What Are Puberty Blockers? Exploring The Mental Health Implications
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Puberty blockers generally block the hormonal changes that cause puberty in children and teens. These medications are often used to stop puberty for those who identify as transgender. However, they can have multiple uses and impacts. Puberty blockers may affect mental health, so being educated about these options can help individuals and their families decide whether they are an appropriate option. For further insight and guidance, consider speaking with your doctor and a licensed mental health professional.
What are puberty blockers?
A doctor might prescribe these medications for a patient who is living with gender dysphoria, in which one’s body or biological sex doesn’t align with one’s gender identity and expression. Transgender and non-binary people may take these medications before or during puberty to block future effects. Puberty generally occurs from ages 10 to 14 in biological females and 12 to 16 in biological males.
The BetterHelp platform is not intended to provide information regarding which medications or medical treatments may be appropriate for you or your child. This content provides generalized information that is not specific to any one individual. You should not take any action without consulting a qualified medical professional.
Why do people take puberty blockers?
Puberty blockers can serve a purpose outside of treating gender dysphoria in gender-diverse children. Below are a few reasons a doctor might prescribe these medications.
As gender-affirming care
Gender-affirming care generally involves a range of physical and mental health care services for transgender individuals. This type of care may reduce the risk of depression, anxiety, and suicide attempts. Gender-affirming care can help someone reduce gender dysphoria symptoms by decreasing or reversing the release of certain sex hormones.
By reversing or preventing puberty, individuals may be able to hide certain physical traits they don’t want to develop. Puberty blockers can also be the beginning of a medical gender transition.
For medical conditions
Puberty blockers generally prevent certain hormones from causing physical changes, like breast growth. Although these medications are most often used in gender-affirming healthcare and to treat premature puberty, they can also be used to reduce sex hormones in people with conditions like prostate cancer.
In some cases, puberty blockers might be used for adults with polycystic ovary syndrome (PCOS), endometriosis, or uterine fibroids. If you believe you might be experiencing a hormone-related medical condition, speak to your doctor about your treatment options.
How can puberty blockers improve mental health?
Puberty blockers themselves are not mental health medications, and these medications are not yet FDA-approved for gender dysphoria treatment (although they are approved for other uses). However, the effects of these medications may improve mental health for those who are using them for gender identity-related reasons.
Studies suggest that gender-affirming care can be a crucial part of reducing the risk of adverse mental health outcomes for those who identify as transgender. Below are some ways puberty blockers may support those who take them:
- They may reduce the risk of mental illness
- They may decrease stress levels
- They may prevent the bullying of transgender and non-binary children who develop unwanted traits
- They may reduce the risk of suicidal thoughts
- They may improve self-esteem
- They may help someone express themselves authentically
- They may help children focus more on other areas of life, such as academics and social life
Are there any risks to taking puberty blockers?
New data on puberty blockers in 12- to 15-year-old children with gender dysphoria suggests that there may be negative mental health impacts for some people using puberty blockers.
A 2023 study that evaluated participants’ mental health over 36 months reported that “the majority of participants experience no reliable change in distress across all time points. Between 15% and 34% deteriorate and between 9% and 20% reliably improve.” However, additional research may be necessary to make any reliable conclusions about the mental health effects of puberty blockers for gender dysphoria.
The US Food and Drug Administration (FDA) has approved the use of puberty blockers for precocious puberty, and they are typically used off-label to treat gender dysphoria. In 2022, the FDA added the risk of pseudotumor cerebri (increased pressure in the skull) to puberty blocker labels.
Other potential side effects can include reduced bone health and bone density. Puberty blockers may also impact fertility. Some effects may be reversible, but more research is needed.
Children and their families should discuss the risks of this type of medication with their doctor before moving forward with treatment. Alternatives to puberty blockers can include hormone injections, nasal sprays, or testosterone gel. These options must also be prescribed by a doctor.
The importance of gender-affirming healthcare
Gender-affirming healthcare typically looks at all aspects of an individual’s health as a transgender or non-binary person. A doctor who practices this type of healthcare usually takes steps to be affirming, trauma-informed, and educated in LGBTQIA+ health. They may ask clients about their pronouns, discuss their gender identity, explore options for hormone replacement therapy (HRT), and support clients in getting a recommendation for gender-affirming surgery.
In general, children and teens do not receive medically permanent treatment, as fully informed consent may not be possible due to their age. Before puberty, a child’s gender transition may primarily focus on socially transitioning with outfits, haircuts, pronouns, one’s name, and the way they express themselves. Puberty blockers and gender-affirming hormone therapy might be used for some children. Adults can decide whether they’d like to try hormone therapy or gender-affirming surgery. Not all transgender or non-binary people medically transition.
Below are some statistics on how gender-affirming care may impact those who receive it:
- Parents who support their child’s gender identity and help them find medical support can make a difference. Children who identify as transgender with supportive families usually report higher levels of well-being and lower levels of gender dysphoria.
- Gender-affirming care can improve the quality of life of transgender children and adults.
- According to a 2022 study, “receipt of gender-affirming care, including puberty blockers and gender-affirming hormones, was associated with 60% lower odds of moderate or severe depression and 73% lower odds of suicidality over a 12-month follow-up.”
How to find a gender-affirming doctor or therapist
Finding a gender-affirming provider can be challenging, as some providers may not have experience in this area or offer gender-affirming services. In some states, legislation may prevent the use of gender-affirming care for minors. Some people may leave the state to receive care. Below are some options for finding a gender-affirming provider.
Referrals
You may be able to receive a referral to a gender-affirming doctor or therapist by speaking to a counselor or primary care provider about your needs. Some providers offer gender services, such as a therapeutic note that states a client would benefit from gender-affirming care and has gender dysphoria. You can also get recommendations from friends, family, or others who have used these services in your community or online.
An online search
By conducting an online search for gender-affirming providers, you may find doctors and therapists in your area or through telehealth who have previously supported transgender and non-binary clients. Look for providers that specifically mention their experience treating the LGBTQIA+ community and read about their approach before meeting them. You may be able to consult with multiple providers before settling on one with whom you are comfortable.
LGBTQIA+ organizations
LGBTQIA+ organizations like The Trevor Project offer lists of resources for LGBTQIA+ youth. Families and children can access the gender identity resources page to learn more about resources across the country and how to receive gender-affirming support. LGBTQIA+ youth in crisis can also use The Trevor Project’s hotline or online chat to talk to a supportive peer counselor about their challenges.
Seeking support
Gender dysphoria, transphobia, and other challenges that can arise for transgender youth can be challenging to cope with on one’s own. Family members may also be impacted by supporting their trans child, wondering how they can be a better source of support for them. Talking to a therapist can provide support in these cases. However, some families might not be able to attend in-person therapy due to cost, distance, or a lack of LGBTQIA+-affirming providers. Online therapy through a platform like BetterHelp for adults or TeenCounseling for those aged 13 to 19 may be more accessible.
Through an online platform, clients can meet with their therapist at a time that works for them, including outside of standard business hours. In addition, online platforms can offer tools like worksheets and group sessions, which may be helpful for LGBTQIA+ clients to connect with others and work through challenging thoughts.
According to a 2021 study, online therapy can be effective for the LGBTQIA+ community, especially sexual and gender minority adolescents and young adults. Online cognitive behavioral therapy can reduce symptoms of conditions like depression and anxiety.
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