Gender dysphoria — the feeling that one’s gender identity doesn’t match one’s sex assigned at birth — in minors can be alleviated via the use of puberty blockers. The simple act of temporarily delaying puberty can partially alleviate symptoms of dysphoria and benefit children’s mental health. However, medications that block puberty, have fuelled both serious concerns from confused parents and transphobic gatekeeping by ‘concerned’ cultural commentators. This is due to a lack of clarity regarding the permanence and long-term effects of taking puberty blockers.

Doubters also argue that children might be too young to make permanent body-altering decisions, citing de-transitioners — trans people who choose to transition back to the sex they were assigned at birth — as a prime example of why children shouldn’t receive access to methods that can slow down, even stop, their secondary characteristics from developing. In such a context, information regarding the ways one can block puberty is vital both for parents of children aged 10 to 12 who feel gender dysphoria and to prevent unnecessary whataboutery surrounding the rights of those who choose to transition.

What are puberty blockers?

Puberty blockers are hormone inhibitors that target and render ineffective hormones made in the testes and ovaries — e.g. testosterone, estrogen, and progesterone — for as long as the medication is used. Such blockers are either used in the form of implants that last around a year or injections that last anywhere from one to four months.

A child who uses these blockers will not develop secondary sex characteristics if they start the medication just before puberty starts. For children who start the blockers after hitting puberty, the blockers will not reverse any changes — only pause any further development while the medication is taken. For example: on puberty blockers, a child assigned male at birth will not have their voice deepen, and a child assigned female at birth will not menstruate.

Who would consider using puberty blockers?

Puberty blockers can be used to give gender dysphoric children time to consider their options before fully committing to transitioning to another gender. The effects of puberty blockers are reversible — if children choose to stop using puberty blockers before the age of 18, they will then undergo puberty as usual.

That said, doctors recommend children take puberty blockers only for a period of four years, in order to avoid long-term side effects, like loss of bone density.

How do puberty blockers work?

By inhibiting the release of sex hormones, puberty blockers slow the growth of primary sex organs, like the testes and the ovaries, and slow the development of secondary sex characteristics, like breasts and a deeper voice. For young children assigned male at birth, height growth may slow, and for young children assigned female at birth, height growth may accelerate.

Related on The Swaddle:

Feminism That Excludes Trans Women Is Bigoted, Not Radical

What precautions do doctors take before prescribing puberty blockers?

According to the Mayo Clinic, doctors are likely to prescribe puberty blockers only when children show long-term, intense gender dysphoria, which began or became worse during the beginning of their puberty. They also check if the potential patient experiences issues like low self-esteem, arrested height growth, and inability to develop enough penile/scrotal skin.

Most importantly, doctors look for informed consent — wherein the child and their guardian(s) must both know what they are signing up for.

What are the benefits of using puberty blockers?

Puberty blockers are beneficial mainly because they can greatly reduce the number and invasiveness of surgeries required to transition as an adult.

Additionally, a 2020 study published in Pediatrics journal, also stated that young dysphoric children who used puberty blockers were much less likely to commit suicide and undergo severe psychological distress, as the medication arrests the biological development of secondary sex characteristics that the children do not identify with. The Mayo Clinic states that other benefits include improved social interaction with other children and overall better mental wellbeing.

What are the problems that come with using puberty blockers?

Potential immediate side effects of puberty blockers include hot flashes, swelling, headaches, and weight gain. Long-term side effects could possibly include bone density loss and subfertility, which is why using puberty blockers for more than four years is not recommended.

According to the BBC, there is no clear data on how exactly puberty blockers might affect adolescent brain development and mental health. Obtaining informed consent from children — considered unfit to make mature, long term decisions — for a process that might affect them for their entire adult life is also a debate that hasn’t found any clear-cut answers.

However, much like antidepressants help people cope with depression, puberty blockers are one of the few aides that can alleviate serious psychological distress while coping with gender dysphoria, a condition that is still little understood.