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I’m a trans adult, why do I need puberty blockers?

At GenderGP, we are often asked about the role of puberty blockers in transition. This post aims to answer some of your key questions.

The hormone we produce naturally is dictated by our gonads. Put simply: ovaries produce oestrogen, testicles produce testosterone. There is a little of both hormones produced elsewhere in your body, but that is not really relevant here.

For a trans individual to achieve masculinisation, the majority hormone needs to be testosterone. This essentially means you want more testosterone than oestrogen in your bloodstream. The reverse is true for feminisation, which requires more oestrogen. In order to prevent your naturally occurring hormones from ‘fighting’ those which are medically introduced, we can introduce a ‘blocker’.

Technically known as gonadotropin-releasing hormone (GnRH) agonists, this medication inhibits the production of those hormones which cause puberty to start, the changes in our bodies to develop, and they continue to flow through our body until the menopause.

The confusion comes in the name of the so-called ‘puberty blockers’, technically we should refer to them as ‘sex-hormone blockers’ but, because we often talk about their introduction when puberty occurs, the name has stuck!

In truth, it doesn’t matter if you are 15 or 50, have testes or ovaries, are early on in your medical transition or well established. These blockers are highly effective at blocking your natural hormone production, stopping the battle between testosterone and oestrogen and allowing your body to develop in the way you want it to.

 

So what is the ideal way to use hormone blockers?

  • When puberty starts – block it.
  • If you ever want to ‘try out’ your natal hormone again, just stop the blocker and your own natural production will restart.
  • Carry on with the blocker for as long as you want to block your own production.
  • Use HRT to give you the right amount of hormone to achieve the masculinisation or feminisation you need (while letting the blocker get rid of your naturally occurring hormone).

 

Of course the above is a very binary approach to hormone profiling which for some non-binary gender identities will not be appropriate or desirable. Some people need both oestrogen and testosterone on board to create their perfect hormonal balance. So, if the preferred outcome is somewhere in the middle, what is the best approach?

There are degrees by which you can block your natural hormone production, adding in some of the other hormone can help you to find the balance that truly suits you. The important thing to remember is that nothing changes overnight. You will have plenty of time to feel what is right for you and you can continue to adjust it as time goes on.

Blockers are available as an injection or a nasal spray and are the best way of suppressing hormone production, however old you are. If you would like to find out more, ask the team or you can book a consultation with one of our doctors.

 

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