Voluntary Puberty Delay for Transgender Pre-Teens Looks Promising

Debbie says:

Until I saw this rather brief article, I hadn’t heard about hormonal puberty suppression as an alternative for young transgender people. I am especially interested because I have a (very) young transgender person in my life, and it has been fascinating to watch how completely this child is committed to a gender identity different than their physical conformation. And, of course, I wonder how puberty (many years in the future) will affect them.

Dutch scientists closely monitored 55 young adults who had been previously diagnosed with “gender dysphoria,” which meant that they identified as transgender and were experiencing mental health consequences as a result, such as anxiety, emotional distress, and body image concerns. At an average age of about 14, they each used hormones to block puberty and prevent the development of sex characteristics. The study found that this gave them “the opportunity to develop into well-functioning young adults.”

Lead Author Dr. Annelou de Vries explained to CBS News that puberty suppression is a “fully reversible medical intervention” and the extra time allows the young people to work out their struggles related to gender dysphoria before taking permanent steps toward a transition. As a result, they “have the lifelong advantage of a body that matches their gender identities without the irreversible body changes of a low voice or beard growth or breasts, for example.”

As the champion of calling out junk science, I will start by noting that 55 test subjects is hardly conclusive, and the Netherlands is a small country, increasing the likelihood that the sample of young people was not very diverse. Further, although Dr. De Vries is calling this “fully reversible,” when I follow the links to more information, I learn that she is aware that she did not study side effects of puberty suppression. If this was something I or my own child was considering, I would want to do a lot more research on side effects and what “fully reversible” means. It would also appear that all 55 subjects elected gender reassignment, which is something else that would benefit from more attention. Nonetheless, instead of explaining something about human behavior based on a small sample, these researchers are exploring a possible intervention, and reporting positive early results.

One issue here is that the Endocrine Society and the World Professional Association for Transgender Health recommend that gender-dysphoric or transgender teens do not take hormones before age 16, which pretty much ensures that they will experience puberty as a person of their biological gender rather than of their identified gender. De Vries’ study leads the way to earlier intervention, which makes it possible to delay puberty until after gender reassignment surgery, and never develop in a body that they experience as wrong. (Yes, transgender experiences, teenage and otherwise, are much more complicated than “growing up in the wrong body,” but then not every trans teen will need, or choose, this path even if it turns out to be as positive as these early indications imply.) Another positive feature is that many trans people who start hormones later in life experience a second puberty, and have both the fun and the no-fun-at-all experiences of puberty twice; some people might be delighted to only go through that once.

For now, I’m filing this study under “good to know,” “needs more information,” and “hopeful for good experiences for trans children and teens.” And that’s good enough for me.