Can You Start Puberty Blockers At 12
Although parents might think they should start puberty blockers very young, so that a child never has to experience any physical changes associated with the unwanted gender, experts say its better to wait at least until the early stages of puberty have started. Dr.
Can you start puberty blockers at 13? Related Questions
Transgender Youth And Sports
What are the current guidelines in the U.S. for the participation of transgender people in sports?
Policies on the participation of transgender students in high school sports vary from state to state. At least 16 states and the District of Columbia have policies that help facilitate the full inclusion of transgender, nonbinary and gender-nonconforming students in high school sports, according to TransAthlete.com and the American Civil Liberties Union.A patchwork of policies exists in other states, with at least 10 states requiring trans athletes to undergo some treatment, and11 states banning participation.
At elite levels, policies also vary across national and international associations and federations. The International Olympic Committee issued guidance in 2015 for determining eligibility. According to the guidance, transgender men can compete in male categories without restriction, but transgender women must meet certain conditions, including demonstrating that their total testosterone level in serum has been below 10 nmol/L for at least 12 months before their first competition.
What research is available about transgender athletes and whether they have an advantage over cisgender athletes?
But studies of the performance of transgender athletes so far are limited and based on small, narrow samples that some researchers say cannot necessarily be applied to high school sports.
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Effects On Reproductive And Sexual Capability
Additional concerns regarding puberty delaying treatment relates to its effects onreproductive capability .
There are two most likely scenarios. In one, the adolescent proceeds with the transitionto the other gender, and eventually in adulthood receives full genital surgery. In thesecases, natural conception is not possible. However, it might still be possible to havegenetically related children with assisted reproduction technologies. In this scenario,one concern is that the use of blockers in early puberty might prevent the extraction andstorage of sperm and of ova .However, the suppression of spermatogenesis in natal males is temporary and can berestored by interrupting treatment. A male assigned at birth whose puberty has beensuppressed before spermatogenesis has occurred could decide to stop treatment long enoughfor spermatogenesis to start if they wish to collect and store sperm for reproductivepurposes . They can then continuewith treatment for transition to female gender.
Gender Identity And Puberty Blockers
Another indication for puberty blockers is having a gender identity other than the one associated with one’s sex at birth. For transgender and non-binary youth, starting puberty can be an incredibly upsetting experience. Puberty blockers are a way that doctors can give teens and their parents time to fully understand the young person’s gender identity. When ready, the young person can go through puberty in their identified gender. If that’s the gender associated with their sex assigned at birth, they can stop blockers and start puberty naturally. If it’s not, they can be treated with cross-sex hormone therapy.
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What Do Puberty Blockers Do
Medically speaking, puberty blockers are medication in the group GnRHa.
- When you give the blocker , the medication stops the signals. When the infusion or spray wears off, the signals will restart.
- Finally, theyll start producing their natal hormones again. No medication lasts forever. When you stop taking it wears off and stops working.
Puberty blockers are reversible.
Puberty blockers have been used for a long time with great benefits.
In medicine, hormone blockers help fight prostate cancer. Prostate cancer is an aggressive cancer, and prostate cancer feeds off testosterone.
People with endometriosisare given puberty blockers. They get blockers to stop the hormone cycles that cause endometriosis to flare up.
Children with precocious puberty are prescribed them to stop them from going through puberty too early. A considerable number of these children have reached final height.
With puberty blockers, transgender kids can go through puberty alongside their peers.
The secondary sex characteristics that develop can be of the transgender adolescents preferred gender identity.
People are asking are puberty blockers reversible?, without ever seeing the irreversibility of a transgender kid going through natal puberty.
If any of these patient groups stop the puberty blocker, then it wears off and is no longer effective.
This is obviously important for children with precocious puberty as they need to, and must, go through puberty when the time is right.
Legal And Political Challenges
There is criticism regarding issues of informed consent and limited research support for the use of puberty blockers on transgender children. The Endocrine Society Guidelines call for more rigorous safety and effectiveness evaluations and careful assessment of “the effects of prolonged delay of puberty in adolescents on bone health, gonadal function, and the brain .”
