What are puberty blockers?

Puberty blockers are medications that prevent the body from producing the hormones that cause the physical changes of puberty.
Young people who are transgender may take puberty blockers to prevent the development of breasts, facial hair, and periods.
This article will discuss what puberty blockers are, who they are for, how long until they take effect, and their benefits and safety.
What are they?
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According to Planned Parenthood, puberty blockers are medications that block the hormones testosterone and estrogen. When a person reaches puberty, these hormones cause changes in the body, such as periods, breast growth, and facial hair growth.
Planned Parenthood
testosterone
estrogen
The National Health Service (NHS) note that puberty blockers do not permanently stop the body’s production of testosterone and estrogen. Instead, they pause the physical effects of puberty.
National Health Service (NHS)
There are two types of puberty blocker: histrelin acetate and leuprolide acetate.
two types
Histrelin acetate is a flexible rod that goes under the skin in the arm. It lasts for 1 year before a person must have it replaced.
The leuprolide acetate puberty blocker is an injectable shot. Different forms of leuprolide acetate work for different lengths of time. A person will need another shot every 1–4 months.
Both puberty blockers are forms of gonadotropin-releasing hormone agonist.
According to one 2021 article, when a person begins puberty, the hypothalamus in the brain begins producing gonadotropin-releasing hormones.
2021 article
These hormones activate the pituitary gland, which triggers the release of further hormones, such as gonadotropins.
The gonadotropins cause the maturation of the gonads. This, in turn, produces and releases the sex hormones testosterone and estrogen from the testes and ovaries.
Histrelin acetate and leuprolide acetate prevent the pituitary gland from producing gonadotropins. This means that the body cannot produce the sex hormones that cause the physical effects of puberty.
How long until they take effect?
A person can use puberty blocker medications for several weeks before noticing any effects.
The Food and Drug Administration (FDA) note that histrelin acetate can cause an increase in some hormones within the first week of treatment. People who are assigned female at birth may notice light vaginal bleeding and breast enlargement.
Food and Drug Administration (FDA)
However, people should notice that signs of puberty stop within 4 weeks of treatment.
Leuprolide acetate can initially cause an increase in puberty hormones.
The FDA state that a person may notice an increase in the signs of puberty for 2–4 weeks. However, people should notice signs of puberty stopping within 4 weeks of treatment.
FDA
The puberty blockers significantly suppress puberty by the sixth month of treatment.
Who are they for?
Healthcare professionals prescribe puberty blockers to young people who are transgender and who may be experiencing gender dysphoria.
Gender dysphoria is a term that describes the sense of unease that a person may have when their sex assigned at birth does not match their gender identity.
Learn more about gender dysphoria here.
Learn more about gender dysphoria here.
Young people who are transgender may find puberty blockers beneficial. These medications can give a young person time to consider further clinical options and to explore their gender identity.
Healthcare professionals may also prescribe puberty blockers to children who are experiencing precocious puberty.
Precocious puberty is a condition wherein children aged 1–9 years old experience an early onset of puberty and have secondary sexual characteristics.
1–9 years old
Are they reversible?
The effects of puberty blockers are physically reversible.
are physically reversible
Puberty blockers only pause the production of testosterone and estrogen hormones. Once a person stops using this medication, their body begins production once more, leading to the development of breasts and facial hair.
However, although the physical effects of puberty blockers are reversible, the Gender Identity Development Service (GIDS) in the United Kingdom note that researchers do not know how these types of medication psychologically affect a person.
Gender Identity Development Service (GIDS)
Are they safe?
A 2017 systematic review investigated the effects of puberty suppression in transgender children and adolescents.
2017 systematic review
The consensus is that puberty blockers are safe.
The authors looked at studies that researched how puberty blockers affect cognitive function. Cognitive function remained the same in both transgender and cisgender participants who undertook several tasks, suggesting that puberty blockers do not have an adverse effect in this area.
However, those who take puberty blockers may process emotional stimuli differently than those who do not take these medications. Participants who took puberty blockers to treat precocious puberty reacted faster to fearful faces in a test than participants who did not take these medications.
It is important to note, however, that puberty blockers may not actually cause this reaction. The participants who took puberty blockers may have processed emotional stimuli differently due to social experiences related to their precocious puberty.
The systematic review also investigated the effect of puberty blockers on bones. Sex hormones affect bone mass accrual in adolescents, which is a process that affects the risk of osteoporosis and fractures in later life.
osteoporosis
fractures
Studies in children who experience precocious puberty have not found evidence of bone density loss after 3 years of using puberty blockers, in comparison with children who did not take these medications.
The authors of the systematic review noted that more research is necessary into the long-term effect of puberty blockers on bone density in those who are transgender.
