treatment modality for boys with short stature. The cognitive effects of such therapy are unknown. In this study, we explored the effects of aromatase inhibition on cognitive performance in peripubertal boys.DesignProspective, double-blind, randomised, placebo-controlled clinical study.MethodsTwenty-eight boys, aged 9.0–14.5 years, with idiopathic short stature were treated with the aromatase inhibitor letrozole (2.5 mg/day) or placebo, for 2 years. During the treatment, the progression of physical signs of puberty and the concentrations of sex hormones were followed up. A selection of cognitive tests, focusing on memory function, was administered to the participants at entry, at 12 months and at 24 months after the start of the treatment.ResultsLetrozole effectively inhibited the conversion of androgen to oestrogen, as indicated by high serum testosterone and low serum oestradiol concentrations in letrozole-treated boys who progressed into puberty. In both the groups, there was a gain in performance during the follow-up period in tests of verbal performance, in most of the tests of visuospatial performance and in some tests of verbal memory. No significant differences between the letrozole- and placebo-treated boys in development of cognitive performance were found in any of the tests during the follow-up period.ConclusionsOur results suggest that blockade of oestrogen biosynthesis with an aromatase inhibitor does not influence cognitive performance in peripubertal males.

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Pilgrim, David, and Kirsty Entwistle. "GnRHa (‘Puberty Blockers’) and Cross Sex Hormones for Children and Adolescents: Informed Consent, Personhood and Freedom of Expression." New Bioethics 26, no. 3 (2020): 224–37. http://dx.doi.org/10.1080/20502877.2020.1796257.

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25

Brown, Nick. "Correspondence, update and clarification on ‘Puberty blockers in gender dysphoria: an international perspective’ by Barbi L, Tornese G." Archives of Disease in Childhood 107, no. 12 (2022): e32-e32. http://dx.doi.org/10.1136/archdischild-2022-325109.

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26

Shepard, Charles F., Darius A. Green, Karli M. Fleitas, and Debbie C. Sturm. "Informing Consent: A Grounded Theory Study of Parents of Transgender and Gender-Diverse Youth Seeking Gender-Confirming Endocrinological Interventions." Professional Counselor 11, no. 4 (2021): 440–58. http://dx.doi.org/10.15241/cfs.11.4.440.

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This qualitative grounded theory study is the first of its kind aimed at understanding the decision-making process of parents and guardians of transgender and gender-diverse (TGD) youth providing informed consent for their children to undergo gender-confirming endocrinological interventions (GCEI), such as hormone replacement therapy and puberty blockers. Using primarily intensive interviews supported by observational field notes and document review, this study examined the decision-making processes of a national sample of participants who identified as a parent or legal guardian of at least one TGD youth and who have given informed consent for the youth in their care to undergo GCEI. A variety of inhibiting and contributing factors were illuminated as well as a “dissonance-to-consonance” model that participants used to combine contributing factors to overcome inhibitors and grant informed consent. Implications for professional counseling practitioners are discussed, including guidance for direct services, gatekeeping, case management, and advocacy functions.

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Bhattacharya, Dr Maumita, Dr Surajit Bose, Dr Subhalakshmi Sen, Avinandan Dey, Bidushi Roy, and Aditi Bahal. "Gingival Hyperplasia - A Multifaceted Enigma." IOSR Journal of Dental and Medical Sciences 23, no. 10 (2024): 16–24. http://dx.doi.org/10.9790/0853-2310061624.

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Gingival hyperplasia or, gingival enlargement has become an increasing concern due to a number of factors prevalence whether it be an inflammatory enlargement or a drug induced enlargement; hyperplasia associated with conditions like pregnancy, puberty, vitamin C deficiency or systemic diseases like leukaemia, sarcoidosis and Wegener granulomatosis; whether it be a neoplasm addressed as “gingival tumours” or a false gingival hyperplasia. All these entities and conditions seriously impose a massive effect on the gingival tissue. Drug induced gingival overgrowth occurs due to adverse effects of drug reactions or adverse drug reaction (ADR), it occurs specifically in patients who are under the influence of immunosuppressives, calcium channel blockers, anticonvulsants, cyclosporine, phenytoin, etc. As the growth of the gingiva occurs patient complains of pain which affects many other functions like masticatory functions and also disfigures the condition of the gingiva. Among many people it is a cause of concern and other unwanted effects. Here we discuss a case that demonstrates the effect of amlodipine on gingival tissues.[3]

