'There's going to be a price': A growing number of medical professionals admit puberty blockers for kids may be irreversible and cause long-term harm

A growing number of medical professionals are questioning the safety and reversibility of puberty blockers when taken by young children, according to a recent analysis commissioned by the New York Times and released on Monday.

Gender dysphoria trends in American adolescents

In the United States, an estimated 300,000 children between the ages of 13 and 17 identify as transgender. Reuters found that 15,000 children from the ages of 6 to 17 were diagnosed with gender dysphoria in 2017, compared to 42,000 in 2021.

The spike in adolescents diagnosed with gender dysphoria has led to increased use of puberty blocker medication.

Medical professionals in support of puberty blockers argue that the drugs positively impact children diagnosed with gender dysphoria who suffer from depression and anxiety.

Dr. Norman Spack, the first physician to introduce blockers to transgender children in the United States, argued that the drugs could be lifesaving.

“Anxiety drains away,” Spack said. “You can see these kids being so relieved.”

How puberty blockers work

Puberty blocker drugs suppress estrogen and testosterone — hormones responsible for developing the reproductive system. The medicine can also impact the bones, the brain, and other parts of the body.

Medical professionals prescribe blockers to children as young as eight. Then, around 12 or 13 years old, transgender children are switched to sex hormones.

Some doctors argue that starting treatment young can be more effective at physically aligning patients with their gender identity and protecting their bones.

Potential risks of puberty blockers

The analysis commissioned by the New York Times, which reviewed scientific papers from and interviews with more than 50 doctors and academic experts across the globe, uncovered substantial evidence that puberty blockers are more harmful than advertised.

Doctors prescribing puberty blockers claim that the drugs only "pause" puberty. Transgender children and their parents are told puberty will continue if the patient stops taking the blockers.

However, the analysis found that puberty blockers may have a harmful, long-term impact on children’s bones and brains. Two studies determined that bone strength did not rebound fully for patients who took puberty blockers and switched to sex hormone treatment.

“We also found concerns that blockers could lock adolescents into a path of medical intervention before they are certain of their identity,” the New York Times reported.

“There’s going to be a price,” Dr. Sundeep Khosla, who leads a bone research lab at the Mayo Clinic, told the New York Times. “And the price is probably going to be some deficit in skeletal mass.”

Bone mass surges during teen years by about 8% to 12% a year. However, the New York Times analysis found that bone density stops growing when children take blockers.

The analysis found that puberty blockers could cause debilitating bone fractures earlier in the aging process.

“When they lose bone density, they’re really getting behind,” said Dr. Catherine Gordon, a pediatric endocrinologist and bone researcher at Baylor College of Medicine in Houston.

Children who stop taking puberty blockers by 11 can see a full recovery in bone density.

“That’s the difference,” Dr. Gordon said. “You shorten that critical window of puberty.”

“The most difficult question is whether puberty blockers do indeed provide valuable time for children and young people to consider their options, or whether they effectively ‘lock in’ children and young people to a treatment pathway,” wrote Dr. Hilary Cass, a pediatrician leading an independent review of treatments for adolescents believed to be suffering from gender dysphoria.