NYDN: Puberty blockers significantly lower suicide risk


Transgender adults who had access to pubertal suppression treatment during adolescence had lower risks of suicidal thoughts during their lifetime, according to a new study.

The research, published Thursday in the journal Pediatrics, is the first to specifically look at the correlations between the access to treatment of a gender-affirming medical procedure for transgender adolescents and suicidality.

The treatment consists of the administration of gonadotropin-releasing hormone analogues (GnRHas) — known as “puberty blockers” — to youth when they begin showing signs of physical development.

After analyzing data from more than 20,000 adults, ages 18 to 36, researchers found that 90.2% of transgender adults who didn’t have access to pubertal suppression during adolescence either thought about, or planned on committing suicide — a rate that was significantly higher than the 75.3% for those who did have access to them.

The results seem to confirm previous evidence that offering gender-affirming medical care for transgender youth can lead to a lifetime improvement of mental health for transgender adults.

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“The study provides evidence in the context of lingering questions among some health care professionals and in the general public about the purpose and mental health implications of pubertal suppression,” Dr. Alex Keuroghlian, the study’s senior author, told the Daily News.

One of the advantages of administering “puberty blockers” to trans youth is that the treatment is “fully reversible,” which makes it a “safe way to mitigate negative health outcomes that can result from undergoing puberty that does not align with a transgender youth’s gender identity,” said Keuroghlian, who’s the director of the national LGBT Health Education Center at The Fenway Institute and director of the Massachusetts General Hospital Psychiatry Gender Identity Program.

Most teens who begin pubertal suppression, however, do decide to go onto gender-affirming hormones, as a recent study from Amsterdam showed.

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Even though there are approximately 1.8% of adolescents in the U.S. who identify as transgender, according to the Centers for Disease Control and Prevention’s Youth Risk Behavior Surveillance System, this potentially life-saving treatment is still grossly underused in the U.S., the study suggested.

Of about 17% of respondents who said they ever wanted to receive “puberty blocking” treatment, only 2.5% were able to access it.

That figure can possibly be explained by the high cost of the treatment when not covered by health insurance, which can range from $4,000 to $25,000.

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“Pubertal suppression can be provided through 1 or 3-month depot injections. However, there are also implants that last one year, sometimes longer. These tend to be more popular,” Dr. Jack Turban, the lead author of the study and a resident physician in psychiatry at The Massachusetts General Hospital and McLean Hospital, told The News.

Another possible reason could be “the misguided notion that gender-affirming care is inherently harmful and should be legislatively banned,” said Turban.

The study was published just a day after an anti-transgender bill in South Dakota, which specifically addressed puberty blockers, cleared its first major hurdle into becoming law, by passing out of committee.

The bill, HB 1057, would make a misdemeanor for doctors to provide gender-expression procedures to children 16 and younger. Currently, similar bills are also making their way in state legislatures in Kentucky, Georgia and Texas.

Rep. Fred Deutsch, the Republican lawmaker who introduced the bill in the South Dakota Legislature , said the legislation would work as “pause button” for minors considering gender-transition procedures.

To Turban, however, “refusing to offer an adolescent pubertal suppression is absolutely not a pause button. Allowing puberty to progress means that the adolescent will go through physical changes that would likely require surgery to reverse down the line.”

“Pubertal suppression, on the other hand, is a true pause, putting puberty on hold so that the adolescent has more time to decide what to do next,” he said.

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Researchers are hopeful that the “research will be useful in future public health and policy discussions,” as Keuroghlian told The News.