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Moscati, M. F. "Trans* identity does not limit children’s capacity: Gillick competence applies to decisions concerning access to puberty blockers too!" Journal of Social Welfare and Family Law 44, no. 1 (2022): 130–32. http://dx.doi.org/10.1080/09649069.2022.2028410.

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29

Gorin, Moti. "What Is the Aim of PEDIATRIC “Gender‐Affirming” Care?" Hastings Center Report 54, no. 3 (2024): 35–50. http://dx.doi.org/10.1002/hast.1583.

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AbstractThe original “Dutch Protocol”—the treatment model comprised of puberty blockers, cross‐sex hormones, and surgery—was intended to improve the mental and physical health of pediatric patients experiencing distress over their sexed bodies. Consequently, both researchers and clinicians have couched eligibility for treatment and measures of treatment efficacy in terms of the interventions’ effects on outcomes such as gender dysphoria, depression, anxiety, and suicide. However, recent systematic reviews have concluded that the scientific evidence supporting these interventions is uncertain, leading to significant international differences in what treatments are offered to youth. Against this backdrop, a different argumentative approach has emerged in support of gender‐affirming care. This approach appeals not to reductions in patient morbidity or mortality but to patient autonomy, where medical intervention is pursued as a means to the satisfaction of a patient's “embodiment goals.” In this article, I raise objections to autonomy‐based justifications for pediatric gender‐affirming care, concluding that these arguments misunderstand the place of autonomy in clinical decision‐making and, consequently, put patients at risk of medical harm.

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Brickman, Barbara Jane. "Guest Editorial." Girlhood Studies 12, no. 1 (2019): vi—xv. http://dx.doi.org/10.3167/ghs.2019.120102.

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In their new groundbreaking study reviewed in this special issue, The Trans Generation: How Trans Kids (and Their Parents) are Creating a Gender Revolution (2018), sociologist Ann Travers details the experiences of transgender children in the US and Canada, some as young as four years of age, who participated in research interviews over a five-year period. Establishing a unique picture of what it means to grow up as a trans child, Travers offers numerous examples of daily life and challenges for children like, for example, Martine and Esme, both of whom sought to determine their own gender at an early age: Martine and her family recount how at the age of seven she responded to her upcoming appointment at a gender clinic by asking if the doctor would have “the machine where you walk in as a boy and walk out as a girl,” while Esme’s story begins in preschool and leads to the care of a “trans-affirmative doctor” (168) from the age of six and the promise of hormone blockers and estrogen at the onset of puberty. Although Travers’s work is devoted to and advocates for trans children as a whole, its implications for our understanding of and research into girls and girlhood cannot be understated. What does it mean to “walk out” of that machine in the doctor’s office “as a girl?” What happens when you displace the seemingly monumental onset of puberty from its previous biological imperatives and reproductive futures? How might feminist work on girlhoods, which has sought to challenge sexual and gender binaries for so long, approach an encounter with what Travers calls “binary-conforming” or “binary-identifying” (169) trans girls or with the transgender boys in their study who, at first, respond to the conforming pressures of adolescence very similarly to cisgender girls who will not ultimately transition away from a female identity?

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Gelly, Morgane Audrey, and Annie Pullen Sansfaçon. "Regards croisés de jeunes trans et de leurs parents sur la transition médicale au Canada : quel impact sur l’épanouissement des jeunes?" Revue Jeunes et Société 6, no. 1 (2022): 104–27. http://dx.doi.org/10.7202/1087101ar.

