Puberty Blockers

Puberty blockers are medications that can temporarily suppress the further progression of puberty. They are usually GnRH analogues or GnRH agonists, which dampen the hormonal signaling between the brain, the pituitary gland, and the gonads. As a result, less LH and FSH are released, so the testes produce much less testosterone or the ovaries produce much less estrogen. They are used, among other things, for certain forms of precocious puberty and, after careful specialist assessment, for some trans and non-binary adolescents with significant puberty-related gender dysphoria.

For trans and non-binary adolescents, puberty blockers can provide time without allowing certain pubertal changes to continue progressing. They can temporarily pause or reduce developments such as voice deepening, facial hair growth, breast development, or menstruation, which may be highly distressing for some people and may later be difficult to change or require surgery. Puberty blockers are not, however, gender-affirming hormone therapy; they primarily delay the body’s own puberty.

Treatment should not be undertaken lightly, but should be supervised by experienced professionals, ideally with medical, psychological, and family support as well as the informed assent or consent of the young person concerned. Regular monitoring of growth, physical development, bone health, mood, and possible side effects such as hot flashes, headaches, fatigue, or changes in bone mineral density is important. If puberty blockers are stopped and no other hormone treatment is started, the body’s own puberty generally resumes; timing and progression can vary from person to person. Before any subsequent hormone therapy, possible effects on fertility and future options for fertility preservation should also be discussed.