Medically speaking, Puberty Blockers are a medication in the group GnRHa (Gonadotrophin Releasing Hormone Agonists). They stop the hormone signals that go from the brain to the gonads (ovaries and testicles) that tell them to produce the hormones of puberty. When you give the blocker (by injection or nasal spray) the medication stops the signals. When the injection or spray wears off, the signals will restart and the hormones will be produced again. No medication lasts forever, when you stop taking it it wears off and stops working.
This medication has been used for a long time with great benefit. It is prescribed to people with prostate cancer because prostate cancer feeds off testosterone. People with endometriosis are given blockers to stop the hormone cycles that cause endometriosis to flare-up. Children with precocious (very early) puberty are prescribed them to stop them going through puberty too early so they can go through puberty with their peers rather than in infant school. Transgender adolescents are prescribed them to stop them developing secondary sex characteristics that do not align with their gender identity.
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 need to, and must, go through puberty when the time is right. People with prostate cancer should stay on this medication for life. People with endometriosis can stop them to see how and if their symptoms re-develop, and start them again if they do. Transgender adolescents can stop them and allow their natural puberty to resume, if that is what they want.
Except if you are trans, that is the last thing you want. You do not want puberty that makes girls have beards, or boys have breasts. They want the same puberty that the other girls and guys have in their class, the one that matches their gender identity. The one that allows their external features match their heart and brain. The one that makes them fit in rather than stick out. The one that is associated with far better mental health outcomes and life satisfaction scores. If they wanted to stop the puberty blocker and let it wear off, then it would – because the medication is reversible.
What is not reversible is their transgender identity. Whether that is masculine, feminine, somewhere in between or neither. And yes, trans adolescents do not stop puberty blockers, because they are the right treatment for the right diagnosis for the right outcome. But if they did want to, they could, and all the effects would cease and their natural hormone production would resume and puberty would restart and it would finish completely, as if it had never stopped. They probably wish that their own body produced the right hormones form the start, they just didn’t get dealt that card when they were developing.
After careful assessment, puberty blockers are prescribed to cisgender children (those who have started puberty and need to have it stopped). After careful assessment, they are prescribed to transgender adolescents (those who have started puberty and need to have it stopped). They are life-savers, they give a trans adolescent the chance to have an identity that is not dominated by being trans. they allow teenagers to concentrate on school, education, music, fun and romance rather than unwanted and irreversible developments to their body.
Putting a trans teenager through a natural puberty is irreversible without invasive corrective surgery. Giving a trans teenager a puberty blocker can be life-saving and is completely reversible. It’s just that if they are trans, they don’t want the effects of that medication to reverse.
If you have been affected by any of the issues raised in this blog post and would like to speak to a member of the team, visit our Help Centre.