What Are Puberty Blockers?

Puberty blockers are a type of prescription medication that is used to stop the onset of puberty.

They are usually the first medical intervention step for transgender, nonbinary, gender non-conforming, gender diverse, or gender expansive children who do not want to go through the puberty of their assigned sex.

They are not a permanent solution, but rather are used for a set period of time to delay the onset of puberty so that a child has time to decide if they want to undergo medically transitioning to the gender they identify as. Puberty blockers are also known as hormone blockers or puberty inhibitors.

They are associated with a reduced risk of suicide for those who take them. Prior to being used as gender-affirming care, puberty blockers were prescribed for cisgender children undergoing puberty at ages that were considered younger than normal.

Common puberty blocker drug options are:

• Goserelin (Zoladex®)  
• Histrelin (Supprelin®LA)
• Leuprolide (Lupron Depo – Ped®) 
• Triptorelin (Trelstar®)

What Do Puberty Blockers Do?

Puberty blockers are antagonists to the production of sex hormones such as estrogen and testosterone. They are known as "gonadotropin-releasing hormone (GnRH) analogs," which are similar to a hormone your body produces naturally, and their function is to stop the progress of changes that would normally occur during adolescence.

That includes growing breasts and menstruating for children who are AFAB (assigned female at birth) and acquiring facial hair, growth of genitalia, and deepening of voice for those who are AMAB (assigned male at birth).

By stopping the process of puberty, puberty blockers buy time for trans, nonbinary, gender-diverse, and gender-expansive children as they head into adolescence. Because the effects of puberty can't be reversed once they occur—at least not without significant medical intervention—these drugs offer a window of time for a child to decide what their next step is as they grow up and prevent the need for future surgeries that will attempt to undo the effects of puberty.

Because puberty can be a stressful, or even devastating, time for someone who does not want its effects, puberty blockers can lead to improved well-being both mentally and emotionally for those who take them. The drugs cannot fully stop gender dysphoria from occurring in a child, but they may mitigate or lessen it considerably.

How Do Puberty Blockers Work?

Puberty blockers work by temporarily halting the process of puberty. When a person decides to stop taking them, unless other medical intervention occurs, such as hormone therapy, the child will then experience the puberty they body was going to experience without the drugs.

These drugs are administered either by an injection or an implant. Injections are given every months or every three months, and the implant will last up to a year. The injections or implants are provided by a medical practitioner.

At What Age Are Puberty Blockers Given?

Puberty blockers are usually taken for up to a few years, from the onset of puberty until a child makes the decision about the next steps in their journey to adulthood.

That's typically by age ten or eleven, but puberty blockers can also be given ever after puberty has begun, to stop further effects of puberty from happening. Puberty can happen as early as age eight for AFAB children and nine for AMAB children.

Are Puberty Blockers Healthy/Safe?

Puberty blockers are generally considered to be safe. That does not, of course, mean that they don't have any side effects, which we will discuss next. It means that the side effects are considered minor enough to warrant their use.

The biggest factor of puberty blockers for many children is that by stopping the onset of puberty, the youth doesn't get put in a situation where they have to take action to reverse the effects of it.

A child who goes on puberty blockers may decide to then take the course of medical intervention to continue their transition, or they might decide to let the puberty of their assigned sex occur.

Side Effects of Puberty Blockers

When considering puberty blockers, it's important to realize that even though there are side effects that can happen, they should be weighed against the potential mental health outcomes of not taking them.

Puberty blockers significantly reduce the risk of depression and suicide for those who take them. When weighing the pros and cons of puberty blockers, those statistics must be taken seriously. It is also worth noting that the side effects of puberty blockers can be exasperated by not being used in conjunction with hormonal therapy.

Decreased bone density may be the biggest long-term risk of taking puberty blockers. Studies regarding the potential loss of bone density in children who receive puberty blockers are ongoing. Some initial studies have found that taking puberty blockers may result in decreased bone density. This can potentially be mitigated by adding calcium, exercise, and vitamin D.

Additional side effects of puberty blockers can include hot flashes, weight gain, acne, insomnia/fatigue, and delayed growth plate closure, which could lead to being taller as an adult than a person would otherwise have been.

The Process of Being Prescribed Puberty Blockers

In order to be prescribed puberty blockers, a child needs to qualify for them. Additionally, because they are under eighteen they need the consent of a parent or guardian.

To qualify for puberty blockers, a child should be at the start or later of puberty. They aren't prescribed before its onset. Additionally, there needs to be a clear history of gender dysphoria or gender nonconformity.

All other medical and/or psychological issues that could interfere with the puberty blockers need to be addressed first in order for a child to qualify. Additionally, the adolescent must be able to successfully consent in an informed manner to the drugs.

Why Finding Accurate Information May Be a Challenge

If you have done any preliminary research about puberty blockers, you have likely noticed that many websites are biased against them. From an initial Google search, it can be very hard to discern which websites are offering accurate information and which are for the purpose of arguing against gender-affirming care.

The states of Alabama, Arkansas, Texas, and Arizona have all taken action to ban gender-affirming care for youth, and nearly two dozen more states are considering legislation to. Even though many of these bills and laws get quickly stopped up in court, they still pose enormous risk to accessing care.

Bills and laws to prohibit care are generally centered around not giving children and adolescents access to puberty blockers, medical care, psychological care, and hormonal therapy. Because gender-affirming surgeries are not as often conducted prior to the age of eighteen, for some bills these are less of the focal points than access to other types of affirming care.

Even though legislation attempts to make affirming care illegal for youth, The World Professional Association for Transgender Health, also known as WPATH, has actually shifted its standard of care guidelines progressively younger to reflect how positively affirming care can impact transgender, nonbinary, and gender diverse and expansive children.

If you are seeking additional information for this topic, and don't want to have to sift through anti-trans websites, the WPATH site has numerous valuable resources available.

A Word From Verywell

When seeking healthcare for issues around gender, finding a provider who is affirming is key. Here are steps you can take to ensure that the care you seek for yourself or your child will be trans-affirming.