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Puberty blockers are hormone blockers available on prescription to delay the physical changes of puberty in children. These medications do not cause permanent changes to a child’s body but pause puberty. With the medication, children with precocious puberty can have normal growth spurts by delaying puberty. Furthermore, children with gender dysphoria can get enough time to decide their gender identity without damaging their mental health due to undesired physical changes.
Learn about the types, benefits, and side effects of puberty blockers in children and how they work.
What Are The Types Of Puberty Blockers?
The following types of puberty blockers are available on prescription (1):
- Histrelin acetate is a flexible rod that can be implanted in the skin of the arm. Its effects usually last a year, after which the rod is removed or replaced.
- Leuprolide acetate is an injection given once a month or every three or four months, depending on the requirement.
Puberty blockers are not cross-sex hormones. These medications only prevent pubertal changes in children. In contrast, cross-sex hormones are part of hormone therapy, which helps transition children with gender dysphoria from their biological gender to their desired gender and improve their quality of life (2).
Are Puberty Blockers Safe?
The US Food and Drug Administration approves puberty blockers to treat precocious puberty, where the child reaches puberty at a younger age. Most experts agree that puberty blockers are safe. The Endocrine Society and World Professional Association for Transgender Health also support puberty blockers in children who wish to prevent or delay unwanted physical changes (3).
When Should You Start Taking Puberty Blockers?
The ideal age to start puberty blockers may vary depending on the purpose and other individual factors. Usually, these medications are prescribed when the body begins to show signs of puberty (3). However, children with precocious puberty may only receive prescriptions after diagnosis. The results are evident in a month or two in most children.
Children with gender dysphoria may be examined by various specialists, including psychiatrists, to assess if they fit the criteria to receive puberty blockers. After a detailed assessment, children are referred to hormone therapists for treatment, including counseling and training sessions for the families.
Guardians’ informed consent and a court order are often required to treat children with gender dysphoria. Treatment can be obtained through the Gender Identity Development Service (GIDS) or similar organizations in your area (4). Beginning the treatment early can result in better outcomes and reduces the psychological issues caused by physical puberty changes.
How Do Puberty Blockers Work?
Puberty blockers suppress or prevent puberty by blocking the testosterone and estrogen hormones. Since these hormones are responsible for puberty-related changes, blocking them helps delay the following changes related to sexual maturity in children (1):
- Breast growth
- Menstruation
- Widening of hips
- Facial hair growth
- Voice deepening
Children can continue to have normal pubertal changes after stopping the use of puberty blockers. Thus, these effects are reversible and temporary. Puberty blockers do not stop acne, underarm and pubic hair growth, and body odor since estrogen and testosterone hormones do not regulate these changes (3).
What Are The Benefits Of Puberty Blockers?
Puberty blockers can delay puberty in children with precocious puberty, allowing them to have normal growth and development. Additionally, children with gender dysphoria can avoid the stress and discomfort caused by the development of secondary sexual characteristics.
The benefits of puberty blockers in children with gender dysphoria may include (5):
- Reduction of anxiety and depression
- Elimination of future surgeries and procedures
- Decrease of actions or thoughts causing self-harm
- Improved interpersonal relationships and social interactions
- Improved mental health
Although puberty blockers suppress puberty, they do not ease gender dysphoria. However, this treatment may also allow children enough time to decide whether to continue with their biological gender or desired gender. If the child prefers their biological gender, they can resume puberty by stopping these medications.
Do Puberty Blockers Have Side Effects?
Although these medications are proven safe and effective, some children may experience side effects. The possible long-term side effects of puberty blockers may include (6)
- Low bone densitymay occur in some children, possibly increasing the likelihood of fractures. However, calcium and vitamin D supplements, exercise, and regular monitoring can help prevent this.
- Taller adult height may be seen due to growth spurts caused by delayed growth plate closure. Height may also be monitored in the follow-up visits.
- Underdeveloped genital organs (secondary sexual characteristics) may be seen in some cases, possibly limiting the options for sex reassignment surgeries (bottom surgery) in the future.
Some children may experience the following short-term side effects (6):
- Headache
- Muscle aches
- Fatigue
- Mood swings
- Changes in body weight
- Breast tissue changes
- Spotting or irregular periods if menstruation has begun and has not been fully repressed by puberty blockers
The mental health benefits of puberty blockers often outweigh these risks. Hence, children who want to prevent or delay physical changes often get prescriptions after assessment. Fertility is not affected by puberty blockers alone. However, children who receive cross-hormone therapy after using puberty blockers could permanently damage their fertility (3).
Puberty blockers allow children and families to take time and discover their preferred gender with careful guidance, possibly avoiding future interventions for gender transitions. Seek medical care from approved institutions and practitioners regarding gender reassignment therapy and puberty blockers. It can help prevent side effects and illegal and inappropriate treatments.
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