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The past decade has witnessed significant change in medical care for trans youth. A well-established pathologizing approach focused on asserting a young person’s assigned gender has been challenged by a growing number of experts who favour a model that supports gender exploration (e.g., by providing access to hormonal treatments and puberty blockers). Based on interviews with 36 parent-youth dyads (72 interviews in total), this article explores the expectations and impacts associated with medical transition. On the one hand, the interview data show that young people and their parents agree that access to trans-affirmative medical care has a positive impact on youth development. Specifically, it is seen to reduce suffering associated with gender dysphoria, while promoting both self-recognition and intersubjectivity. On the other hand, the interview data highlight the extent to which available health care pathways (often based on a binary approach) have failed to keep pace with the expectations and concerns of youth and their parents. Our article therefore emphasizes the importance of offering transaffirmative care adapted to the needs of youth seeking to transition.

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Taqwa, Muhamad Dzadit, Venitta Yuubina, and Stephen Joy Herald Manurung. "Gender-Affirming Treatments to Children with Gender Dysphoria." Journal of Southeast Asian Human Rights 8, no. 1 (2024): 143. http://dx.doi.org/10.19184/jseahr.v8i1.43469.

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Gender dysphoria occurs not only in adults but also in underage children. Their inner conviction that their gender identity does not align with their physical body leads to a desire to alter their physical appearance through gender-affirming treatment(s) that affirm their gender identity. Examples include genitoplasty, puberty blockers, and cross-sex hormone therapies. Proponents argue that these desires should be accommodated because everyone, including children, has the right to determine what can be done to their own bodies. Moreover, some findings suggest that such treatments can have positive psychological benefits for these children. On the other hand, opponents question whether the consent given by children who desire such treatments is legitimate. Additionally, providing irreversible medical treatments solely to affirm gender identity can have physiological and psychological impacts. Thus, instead of affirming the desires of these children, medical physicians should focus on saving them from irreversible medical actions. This discourse is conducted by considering proportionally the constitutional rights of children, which need to be balanced with ensuring their knowledge and maturity in making decisions. Keywords: Children, Gender Dysphoria, Gender-affirming Treatments, Constitutional Rights

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Giovanardi, G., P. Morales, M. Mirabella, et al. "Transition memories: experiences of trans adult women with hormone therapy and their beliefs on the usage of hormone blockers to suppress puberty." Journal of Endocrinological Investigation 42, no. 10 (2019): 1231–40. http://dx.doi.org/10.1007/s40618-019-01045-2.

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Lange, Magdalena, Karin Hartmann, Melody C. Carter, et al. "Molecular Background, Clinical Features and Management of Pediatric Mastocytosis: Status 2021." International Journal of Molecular Sciences 22, no. 5 (2021): 2586. http://dx.doi.org/10.3390/ijms22052586.

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Pediatric mastocytosis is a heterogeneous disease characterized by accumulation of mast cells in the skin and less frequently in other organs. Somatic or germline mutations in the KIT proto-oncogene are detected in most patients. Cutaneous mastocytosis is the most common form of the disease in children. In the majority of cases, skin lesions regress spontaneously around puberty. However, in few patients, mastocytosis is not a self-limiting disease, but persists into adulthood and can show signs of systemic involvement, especially when skin lesions are small-sized and monomorphic. Children with mastocytosis often suffer from mast cell mediator-related symptoms. Severe hypersensitivity reactions can also occur, mostly in patients with extensive skin lesions and blistering. In a substantial number of these cases, the triggering factor of anaphylaxis remains unidentified. Management of pediatric mastocytosis is mainly based on strict avoidance of triggers, treatment with H1 and H2 histamine receptor blockers, and equipment of patients and their families with epinephrine auto-injectors for use in severe anaphylactic reactions. Advanced systemic mastocytosis occurs occasionally. All children with mastocytosis require follow-up examinations. A bone marrow investigation is performed when advanced systemic mastocytosis is suspected and has an impact on therapy or when cutaneous disease persists into adulthood.

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Pullen Sansfaçon, Annie, Julia Temple Newhook, Laura Douglas, et al. "Experiences and Stressors of Parents of Trans and Gender-Diverse Youth in Clinical Care from Trans Youth CAN!" Health & Social Work 47, no. 2 (2022): 92–101. http://dx.doi.org/10.1093/hsw/hlac003.

