Puberty Blockers (Pausing Puberty)

What They Do: Puberty blockers are medicines that pause the physical changes of puberty, giving transgender youth more time to explore their gender identity without the distress of unwanted body changes. They are fully reversible—if the blocker is stopped, puberty will resume.

Effects on Mental Health: Research from around the world shows that puberty blockers can greatly improve transgender youths’ well-being. A study from the Netherlands followed teens who used blockers and found their depression and emotional struggles got better while they were on the treatment [1]. Another U.S. study found that teens who got puberty blockers (or hormones) were 60% less likely to feel depressed and 70% less likely to think about suicide than those who didn’t get care [2].

Long-Term Outcomes: In the first group of kids who used blockers and were followed into their 20s, nearly all continued on to hormone therapy and eventually surgery—and they were happy with their decision [3]. By adulthood, their gender dysphoria was gone, and they were doing as well or better in life than their peers [3]. No one in the group regretted starting care [3]. Doctors do monitor for things like bone health, but overall, puberty blockers provide a safe, effective way to support mental health during a tough time [13].

• [1.] de Vries, A. L., Steensma, T. D., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2011). Puberty suppression in adolescents with gender identity disorder: A prospective follow-up study. The Journal of Sexual Medicine, 8(8), 2276–2283. https://doi.org/10.1111/j.1743-6109.2010.01943.x

• [2.] Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S. (2020). Pubertal suppression for transgender youth and risk of suicidal ideation. Pediatrics, 145(2), e20191725. https://doi.org/10.1542/peds.2019-1725

• [3.] de Vries, A. L., McGuire, J. K., Steensma, T. D., Wagenaar, E. C., Doreleijers, T. A., & Cohen-Kettenis, P. T. (2014). Young adult psychological outcome after puberty suppression and gender reassignment. Pediatrics, 134(4), 696–704. https://doi.org/10.1542/peds.2013-2958

• [4.] Hembree, W. C., Cohen-Kettenis, P. T., Gooren, L., Hannema, S. E., Meyer, W. J., Murad, M. H., … & T’Sjoen, G. (2017). Endocrine treatment of gender-dysphoric/gender-incongruent persons: An Endocrine Society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 102(11), 3869–3903. https://doi.org/10.1210/jc.2017-01658