Some opponents of the use of puberty blockers argue that minors are not able to give proper consent. Some advocates for the use of puberty blockers consider the psychological and developmental benefits of puberty blockers compelling enough to overlook the issue of informed consent in many cases. Consent is often achieved after extensive analysis and counseling. A 2021 editorial in The Lancet Child & Adolescent Health stated “Disproportionate emphasis is given to young peopleâs inability to provide medical consent, a moot point given thatâlike any medical careâparental consent is required. … what matters ethically is whether an individual has a good enough reason for wanting treatment”, and that “Social conservatives in the USA, UK, and Australia frame gender-affirming care as child abuse and medical experimentation. This stance wilfully ignores decades of use of and research about puberty blockers and hormone therapy”.
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The Protocol Always Starts With Puberty
Puberty blockers are only given to children who have started puberty. For a child who is assigned female at birth, Dr. Cartaya says puberty typically starts between the ages of 8 and 13. For a child who was assigned male at birth, the range is between 9 and 14.
This threshold exists because there is some evidence that kids who are gender-questioning before puberty starts often decide that they are OK with the gender that they were assigned at birth after they start puberty. The most recent data shows that about two-thirds of kids will.
But if a child has started puberty and is experiencing gender dysphoria, puberty blockers might help them adjust.
Gender dysphoria is when a person experiences psychological distress because the sex that they were assigned at birth doesnt line up with how they feel inside. A kid who is experiencing gender dysphoria might say that they feel like they were born in the wrong body or ask to be treated as the gender with which they identify.
A third of kids will have an exacerbation of their gender dysphoria during puberty. These kids often feel like their bodies are betraying them in many ways, explains Dr. Cartaya. That can also be an indication that gender dysphoria is going to last throughout their lifetime. This is the reason why we wait until puberty to start children with gender dysphoria on puberty blockers.
What Are Puberty Blockers How Do They Stop Precocious Puberty
Puberty blockers are more commonly known as GnRH analogs or GnRH agonists. They are also referred to as GnRHa treatment. These drugs interrupt the signals that the brain puts out to tell the body to start producing the hormones associated with puberty. Before puberty, children have only small amounts of a hormone called GnRHgonadotropin-releasing hormone. The hormone is released infrequently and at low amounts. When puberty starts, the body starts making more GnRH and releasing it more frequently. GnRHa treatment turns down that signal until doctors and patients are ready for puberty to begin. Puberty usually begins within 6 months to a year after stopping GnRHa treatment.
Research has found that young people who receive GnRHa treatment before the age of six for precocious puberty reach greater adult heights than those who are not treated. However, a 2019 meta-analysis found no such effect for cis girls receiving treatment between the ages of seven and ten.
Research suggests that young people receiving treatment may also experience reduced stress and stigma from the ways in which precocious puberty makes them different from their peers. However, more studies are needed before scientists will have a true understanding of the psychological effects of precocious puberty treatment.
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Gnrha Have Unknown Long Term Side Effects
Second, we are rarely in a position where we can predict an individuals response to aparticular drug with absolute certainty. Most drugs have side effects, and most have somerare but serious ones, but our inability to predict whether this particular patient willexperience a serious side effect does not make the prescription experimental. If it didall prescription, even of Aspirin would be experimental. What drives clinical decisions isthe risk/benefit ratio using a probabilistic calculation, which includes elements such anassessment of the risks of the condition if left untreated, the expected benefits of theintervention, the expected risks, the potential more remote risks, their likelihood. Fromthis a conclusion is drawn concerning whether the intervention is overall clinicallyappropriate. However, in response to the concerns around the medium and long term sideeffects of GnRHa, we will briefly summarize the current understanding of its long-termeffects and then discuss the general problems in researching possible side-effects of GnRHatreatment of transgender adolescents.
Broadly the concerns can be divided in the following categories:
What Are The Symptoms Of Gender Dysphoria
- A desire to no longer have the primary sex characteristics of their birth-assigned gender.
- A desire to be treated as the opposite gender.
- A desire to have the primary and secondary sex characteristics of their preferred gender identity.
- The insistence that they are a gender different from their birth-assigned sex.
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Are Puberty Blockers Reversible
When a child starts a puberty blocker, it doesnt mean their bodys puberty changes are permanently suspended. A puberty blocker is more like a short-term solution. It stops the process for as long as a child is using the medication. Once usage stops, puberty will resume.
Its more like a pause. If we stop the medicine, puberty can restart, says Dr. Cartaya. She adds that once it begins again, the body will go through puberty thats associated with the sex assigned at birth.