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Abstract Parents of trans and gender-diverse youth can experience challenges navigating gender-affirming (GA) care such as stigma, transphobia, and lack of support. There is little information available about stressors, worries, and positive feelings of parents as they try to support their youth accessing GA care. This article presents baseline survey data on experiences and stressors of 160 parents/caregivers in the Trans Youth CAN! cohort study, which examined medical, social, and family outcomes in youth age 16 years or younger considering puberty blockers or GA hormones. Data were collected at 10 Canadian gender clinics. Authors report on participating parents’ characteristics, levels of support toward youth, stressors, worries, concerns, and positive feelings related to youth’s gender. Most parent participants were White (85.1 percent), female (85.1 percent), birth or adoptive parents (96.1 percent), and reported strong support for youth’s gender. Participants’ concerns included their youth facing rejection (81.9 percent), generalized transphobia (74.6 percent), or encountering violence (76.4 percent). Parents also reported positive feelings about seeing their youth grow more confident. Most parental worries and stressors were situated outside the family, reflecting the systemic discrimination faced by youth and their families. Social workers could address these by developing systems-focused interventions and by further taking into account intersectional health disparities.

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Beattie, Cameron. "High court should not restrict access to puberty blockers for minors." Journal of Medical Ethics, February 16, 2021, medethics—2020–107055. http://dx.doi.org/10.1136/medethics-2020-107055.

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Gender dysphoria (GD) is a clinically significant incongruence between expressed gender and assigned gender, with rapidly growing prevalence among children. The UK High Court recently conducted a judicial review regarding the service provision at a youth-focussed gender identity clinic in Tavistock. The high court adjudged it ‘highly unlikely’ that under-13s, and ‘doubtful’ that 14–15 years old, can be competent to consent to puberty blocker therapy for GD. They based their reasoning on the limited evidence regarding efficacy, the likelihood of progressing to cross-sex hormone therapy and the ‘life-changing consequences’ of puberty blockers. In this article, I offer two concurrent arguments to dispute their reasoning. First, I argue that minors can be competent to consent to puberty blockers for GD, because the decision to undergo puberty blocker therapy is no more complex or far-reaching than other medical decisions that we accept a child should be able to make. Second, I argue that—irrespective of competence—such legal restriction for all children fundamentally contradicts the central ethical tenet of child healthcare: best interests. For these two reasons, the high court should not restrict access to puberty blockers for competent GD children.

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Baxendale, Sallie. "The impact of suppressing puberty on neuropsychological function: A review." Acta Paediatrica, February 9, 2024. http://dx.doi.org/10.1111/apa.17150.

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AbstractAimConcerns have been raised regarding the impact of medications that interrupt puberty, given the magnitude and complexity of changes that occur in brain function and structure during this sensitive window of neurodevelopment. This review examines the literature on the impact of pubertal suppression on cognitive and behavioural function in animals and humans.MethodsAll studies reporting cognitive impacts of treatment with GnRH agonists/antagonists for pubertal suppression in animals or humans were sought via a systematic search strategy across the PubMed, Embase, Web of Science and PsycINFO databases.ResultsSixteen studies were identified. In mammals, the neuropsychological impacts of puberty blockers are complex and often sex specific (n = 11 studies). There is no evidence that cognitive effects are fully reversible following discontinuation of treatment. No human studies have systematically explored the impact of these treatments on neuropsychological function with an adequate baseline and follow‐up. There is some evidence of a detrimental impact of pubertal suppression on IQ in children.ConclusionCritical questions remain unanswered regarding the nature, extent and permanence of any arrested development of cognitive function associated with puberty blockers. The impact of puberal suppression on measures of neuropsychological function is an urgent research priority.

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Isabelle, van der Meulen, van der Miesen Anna, Hannema Sabine, and de Vries Annelou. "(198) THE EFFECT OF PUBERTY SUPPRESSION ON SEXUAL FUNCTIONING IN TRANSWOMEN AFTER GENDER AFFIRMATIVE SURGERY." Journal of Sexual Medicine 20, Supplement_4 (2023). http://dx.doi.org/10.1093/jsxmed/qdad062.090.

