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as England’s National Health Service Decided to stop prescribing puberty blockers to minors accompanied by gender dysphoria Or gender disparity, many people wonder what it is and why it’s such a hot-button issue.
Dr. Michelle Forcier, professor of pediatrics at Warren University, said: “Puberty blockers are analogous to artificial hormones, and what they do is essentially trick the brain into sending messages to the ovaries and testicles to secrete hormones.” We need to make sure that doesn’t happen.” He has specialized in gender, sexual, and reproductive health for 25 years at Brown University’s Alpert School of Medicine in Rhode Island.
“The brain thinks it has enough hormones and doesn’t send a message to the ovaries or testicles to get to work,” added Forcier, who is also a clinician at Volks Health. “So the ovaries and testicles are either resting or sleeping until the brain glands wake up again and say, ‘It’s time to secrete hormones.'”
According to Professor Forcier, temporarily halting puberty in people assigned male at birth could result in wider shoulders, a deeper voice, facial hair, and larger testicles and penises. It is said that it can temporarily prevent this from happening. For those assigned female at birth, puberty blockers can cause breast development, wider hips, or a pause in menstruation.
This limbo gives the youth time to: think about your gender identity Forcier said parents need time to consider their options before physical changes begin that “can cause severe discomfort, depression, suicidal tendencies, and a variety of other poor health outcomes.” Stated.
Blockers “prevent permanent changes that cannot necessarily be fixed or eradicated in the future,” she added. “You can’t go back, but at least everything is (paused) in its place.”
In the United States, at least 121,882 children ages 6 to 17 were diagnosed with gender dysphoria from 2017 to 2021, a rate that increased by 70% from 2020 to 2021. Data collected by Reuters and health technology company Komodo Health. Of that total population, only 17,600 children started taking puberty blockers or gender-affirming hormones within five years. Of these children, 27% were taking puberty blockers.
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Consulting a medical or mental health professional is an important step in considering puberty blockers in your child, experts say.
However, changing availability of these medicines around the world Includes at least 22 states in the United States “Gender-affirming medicine has become a highly politicized issue,” Dr. Melina Wald, a clinical psychologist at Bespoke Health, a practice in Connecticut and New York, said in an email. Wald co-founded the Gender and Sexuality Program at Columbia University Medical Center.
Here’s what else you need to know about puberty blockers and whether they’re what your child needs if you’re a parent.
Forcier said if your child expresses a transgender or other diverse gender identity, you need to have a conversation about what that identity or expression means to your child.
Dr. Lauren Wilson, a pediatric hospitalist and president of the Montana chapter of the American Academy of Pediatrics, said in an email that not all gender-diverse children feel the need for puberty blockers.
However, “if a child is distraught about puberty or has significant behavioral, emotional, or social changes before or with pubertal changes, that’s key to confirmation.” Forcier says. This distress is a major factor in whether they qualify for access, she said. Parents should ask if there is anything that makes them nervous or excited, or if there is anything they would like to discuss with a professional.
“Ideally, parents considering using puberty blockers for their children should work with a qualified mental health professional who has extensive experience counseling families about whether to use puberty blockers. “It’s about doing things,” said Wald, who volunteers as an assistant professor at Columbia University. Medical psychology. “This decision is never taken lightly and is often made in the context of a long-standing relationship with the child, parent/carer, and physician.”
Forcier said puberty is occurring earlier these days, starting around age 8 or 10 for most children.
“Many kids have already gone through puberty by age 13 or 14…so they start blockers when puberty starts,” Forcier says. “We will discontinue the blocker if appropriate or add sex hormones to the blocker if appropriate.”
Puberty blockers suspend puberty, while gender-affirming hormones for teens and older adults can alter physical characteristics associated with gender identity, such as facial hair with testosterone or a soft voice with estrogen. Helps you mature hormonally. The right time to start may be when the child is ready in late adolescence, when the family is ready, or when the child witnesses a peer entering puberty, Forcier said. added.
Forcier said taking puberty blockers may also avoid the need for future gender reassignment surgery. For example, a child assigned female at birth may take blockers to prevent breast growth. The child may later transition to testosterone and not develop breasts.
“Everyone’s body is different, which is why the government shouldn’t be making decisions about individuals’ bodies,” Forcier said. The only right way to do things is to listen to the patient. ”
The NHS decision, which has been condemned by many LGBTQ groups and some medical experts, builds on its conclusions. We are considering considering the evidence. According to other information commissioned in 2020 and published since then, there is no “sufficient evidence to support the safety or clinical effectiveness” of puberty-suppressing hormones.
But transgender youth have been using blockers for 30 years, Wilson said.
Since the 1980s, it has also been used to treat children who begin puberty at an unusually early age, allowing them to delay the onset of puberty. Wilson and Wald said Blocker has been proven to be very safe and effective.
“In adults, it can also be used to treat prostate cancer, endometriosis and polycystic ovary syndrome, among others,” Wilson said.
“Using puberty blockers in any child or adolescent carries a risk of loss of bone density because puberty hormones increase bone mineralization,” Wilson said. “However, once the medication is discontinued and puberty resumes or other hormonal treatments are started, bone mineralization normalizes.”
Another reason you don’t need to worry about bone risk is that any human being has multiple factors that influence bone loss and osteoporosis later in life, including genetics, health, and lifestyle factors such as diet and exercise. There is, Forcier said.
The lack of bone formation during puberty due to medication is important to consider, but so are the potential harms of living without puberty blockers and living in a gender-contradictory body, she says. added.
Experts say there is also a risk of infertility when children go directly from puberty blockers to hormone therapy.
Some people worry that children who take puberty blockers may change their minds about their gender identity in the future. However, according to some studies, most people who choose gender-affirming care don’t regret your choice later – include October 2022 survey A study conducted in Amsterdam, Netherlands, found that 98% of transgender youth who started gender-affirming treatment during adolescence continued to use those hormones approximately five to six years into adulthood. It turned out that
“I met some older adults who had been thinking about gender, and they knew they had felt the same way from a young age,” Forcier said, adding that her children I challenged the idea that I don’t know myself. “Either they didn’t have the means to do anything about it, or they were very scared and discouraged.”
Long-term studies of puberty blockers in transgender youth are underway, Wilson said.
“Medications always come with risks and benefits, and good decisions are first and foremost based on accurate information and the child’s needs,” she added.
CNN’s Tara John contributed to this report.
