How hormone blockers put puberty on pause
CBC
Hormone therapies are medications with a variety of uses — from birth control, to treating symptoms of menopause, to fighting prostate cancer. But lately, one use in particular has been at the centre of a growing political storm: blocking puberty.
When used as a puberty blocker, hormone therapy delays the sexual development changes of puberty.
Puberty blockers have become a contentious issue in Canada, the U.S. and Europe, as politicians debate the use of these medications in children of various ages. Their use has been banned for minors in several U.S. states, and Alberta Premier Danielle Smith recently announced her government plans to introduce similar policies.
Here's a closer look at how puberty blockers are used in medicine.
Puberty blockers were originally used for precocious puberty, which is when a child's body starts to take on adult characteristics — such as breast development or pubic hair — before the age of eight for girls or nine for boys.
Doctors also prescribe puberty blockers to adolescents with gender incongruence or dysphoria — lasting distress due to a mismatch between one's sense of their own gender and their biological sex assigned at birth — in order to pause puberty and give them more time to explore their options.
"The clinical objective of prescribing a hormone blocker is to provide a young person with time to further explore their gender identity without pressure or distress related to ongoing development of secondary sex characteristics," or gendered experiences such as menstruation or erections, the Canadian Paediatric Society says in its 2023 position statement on affirming care for transgender and gender-diverse youth.
It adds that hormone blockers should not be prescribed before a child begins puberty.
Before an adolescent can consent to treatment, mental health providers confirm their understanding of the pros and cons of treatment and how puberty will resume if they stop taking the blockers.
Dr. Jake Donaldson, a primary care physician at Pinnacle Medical Centres in Calgary, consults on 2SLGBTQ+ care, including hormone replacement therapy for transgender and gender non-binary individuals.
He says when puberty blockers are given too late in the process of puberty, some changes to the body become permanent and might need surgery to reverse.
"The critical time for puberty blockers is the onset of puberty," Donaldson said in an interview with CBC's Canada Tonight. "If you introduce it after that, it's too late."
WATCH | Trans teen health in a rural community:
A common type of puberty blocker is gonadotropin-releasing hormone (GnRH) analogues. These are chemical compounds similar in structure to the hormone made and released by a gland in the brain.
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