One of the many tough things about being a kid with severe and persistent gender dysphoria — the intense feeling that you were born into the wrong body and are actually, despite the gender you were assigned at birth, a boy or a girl — is the prospect of puberty. Imagine all the normal stress and confusion and emotion of this time, and then layer on that the knowledge that you are going to develop an adult body to which you will feel a visceral aversion.
The age of puberty’s onset, though, is considered by most experts to be too young for cross-hormone therapy, which is irreversible, or other procedures that help (usually slightly older) people transition to their felt gender. So for transgender young people, an increasingly common tactic is for their doctors to help them “buy time” by prescribing them drugs that will block puberty — that way, they don’t have to deal with the potential trauma of puberty, and when they turn 16 or so (the age can vary) they can pursue cross-hormone therapy to develop a body much closer to the one they want.
There’s only been one study, from 2014, attempting to carefully measure the psychological effects of the puberty-blocking approach, and it suggested good outcomes. Even less is known about the potential physical side effects of puberty-blockers, though, and some scientists worry that there could be long-term ones we don’t yet know anything about.
Luckily, we’ll soon know a lot more about all of this, reports Nature:
Funded by the US National Institutes of Health (NIH), the US$5.7-million project will be not only the largest-ever study of transgender youth, but also only the second to track the psychological effects of delaying puberty — and the first to track its medical impacts. It comes as the NIH and others have begun to spend heavily on research related to the health of transgender people, says Robert Garofalo, a paediatrician at Ann and Robert H. Lurie Children’s Hospital of Chicago, Illinois, and a leader of the study. “We seem to really be at a tipping point,” he adds.
Garofalo and his colleagues aim to recruit 280 adolescents who identify as transgender, and to follow them for at least five years. One group will receive puberty blockers at the beginning of adolescence, and another, older group will receive cross-sex hormones. Their findings could help clinicians to judge how best to help adolescents who are seeking a transition.
In the 2014 study, the authors reported that the well-being of their subjects, who had been prescribed puberty-blocking drugs, cross-sex hormones, and then undergone gender-reassignment surgery, “was similar to or better than same-age young adults from the general population.” If Garofalo’s study yields similar results, it will be an even stronger sign researchers have hit upon an approach that works.