There is not enough research to know for sure whether puberty blockers adversely affect bone development over a long period of time.
Benefits
The 2017 systematic review also found that transgender people who use puberty blockers may experience several benefits.
2017 systematic review
Research suggests that taking puberty blockers may help alleviate gender dysphoria. Puberty blockers can prevent the development of secondary sexual characteristics, such as breast tissue, penis, and testicle growth.
A person who is transgender may experience gender dysphoria if they develop secondary sex characteristics that do not align with their gender identity. For example, a transgender man may experience gender dysphoria if they have breasts.
Taking puberty blockers and undergoing other medical treatments may help alleviate gender dysphoria, as this medication prevents the development of secondary sexual characteristics.
Studies suggest that a person’s mental health increases after medical intervention.
mental health
People who are transgender are more likely to experience:
depression
depression
social phobia
separation anxiety
separation anxiety
substance use
Research shows that although puberty blockers do not prevent these mental health conditions, they can reduce the symptoms.
Side effects
People may experience several side effects after starting puberty blockers.
Some possible side effects of the histrelin acetate puberty blocker include:
possible side effects
scarring at the injection site
crying
irritability
restlessness and impatience
anger
an increase in aggressive behaviors
Some possible side effects of the leuprolide acetate puberty blocker include:
possible side effects
injection site reactions
general pain at the injection site
headaches
headaches
dilation of blood vessels, which decreases blood pressure
blood pressure
acne
acne
rashes
mood changes
vaginal dryness, bleeding, or discharge
Cost
Puberty blockers can cost several thousand dollars per year. Without insurance, people may spend $4,000–$25,000 per year depending on the form of puberty blocker they use.
$4,000–$25,000
It is important to check whether or not one’s health insurance covers the cost of puberty blockers. More insurance companies are covering these medications. This means that more young people may have access to puberty blockers than before.
health insurance
How and where to get started
If a young person believes that puberty blockers are the correct choice for them, it is important to discuss starting treatment with a healthcare professional.
If a person has health insurance that covers gender-affirming procedures, they can search for an in-network doctor who offers puberty blockers.
Additionally, some Planned Parenthood branches may offer services for those who are transgender. For those under the age of 18 years, they will need a parent or caregiver’s consent.
under the age of 18 years
If a young person does not feel safe talking to their parents or caregivers about making an appointment with a healthcare professional, it is possible to get advice from LGBTQIA+ friendly organizations.
Out in Science, Technology, Engineering, and Mathematics, a nonprofit chapter organization, have several hotlines that people can use for help.
Out in Science, Technology, Engineering, and Mathematics
Are other treatments necessary?
A person does not have to undergo any medical procedures, such as taking puberty blockers or undergoing surgery, unless they believe that it is the right decision for them.
Healthcare professionals may recommend that a person undergoes counseling or other talk therapies with a professional who has experience with transgender mental and physical health. A person may take this step before going on to take medication.
may recommend
After an assessment, a person may start taking puberty blockers. The GIDS recommend that young people take puberty blockers until reaching 16 years of age or having taken puberty blockers for 12 months before considering other medical procedures.
GIDS
After taking puberty blockers, a person may start taking estrogen or testosterone hormones. These can cause irreversible changes to the body, such as the development of breasts or a deepening of the voice.
Once a person becomes an adult, they may begin to consider further gender-affirming procedures, such as surgery to remove or add secondary sexual characteristics.
A person may take all or none of these steps. A person who does not undergo gender-affirming medical treatment has a gender identity that is just as valid as that of a person who does undergo gender-affirming treatments.
Support
A person may find support from family, friends, or healthcare professionals.
As well, several organizations offer support and advice for young transgender people, including:
The Trevor Project
The Trevor Project
Trans Youth Family Allies
Trans Youth Family Allies
National Center for Transgender Equality
National Center for Transgender Equality
Gender Spectrum
Gender Spectrum
PFLAG Transgender Network
PFLAG Transgender Network
A person in the U.K. can use the following services:
Gendered Intelligence
Gendered Intelligence
Stonewall
Stonewall
All About Trans
All About Trans
IMAAN, a charity who provide support for LGBTQIA+ Muslims
IMAAN
Non-Binary Northern Ireland
Non-Binary Northern Ireland
Mermaids, a charity who support young people who are questioning their gender identity
Mermaids
Summary
Puberty blockers are medications that pause the physical changes associated with puberty. These medications can help alleviate gender dysphoria and mental health conditions in young transgender people.
Their effects are reversible. However, a person who takes puberty blockers may later decide to take further hormones to cause irreversible changes, such as the development of secondary sex characteristics.
Although puberty blockers can be expensive, many health insurance companies now cover gender-affirming procedures. A person can seek support from several organizations at any stage in their journey.