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Abstract Objectives To improve informed and evidence based care for transgender adolescents by gaining insight into the long-term effects on sexual development and functioning of early treatment with puberty suppression in transgender adolescents. This is the first study to specifically evaluate postoperative sexual function in transgender women who have not gone through endogenous pubertal development, with a special focus to their ability to orgasm. Methods A questionnaire on sexual experiences was used approximately one year after genital gender affirmative surgery. We then compared the answers of transwomen that were treated with puberty suppression in early puberty (Tanner stage 2 or 3), with those that were treated with puberty suppression in late puberty (Tanner Stage 4 or 5), under more with the use of Pearson ChiSquare tests. Results 37 transwomen that received gender affirmative treatment, consisting of puberty suppression, cross-sex hormones and vaginoplasty, were included. Of all transwomen, 76% was able to reach an orgasm after vaginoplasty. Of the transwomen that were treated with puberty blockers early in puberty, 81% was able to experience an orgasm postsurgery. When looking at the ability to reach an orgasm after vaginoplasty, we found that there was no difference (p=0,278) between those that were treated with puberty blockers in early versus those that were treated in late puberty. Of the transwomen who did not experience an orgasm before surgery, 75% was able to reach one after. Approximately half to three quarters of the transwoman experienced sexual difficulties when having sexual intercourse. Conclusions Both transwomen treated with early and late puberty suppression are equally able to experience an orgasm after vaginoplasty. Likewise, it is not necessary to experience desire, arousal or orgasms presurgery to be able to experience these postsurgery. The majority of transwomen sometimes experience some difficulties in their sex life, but this is not dependent on the puberty stage they started blockers in. Conflicts of Interest We have no conflicts of interest to disclose.

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Latham, Antony. "Puberty Blockers for Children: Can They Consent?" New Bioethics, June 27, 2022, 1–24. http://dx.doi.org/10.1080/20502877.2022.2088048.

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Horton, Cal. "“I Didn’t Want Him to Disappear” Parental Decision-Making on Access to Puberty Blockers for Trans Early Adolescents." Journal of Early Adolescence, June 4, 2022, 027243162211070. http://dx.doi.org/10.1177/02724316221107076.

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Puberty can be a particularly challenging time for adolescents who are transgender. Access to puberty blocking medication, commonly called ‘puberty blockers', is considered an integral component of gender affirmative healthcare. Existing literature provides little insight into how parents of trans children entering into early adolescence navigate decision-making related to puberty blockers. This unique research examines parental perspectives on medical decision-making from a cohort of families with trans children who socially transitioned pre-adolescence (average age 7), and who at time of parental interview were in or approaching, early adolescence (average age 11). Data were analysed through inductive reflexive thematic analysis. Parental reflections are presented within three main themes, concern for protection of adolescent mental health and well-being, parental perspectives on adolescent consent, and managing decision-making without certainty. These findings hold relevance for healthcare policy makers, for parents of trans children, and for healthcare, social services and other professionals supporting trans adolescents and their families.

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Lee, Janet Y. "Puberty Assessment and Consideration of Gonadotropin-Releasing Hormone Agonists in Transgender and Gender-Diverse Youth." Pediatric Annals 52, no. 12 (2023). http://dx.doi.org/10.3928/19382359-20231016-03.

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Transgender and gender-diverse (TGD) youth may pursue gender-affirming medical therapy in the form of gonadotropin-releasing hormone analogues (GnRHa), or “puberty blockers,” if pubertal changes result in the development or worsening of gender dysphoria. GnRHa monotherapy can allow TGD youth to explore gender without the distress of unwanted secondary sexual characteristics. However, given the potential effects of GnRHa on growth, skeletal development, neurodevelopment, fertility, and future surgical outcomes, it is critical to accurately assess pubertal status to facilitate fully informed conversations with TGD youth and families about risks, benefits, and unknown consequences of GnRHa monotherapy. The focus of this discussion will be on the approach to puberty assessment in TGD youth as well as the different effects of GnRHa monotherapy that may be important to TGD youth and their families. [ Pediatr Ann . 2023;52(12):e462–e466.]

