Puberty Blockers: New Study Affirms Safety, Reversibility, and Calls for Further Research

An independent review commissioned by the New South Wales (NSW) government has affirmed that puberty blockers are generally safe, effective, and reversible for transgender youths. This comprehensive study, triggered by a 2021 investigative report into Westmead Children’s Hospital, aims to clarify the benefits and potential drawbacks of these treatments.

What the Review Found

The Sax Institute’s review, which analyzed 82 studies on gender-affirming care, including 17 focused on puberty suppression, concluded that the treatment is “safe, effective, and reversible.” This update challenges recent criticisms and reassures that, despite some concerns, the benefits of puberty blockers outweigh the risks.

Key Findings:

• Safety and Effectiveness: The report underscores that puberty blockers, used primarily for individuals under 18, delay the onset of unwanted physical changes during puberty. The NHS also supports the notion that these effects are reversible, with no definitive evidence suggesting harm.
• Research Quality: The review highlights that while existing studies generally support the use of puberty blockers, many are limited by poor design, small sample sizes, and a lack of control groups. The report emphasizes the need for more robust, long-term research to strengthen the evidence base.
• Mental Health Outcomes: The study found a predominance of positive mental health outcomes among those receiving hormone treatment, including improvements in body image, gender dysphoria, and overall quality of life. However, some studies reported neutral or negative results, highlighting the variability in individual responses.

Background and Context

This review comes in the wake of a Four Corners investigation that revealed concerns about the gender clinic at Westmead Children’s Hospital, including high staff turnover and a decrease in new patients. The investigation also raised issues about the quality of research and patient experiences at the clinic.

The Sax Institute’s report noted that while the evidence base for puberty blockers is improving, it remains limited by outdated and poorly designed studies. The report calls for further research to address these gaps and provide clearer insights into the long-term effects of these treatments.

Implications and Next Steps

The findings of the review have significant implications for both current and future practices in gender-affirming care. The report stresses the importance of continued research to ensure the safety and effectiveness of puberty blockers. It also suggests that clinicians should remain vigilant about monitoring potential risks, such as bone density changes, while acknowledging that evidence on this issue remains sparse.

In the UK, the NHS has paused prescribing puberty blockers for transgender youth amid ongoing debates about their use. This situation underscores the need for comprehensive, high-quality research to guide policy and clinical decisions.