What you need to know
- Puberty blockers are medications that temporarily stop the production of the hormones that start puberty.
- These medications have been safely administered for decades in children experiencing early puberty, or “precocious puberty.” Sometimes they’re also prescribed to trans kids experiencing gender dysphoria.
- If you think your child may be experiencing precocious puberty or gender dysphoria, talk to a health care provider about your options.
Puberty can be distressing, and some children face more challenges than others. Those who go through early puberty might face social and emotional problems, and some transgender children may experience negative mental health outcomes when physical changes don’t match their gender identity.
Puberty blockers are safe medications that temporarily delay or “press pause” on puberty. However, some states are restricting who can access them.
Read on to learn how puberty blockers work and how researchers know they’re safe.
What is puberty?
Puberty is a series of physical and hormonal changes that occur between childhood and adulthood. It begins when a part of a child’s brain tells their sex organs—ovaries or testes—to start releasing sex hormones, either estrogen or testosterone.
Children with ovaries typically start puberty between the ages of 8 and 13, when they experience physical changes like breast and body hair growth and menstruation. Children with testes usually start puberty between 9 and 14, which typically leads to a lower voice, increased muscle mass, and body hair growth, including facial hair.
Young people going through puberty may also experience growth spurts, increased sweating, body odor, and acne. They may also experience emotional and mental changes, including mood swings and increased self-consciousness.
What are puberty blockers, and what do they treat?
Puberty blockers are medications that temporarily stop the production of the hormones that start puberty. These medications have been safely administered for decades in children experiencing early puberty, or “precocious puberty.”
“We want to make sure development isn’t happening too quickly, so that the child feels comfortable around their peers—not different or in a body that’s older than they are emotionally,” said Dr. Bahareh Schweiger, a pediatric endocrinologist (specialist in hormone-related conditions) at Cedars-Sinai Medical Center in Los Angeles, in a 2023 article.
These medications can also be used to delay puberty in trans youth, whose gender identities or gender expressions do not conform to their sex assigned at birth. Some trans people experience gender dysphoria, a feeling of unease when their perceived gender doesn’t match their gender identity.
Puberty blockers give trans youth more time to understand their gender identities before deciding if they want to pursue other types of gender-affirming care, like hormone replacement therapy.
“Just as it would be distressing for a cisgender boy to grow breasts (which does happen and is treated) or for a cisgender girl to grow a beard (which also happens and is treated), it can be deeply distressing for trans girls to develop facial hair and trans boys to develop breasts,” said Jonah DeChants, a senior research scientist at The Trevor Project, in a Healthline article. “Puberty blockers are lifesaving for transgender, nonbinary, and gender-questioning youth because they prevent these kinds of changes.”
How do puberty blockers work?
Like other hormonal medications, puberty blockers work by influencing hormone levels in the body. In children, temporarily pausing sex hormone production also pauses the resulting physical changes.
Children who stop taking puberty blockers and don’t take other hormonal medications go through puberty as expected. The amount of time that it takes to resume puberty varies.
“It’s similar to how people’s bodies respond differently when they go off birth control pills,” Dr. Jennifer Osipoff, a pediatric endocrinologist at Stony Brook Children’s Hospital in New York, told Healthline. “Some people take a few weeks, while some people take just a few days.”
After stopping puberty blockers, some trans youth may decide to start gender-affirming hormone therapy to experience the body changes that match their gender identity.
Are puberty blockers safe?
Puberty blockers are safe, and research shows that taking them alone does not affect future fertility. Side effects tend to be minimal. Since they are typically administered via an injection in the muscle or a surgical implant, some skin irritation may occur.
If taken for more than a few years, they may also negatively affect bone health since sex hormones help bones absorb calcium. However, bone density typically recovers after puberty blockers are stopped.
“From an ethical and a legal perspective, this is a benign medication,” said Simona Giordano, a professor of bioethics at the University of Manchester in England, in a 2023 Scientific American article.
Withholding puberty blockers from children who need them may come with consequences. Children experiencing precocious puberty who do not receive puberty blockers may experience reduced adult height and social and emotional problems. Trans youth experiencing gender dysphoria may face depression, anxiety, self-harm, and suicidal ideation.
“Puberty blockers improve a young person’s quality of life by preventing potentially permanent changes associated with puberty, which may be very distressing for youth experiencing gender dysphoria,” DeChants said. “They also give youth, their doctors, and families the time and space to determine what future gender affirming healthcare may be best for them, if any at all.”
Research shows gender-affirming care improves mental health in trans youth and adults. A 2022 study found that access to puberty blockers and hormone replacement therapy lowered the odds of depression in trans people between the ages of 13 and 20 by 60 percent and reduced the odds of self-harm and suicidal thoughts by 73 percent.
Both the Endocrine Society and the American Academy of Pediatrics recommend that trans children and teens have access to developmentally appropriate gender-affirming care.
Are puberty blockers legal?
While it’s legal to prescribe puberty blockers to treat precocious puberty, giving trans youth puberty blockers is only legal in some states. As of July, about 40 percent of trans youth ages 13 to 17 are living in states that have passed bans on gender-affirming care. Learn about your state’s laws from KFF.
In January, President Donald Trump signed an executive order attempting to limit access to gender-affirming care for trans youth. Since then, the Trump administration has threatened legal action against children’s hospitals that provide gender-affirming care, leading several clinics to close in states where gender-affirming care is legal.
Some states and advocacy groups like the American Civil Liberties Union and Lambda Legal have filed ongoing lawsuits aiming to protect gender-affirming care.
How can I help my child access puberty blockers?
If you think your child may be experiencing precocious puberty or gender dysphoria, talk to a health care provider about your options.
If you or anyone you know is considering suicide or self-harm or is anxious, depressed, or upset or needs to talk, call the Suicide & Crisis Lifeline at 988 or text the Crisis Text Line at 741-741. For international resources, here is a good place to begin.