Puberty Blockers Aren't Curing Gender Dysphoria. They're Manufacturing It.

By Dr. Julia Mason

The Department of Health and Human Services recently proposed regulations that would effectively ban hospitals from using puberty blockers on children, citing research that the drugs can cause irreversible harm. Activist groups decried the move, claiming that puberty blockers -- when prescribed to children diagnosed with gender dysphoria -- are reversible and merely pause development.

Those activists are mistaken. The drugs do have lasting effects, and there's little credible evidence that puberty blockers help patients.

While gender nonconformity has existed throughout history, persistent pediatric gender dysphoria -- defined as distress severe enough to prompt a desire for medical transition -- was exceedingly rare until relatively recently.

We know this because long-term follow-up studies conducted before the advent of pediatric medical transition consistently found that most gender-nonconforming children did not go on to experience persistent dysphoria or pursue medical transition as adults, even in countries where adult transition was legal and publicly funded.

That changed after Dutch clinicians in the 2010s introduced the "Dutch Protocol," which for the first time offered children a medical pathway beginning with puberty suppression.

In the 1980s, Dutch researchers began tracking a group of "gender variant" children -- those who behaved or wished to be like the opposite sex -- as they reached adulthood.

Medical gender reassignment was legal and covered by Dutch health insurance. But roughly two decades later, not a single one of the "gender variant" children had decided to pursue a medical transition. Instead, their gender distress appeared to resolve on its own, with many ultimately identifying as gay or lesbian as adults.

In other words, the widely accepted notion that medicalized care is necessary to treat dysphoria seems to have created a clinical pipeline -- one that channels children toward permanent medicalization rather than allowing their distress to resolve naturally.

Later analysis has shown serious problems with the researchers' approach. The researchers found ample evidence of harm resulting from their interventions. Although the researchers claimed to have followed groups of children who first underwent puberty suppression, then cross-sex hormones, the final analysis only included adolescents who were deemed psychologically stable enough to proceed to cross-sex hormones -- excluding those who experienced negative outcomes during the puberty suppression phase.

Several participants who suffered serious harm were reclassified as 'nonparticipants' and omitted from final outcome analyses. At least three developed severe obesity and insulin resistance during treatment. One discontinued medical transition before the study concluded. Another died following surgical complications connected to insufficient genital tissue -- a known consequence of puberty suppression.

Other research has found that puberty suppression, especially when followed by cross-sex hormones, frequently results in permanent infertility and impaired sexual function.

These findings should be front and center when we talk about puberty blockers today. While these drugs are often described as benign and reversible, the reality is far less certain. There are no randomized controlled trials demonstrating that puberty blockers improve long-term mental health outcomes for children with gender dysphoria. The evidence we do have suggests significant risks.

Health policy leaders are right to proceed with caution. Right now, the widespread use of puberty blockers amounts to conducting large-scale, uncontrolled medical experiments on children. The more we normalize these interventions, the greater the risk that children will be steered onto irreversible paths they might never have chosen if given time, psychological support, and honest information.

Dr. Julia Mason is a board-certified pediatrician and Fellow of the American Academy of Pediatrics. She is a founding board member of the Society for Evidence-Based Gender Medicine (SEGM).

Editor’s Note: This is an opinion article reflecting the author’s views on a complex and evolving medical issue. Some interpretations of research are debated within the scientific community. Desert Local News publishes this piece to inform public discussion and does not endorse the conclusions presented.