I have a few more pieces that I’ve written, just for some more additional education!
Puberty Blockers and Brain Development
Puberty blockers have been safely used with cis children to treat precocious puberty (the medical term for early puberty) or to treat puberty that is happening too fast for decades. Puberty blockers have been prescribed since the early 1980’s off label to treat precocious puberty in children, and was approved by the FDA for that specific use in 1993 (as well as to treat other conditions such as idiopathic short stature in children). Adults can take the same drugs labeled as puberty blockers and are used to treat some forms of breast and prostrate cancer, polycystic ovary syndrome, and endometriosis (with varying results and very different risk profiles for adults than for children).
In the US, which is where my experience comes from, puberty blockers are still regulated and approved by the FDA, and are extremely well studied.
There are very few studies on the long-term affects of puberty blockers and brain development. A metanalysis of published studies did not find agreement amongst studies that there even is any statistically significant relationship between the blocker and developmental milestones.
HOWEVER, it is very very important to note that long term robust studies were only rarely conducted for children with precocious puberty, mostly because of the drug safety and doctors seeing the results that children weren’t developmentally altered once they stopped taking the puberty blocker. It only became an issue of major concern when puberty blockers started to be used for trans and non-binary youth, and they are mostly concerns pushed by those who are vehemently against any measures that affirm trans lives. Studies on this have exploded with the criticism and scare tactics of trans antagonists demanding a “reason” to deny puberty blockers from gender diverse youth.
A study published in 2016 looked at the effects of precocious puberty on Korean women and found that there were significant barriers for those who did NOT receive puberty blockers, and they were mostly psychosocial in nature. Things like risky sex, cigarette and alcohol use, internalizing body image and eating disorders, and easy influence by peers, as well as biochemical alterations. This study concluded that untreated precocious puberty was damaging to these adults.
There is one long-term study of ONE individual that I could find that began in 1988 and progressed until 2010. That study found no statistically-significant declines in brain development in that person compared to adults who did not receive puberty blockers as children at the end of the study.
Another study published in 2023 with a focus on gender diverse youth found that of the 40 people who took puberty blockers (compared against 398 who did not receive puberty blockers as youth), there were statistically significant decreases in anxiety, depression, stress, and internalizing negative beliefs.
So all in all, so far there are no significant indications of decreased brain development on any child who receives puberty blockers, whether it is for precocious puberty or gender diverse youth. That isn’t to say that some youth might have different experiences or difficulties when not given appropriate support and care, but so far these numbers appear to be very very low.
References:
WPATH Guidelines: https://www.tandfonline.com/doi/pdf/10.1080/26895269.2022.2100644
Summary of that PLOS One study if this is easier to read: New Study Shows Transgender People Who Access Gender-Affirming Hormones During Adolescence Are Significantly Less Likely To Experience Psychological Distress Or Suicidal Ideation - Fenway Health
The Trevor Project about LGBTQIA+ su1 rates https://www.thetrevorproject.org/resources/article/facts-about-lgbtq-youth-suicide/
Article about the WPATH lowering recommendations for HRT to start at age 14 in the most recent edition Guidelines lower minimum age for gender transition treatment and surgery | AP News
Great study from the American Academy of Pediatrics about comprehensive care for trans and gender-diverse youth Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents | Pediatrics | American Academy of Pediatrics
Children’s Hospital Boston page on precocious puberty Precocious Early Puberty | Boston Children's Hospital
Cleveland Clinic page on precocious puberty Precocious Puberty - Early Puberty: Symptoms & Causes
Yoo, 2016 Effects of early menarche on physical and psychosocial health problems in adolescent girls and adult women https://www.e-cep.org/journal/view.php?doi=10.3345/kjp.2016.59.9.355
Cohen-Kettenis et. al, 2011, “Puberty Suppression in a Gender-Dysphoric Adolescent: A 22-Year Follow-Up” Puberty Suppression in a Gender-Dysphoric Adolescent: A 22-Year Follow-Up - PMC
McGregor et. al, 2023, Association of Pubertal Blockade at Tanner 2/3 With Psychosocial Benefits in Transgender and Gender Diverse Youth at Hormone Readiness Assessment https://www.sciencedirect.com/science/article/abs/pii/S1054139X23005608