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Thornton, Jacqui. "Court upholds Gillick competence in puberty blockers case." Lancet, September 2021. http://dx.doi.org/10.1016/s0140-6736(21)02136-x.

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Barbi, Ludovica, and Gianluca Tornese. "Puberty blockers in gender dysphoria: an international perspective." Archives of Disease in Childhood, July 27, 2021, archdischild—2021–321960. http://dx.doi.org/10.1136/archdischild-2021-321960.

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Olson, Kristina R., G. F. Raber, and Natalie M. Gallagher. "Levels of Satisfaction and Regret With Gender-Affirming Medical Care in Adolescence." JAMA Pediatrics, October 21, 2024. http://dx.doi.org/10.1001/jamapediatrics.2024.4527.

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ImportanceThere is a need to improve the evidence base for gender-affirming medical care provided to adolescents, including the experiences of those who have received this care.ObjectiveTo examine rates of satisfaction, regret, and continuity of care in adolescents who received puberty blockers and/or gender-affirming hormones as part of gender-affirming medical care.Design, Setting, and ParticipantsThis survey study used the 2023 online survey wave of an ongoing longitudinal study, the Trans Youth Project, among a community-based sample of transgender youth and their parents initially recruited throughout the US and Canada between 2013 and 2017. The satisfaction and regret data include responses from a youth or their parent representing 87% of the youth aged 12 years or older in the cohort who have received gender-affirming medical care (235 of 269 youths). Of these, 220 completed the 2023 survey (main sample); information about continuity of care was available for all youth. Data analysis was performed from April to August 2024.ExposureSatisfaction, regret, and continuity of care following puberty blockers or suppression and/or gender-affirming hormones.Main Outcomes and MeasuresSelf- or parent-reported satisfaction or regret with gender-affirming care and continuation of care.ResultsAmong the 220 youths in the main sample (mean [SD] age, 16.07 [2.40] years; 30 [14%] multiracial, non-Hispanic; 18 [8%] White, Hispanic; 155 [70%] White, non-Hispanic; 17 [8%] other race and ethnicity, including Asian, Black [Hispanic and non-Hispanic], Hispanic with unknown race, multiracial Hispanic, or Native American; gender at last interaction: 68 [31%] boys, 132 [60%] girls, 20 [9%] gender diverse, eg, nonbinary) and their parents, very high levels of satisfaction and low levels of regret with puberty blockers and gender-affirming hormones as well as high levels of continuation of care were reported. Of these 220 respondents in the main sample, 9 were regretful of having received blockers (n = 8) and/or hormones (n = 3; 2 of these individuals reported regret with both), of whom 4 have stopped all gender-affirming medical care and 1 has continued to receive blockers but plans to stop. The 4 others have continued care, suggesting that regret is not synonymous with stopping care.Conclusions and RelevanceThe findings suggest that youth accessing puberty blockers and hormones as part of gender-affirming care tend to be satisfied with and not regretful of that care several years later. While regret was rare, these experiences need to be better understood.

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Jorgensen, Sarah C. J., Nicole Athéa, and Céline Masson. "Puberty Suppression for Pediatric Gender Dysphoria and the Child’s Right to an Open Future." Archives of Sexual Behavior, April 2, 2024. http://dx.doi.org/10.1007/s10508-024-02850-4.

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AbstractIn this essay, we consider the clinical and ethical implications of puberty blockers for pediatric gender dysphoria through the lens of “the child’s right to an open future,” which refers to rights that children do not have the capacity to exercise as minors, but that must be protected, so they can exercise them in the future as autonomous adults. We contrast the open future principle with the beliefs underpinning the gender affirming care model and discuss implications for consent. We evaluate claims that puberty blockers are reversible, discuss the scientific uncertainty about long-term benefits and harms, summarize international developments, and examine how suicide has been used to frame puberty suppression as a medically necessary, lifesaving treatment. In discussing these issues, we include relevant empirical evidence and raise questions for clinicians and researchers. We conclude that treatment pathways that delay decisions about medical transition until the child has had the chance to grow and mature into an autonomous adulthood would be most consistent with the open future principle.

