Puberty can be confusing or difficult for a child who is transgender, genderqueer, nonbinary or questioning their gender.
Puberty blockers, also called hormone blockers, help delay unwanted physical changes that don’t match someone’s gender identity. Delaying these changes can be an important step in a young person’s transition. It can also give your child more time to explore their options before deciding whether or how to transition.
How Do Puberty Blockers Work?
Using puberty blockers is like hitting a pause button. By blocking the sex hormones testosterone and estrogen, puberty blockers delay changes that can affect gender expression, including:
- Breast growth
- Facial hair growth
- Voice deepening
- Widening hips
Puberty blockers don’t stop acne, body odor, or underarm and pubic hair development, because these changes are not controlled only by estrogen or testosterone.
Are Puberty Blockers Safe?
Most experts, including our team, believe that puberty blockers are safe:
- The Endocrine Society and the World Professional Association for Transgender Health support the use of puberty blockers for kids who want to delay or prevent unwanted physical changes.
- The U.S. Food and Drug Administration has approved puberty blockers for children who start puberty at a young age.
What Are the Side Effects of Puberty Blockers?
While puberty blockers are generally considered safe, they have some side effects. Not everyone experiences the following, but some people do.
Possible long-term side effects of puberty blockers
- Lower bone density. To protect against this, we work to make sure every patient gets enough exercise, calcium and vitamin D, which can help keep bones healthy and strong. We also closely monitor patients’ bone density.
- Delayed growth plate closure, leading to slightly taller adult height.
- Less development of genital tissue, which may limit options for gender affirming surgery (bottom surgery) later in life.
- Other possible long-term side effects that are not yet known.
Possible short-term side effects of puberty blockers
- Headache, fatigue, insomnia and muscle aches.
- Changes in weight, mood or breast tissue.
- Spotting or irregular periods (in menstruating patients whose periods are not completely suppressed by puberty blockers).
For children who want to delay or prevent unwanted physical changes, the mental health benefits of puberty blockers may outweigh these risks.
At What Age Can You Start Taking Puberty Blockers?
Because every child is different, there isn’t a single best age to begin puberty blockers.
In general, starting puberty blockers in early puberty leads to better outcomes and prevents the lifelong difficulties that can result from living with undesired sex characteristics. While they can stop puberty from progressing, however, blockers can’t reverse changes that have already happened.
Are Puberty Blockers Permanent?
No, puberty blockers are temporary:
- Injectable blockers (such as Lupron) can last one, three or six months. Patients can continue getting injections until they decide what to do next.
- Implants (such Supprelin), which are placed just under the skin in the arm, can last 12 to 24 months before they need to be replaced.
Both types are meant to give patients more time to consider their options:
- If your child decides to continue transitioning, they will likely want to consider hormone therapy and possibly gender affirming surgery.
- If your child decides that they want to develop characteristics of the sex they were assigned at birth, they can simply stop taking puberty blockers. Once the puberty blockers are out of their system, they’ll go through the puberty of the sex assigned at birth. Puberty blockers alone should not affect your child’s fertility, but hormone therapy can.
Why Choose the Transgender Center for Puberty Blockers
A research-based approach: We understand that starting puberty blockers is both an emotional decision as well as a medical one. When you meet our team, we’ll discuss the available research to help you make an informed choice.
Support at every step: In addition to comprehensive mental health care, we offer case management services and an educational liaison who helps kids with school-related issues
Connections to the community: Now is the time to meet other families and children who can offer their support and guidance. We’re happy to discuss resources and organizations that can get you connected to the LGBTQ+ community.
Help dealing with insurance: We have a pre-certification coordinator who can work with you to get puberty blockers approved by your insurance provider. Puberty blockers are not always covered by insurance, but we do our best to make the case for children who need them.