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 caregivers consent.
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.
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What Are The Side Effects Of Puberty Blockers
While puberty blockers are generally considered safe, they have some side effects. Not everyone experiences the following, but some people do.
Possible long-term side effects of puberty blockers
- Lower bone density. To protect against this, we work to make sure every patient gets enough exercise, calcium and vitamin D, which can help keep bones healthy and strong. We also closely monitor patients bone density.
- Delayed growth plate closure, leading to slightly taller adult height.
- Less development of genital tissue, which may limit options for later in life.
- Other possible long-term side effects that are not yet known.
Possible short-term side effects of puberty blockers
- Headache, fatigue, insomnia and muscle aches.
- Changes in weight, mood or breast tissue.
- Spotting or irregular periods .
For children who want to delay or prevent unwanted physical changes, the mental health benefits of puberty blockers may outweigh these risks.
Puberty Suppression For Trans And Gender Diverse Youth
Phoenix is requesting puberty blockers to prevent the development of unwanted and distressing secondary sex characteristics . Puberty blockers are typically administered via subcutaneous implant or injection given on a monthly, quarterly or yearly basis. Puberty suppression is often described in the literature as reversible that is, if the young person discontinues puberty blockers, they will recommence the puberty consistent with the sex assigned to them at birth.
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Hormone Blockers And Mental Health
“A common misconception is to do ‘watchful waiting’ or ‘observation’ of a child where puberty-blocking medications or gender-affirming hormones are really indicated. But if the child does not receive those puberty-blocking medications, that’s not a neutral decision,” says Dr. Roberts. “By not intervening when it is indicated to do so, that has the clear potential to do harm.”
Many trans and gender nonconforming kids suffer psychosocially as puberty begins. A trans boy who experiences menstruation, for example, might feel alienated from peers or disconnected from his body and likely lacks access to hygiene products in many settings. When trans kids who want to take blockers have access to the medication, they have lower risks for suicidal ideation throughout their lifetime, improved psychological effects, and better social lives.
Kids who go through precocious puberty can also be negatively impacted without treatment. Research shows a correlation between early puberty and adverse psychological, social, and behavioral outcomes, including negative self-image, strained peer relationships, greater likelihood of substance use, and higher rates of depression and anxiety.
Can You Take Puberty Blockers At 15
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. After taking puberty blockers, a person may start taking estrogen or testosterone hormones.
Can you start testosterone at 14?
Doctors can prescribe estrogen or testosterone at gradually higher amounts to mimic the puberty of the female or male gender. The Endocrine Society recommends that kids start taking these hormones around age 16, but doctors will start them as early as 13 or 14.
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Medical Organization Policy Changes
On June 30, 2020, the British National Health Service changed the information it displayed on its website regarding the reversibility of the effects of puberty blockers and their use in the treatment of minors with gender dysphoria, according to a report by BBC’s Woman’s Hour. Specifically, the NHS removed “the effects of treatment with GnRH analogues are considered to be fully reversible, so treatment can usually be stopped at any time after a discussion between you, your child and your MDT ,” and added “little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria. Although the Gender Identity Development Service advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be. Itâs also not known whether hormone blockers affect the development of the teenage brain or childrenâs bones. Side effects may also include hot flushes, fatigue and mood alterations.”
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.
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
investigated the effects of puberty suppression in transgender children and adolescents.
The consensus is that puberty blockers are safe.
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Treatment For Children And Young People
If your child is under 18 and may have gender dysphoria, they’ll usually be referred to the Gender Identity Development Service at the Tavistock and Portman NHS Foundation Trust.
GIDS has 2 main clinics in London and Leeds.
Your child or teenager will be seen by a multidisciplinary team at GIDS including a:
- clinical psychologist
- family therapist
The team will carry out a detailed assessment, usually over 3 to 6 appointments over a period of several months.
Depending on the results of the assessment, options for children and teenagers include:
- group work for young people and their parents
- regular reviews to monitor gender identity development
- referral to a local Children and Young People’s Mental Health Service for more serious emotional issues
- a referral to a specialist hormone clinic for hormone blockers for children who meet strict criteria
Most treatments offered at this stage are psychological rather than medical. This is because in many cases gender variant behaviour or feelings disappear as children reach puberty.