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Limb, Matt. "Private clinics are told not to prescribe puberty blockers." BMJ, May 31, 2024, q1200. http://dx.doi.org/10.1136/bmj.q1200.

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Dyer, Clare. "Puberty blockers: UK bans drugs indefinitely after safety advice." BMJ, December 13, 2024, q2814. https://doi.org/10.1136/bmj.q2814.

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Gordon, Catherine M. "Caught in the Middle: The Care of Transgender Youth in Texas." Pediatrics, March 31, 2022. http://dx.doi.org/10.1542/peds.2022-057475.

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In the US, approximately 0.7% of adolescents identify as transgender or gender fluid.1 Many pediatric centers now provide multidisciplinary care to assist in the transition from a child’s or adolescent’s assigned sex at birth (or natal sex) to their affirmed (or preferred) gender. During early puberty, therapy is available that results in the suppression of sex steroid production and secretion, followed later in adolescence by the administration of supraphysiologic doses of sex hormones appropriate for their gender identity.1-3 The duration of pubertal suppression with gonadotropin hormone releasing hormone agonists (GnRHa) varies, but can extend up to 4 years for younger patients who are not able to provide consent until age 16 for receipt of gender-affirming therapy. Puberty blockers represent an invaluable intervention for these children and adolescents, to reduce anxiety and “buy time” until final decisions can be made about gender assignment.

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Ashley, Florence. "Flawed reasoning on two dilemmas: a commentary on Baron and Dierckxsens (2021)." Journal of Medical Ethics, August 27, 2021, medethics—2021–107647. http://dx.doi.org/10.1136/medethics-2021-107647.

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A recent paper by Teresa Baron and Geoffrey Dierckxsens (2021) argues that puberty blockers and hormone therapy should be disallowed before adulthood on prudential and consent-related grounds. This response contends that their argument fails because it is predicated on unsupported premises and misinterpretations of the available evidence. There is no evidence that a large proportion of pubertal and postpubertal youths later discontinue medical transition. Meaningful assent is a viable and commonly accepted alternative to meaningful consent in paediatric bioethics. And finally, the primary purpose of transition-related interventions is to actualise youths’ gendered self-image, not treat an underlying mental illness.

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Oliveira, Gabriela de Faria, Amber T. Nguyen, Leykza Carreras-Simons, et al. "Puberty blocker, leuprolide, reduces sex differences in rough-and-tumble play and anxiety-like behavior in juvenile rats." Endocrinology, April 10, 2024. http://dx.doi.org/10.1210/endocr/bqae046.

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Abstract We examined the impact of the puberty blocker, leuprolide acetate, on sex differences in juvenile rough-and-tumble play behavior and anxiety-like behavior in adolescent male and female rats. We also evaluated leuprolide treatment on gonadal and pituitary hormone levels and activity-regulated cytoskeleton-protein mRNA levels within the adolescent amygdala, a region important for both rough-and-tumble play and anxiety-like behavior. Our findings suggest that leuprolide treatment lowered anxiety-like behavior during adolescent development, suggesting that the maturation of GnRH systems may be linked to increased anxiety. These data provide a potential new model to understand the emergence of increased anxiety triggered around puberty. Leuprolide also reduced masculinized levels of rough-and-tumble play behavior, lowered follicle stimulating hormone, and produced a consistent pattern of reducing or halting sex differences of hormone levels, including testosterone, growth hormone, thyroid stimulating hormone, and corticosterone levels. Therefore, leuprolide treatment not only pauses sexual development of peripheral tissues, but also reduces sex differences in hormones, brain, and behavior: allowing for better harmonization of these systems following gender-affirming hormone treatment. These data contribute to the intended use of puberty blockers in stopping sex differences from developing further with the potential benefit of lowering anxiety-like behavior.

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