Puberty blockers linked to lower suicide risk for transgender people

The finding suggests that a major — and politically controversial — aspect of trans health care for minors could help reduce the community’s disproportionate suicide risk.
By Tim Fitzsimons

Transgender individuals who received puberty blockers during adolescence have a lower risk of suicidal thoughts as adults than those who wanted the medication but could not access them, according to a study published Thursday in the journal Pediatrics.

“These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes,” the study states.

The finding suggests that a major — and politically controversial — aspect of transgender health care for minors could help reduce the trans community’s disproportionate risk of suicide.

“Puberty blockers” are a type of reversible medication injection or implant that pause puberty. These drugs are prescribed to children who experience early onset puberty and for transgender youth experiencing gender dysphoria. Natural puberty resumes when the injection wears off or the implant is removed.

The study’s lead author, Dr. Jack Turban, a resident psychiatrist at the Harvard Medical School, said the findings add to the “growing evidence base suggesting that gender-affirming medical care for transgender youth is associated with superior mental health outcomes in adulthood.”

“It certainly argues against the misguided notion that gender-affirming care is inherently harmful and should be legislatively banned,” Turban said in a statement, referring to a number of recently introduced state bills seeking to limit transition-related care for minors.

The study surveyed 20,619 transgender people and found that 90 percent of trans adults who wanted, but could not access, puberty blockers experienced suicidal thoughts. For transgender adults who had been able to access puberty blockers, it was a significantly lower 75 percent.

Less than 3 percent of trans adults who say they wanted puberty suppression during adolescence actually received it — showing how hard it has been, historically, to access this particular treatment for gender dysphoria.

The study also found that a minority of trans adults — 17 percent — say they ever wanted puberty blockers, suggesting that not all trans youths will seek this particular type of treatment.

Turban has been at the forefront of transgender mental health research. A study he co-authored in September showed a link between suicide attempts and transgender “conversion therapy.” Conversion therapy is the medically discredited practice of attempting to change a person’s gender identity or sexual orientation.

For decades, doctors who treat transgender children have argued that an affirming, supportive gender transition is the best way to help trans people thrive and survive. Norman Spack, the Boston pediatric endocrinologist who in 1998 pioneered the use of puberty blockers in the treatment of gender dysphoria, said doing so can “save lives.”

But as the use of puberty blockers in trans kids has became more mainstream — thanks to endorsementS from major medical associations such as the Endocrine Society and the American Academy of Pediatricsbacklash has grown in Republican-dominated legislatures across the country.

Even as medical professionals have publicly argued that puberty blockers are safe, reversible and likely to help reduce gender dysphoria in transgender kids, conservative lawmakers in states such as South Dakota, Georgia and Kentucky are moving forward with efforts to criminalize the provision of transition-related health care, including puberty blockers, to trans minors.

In these states, the proposed bans on the prescription of puberty blockers would only apply to transgender children. In cisgender children who are prescribed puberty blockers to treat early onset puberty, these bills would not restrict their use.

“Transgender people, our families and our doctors are begging legislators to follow the science when crafting policy that could alter the very path of our lives,” said Gillian Branstetter, a transgender advocate and press officer at the National Women’s Law Center. “Transition-related care is only controversial among people who know nothing about it, and lawmakers must treat the suicide risks faced by transgender youth as the public health crisis it is.”

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