For children who identify as transgender, going through puberty as their birth sex can be a traumatic, disorienting experience. They may fear their own bodies, question their identity and hide away from the world around them.
“My son got his period at age 12 and a half, and we both cried,” writes Mary Moss in an article entitled “Puberty Blockers: My Son’s Life-Preserver.” “We both had dreaded this day and hoped to avoid it altogether. It’s true my son had the physical parts of a girl and was born my daughter, but I discovered when he came out as transgender he was actually my son. What boy wants to grow breasts and get a period?”
Most physicians believe the best way to help transgender children through the emotional trials of puberty is to give them puberty blockers — or drugs that stunt hormone production and the growth of sexual organs — until they’re mature enough to begin cross-sex hormone treatment, usually at around age 16.
Unfortunately, only one study so far has examined the side effects of puberty blockers on children’s mental health. The study was led by Annelou L.C. de Vries, M.D., Ph.D., a child psychiatrist at the VU University Medical Center in Amsterdam. Her research team monitored 55 transgender adolescents who received puberty blockers at around age 13, cross-sex hormones at around age 16 and gender-reassignment surgery at around age 20. The researchers found that the study participants were as mentally healthy as their non-transgender peers, suggesting that the treatments relieved much of the mental turmoil associated with growing up transgender. The results of this revolutionary study were published in the journal Pediatrics.
As more and more clinicians recognize the validity of transgender individuals and the importance of allowing them to transition to their identified sex, research like this has become not just important, but essential.
“We seem to really be at a tipping point,” says Robert Garofalo, M.D., a pediatrician at Ann and Robert H. Lurie’s Children’s Hospital of Chicago.
Garofalo plans to lead the largest-ever study of transgender youth to determine the psychological and medical effects of delaying puberty. The researchers hope to recruit 280 transgender adolescents and then follow them over the course of five years. The participants will be divided into two groups, with the first group receiving puberty blockers at the beginning of adolescence and the second, older group, receiving cross-sex hormones. The researchers will regularly monitor each child’s physical and mental health.
Some scientists fear that puberty blockers may hinder bone growth or impact neural development. Others believe that denying the use of puberty blockers will severely hinder the mental health of transgender children.
“Not treating adolescents is not being neutral,” says bioethicist Simona Giordano, Ph.D., of the University of Manchester, U.K. “It means exposing children to a lot of harm.”
Ideally, this study will shed light on the advantages and disadvantages associated with puberty blockers, so that clinicians, parents and children can make the best decision possible.
This extensive, in-depth $5.7 million study will be funded by the U.S. National Institutes of Health.
The Sovereign Health Group is a rapidly growing collection of residential treatment centers for substance addiction and co-occurring mental health disorders. We serve both adolescents and adults, regardless of their sexual orientation or gender identity. Here at Sovereign Health of Rancho San Diego, we view each adolescent as an individual — not a diagnosis — and do what we can to help our patients lead long, fulfilling lives. For more information, please contact our 24/7 helpline.
About the author
Courtney Lopresti, M.S., is a senior staff writer for the Sovereign Health Group, where she uses her scientific background to write online blogs and articles for a general audience. At the University of Pittsburgh, where she earned her master’s in neuroscience, she used functional neuroimaging to study how the human cerebellum contributes to language processing. In her spare time, she writes fiction, reads Oliver Sacks and spends time with her two cats and bird. Courtney is currently located in Minneapolis. For more information and other inquiries about this article, contact the author at email@example.com.