Children on puberty blockers saw mental health change - new analysis

[Mosby]

The majority of children in a landmark study on puberty blockers experienced positive or negative changes in their mental health, new analysis suggests.

The original study of 44 children, who all took the controversial drugs for a year or more, found no mental health impact - neither benefits nor harm.

But a re-analysis of that data now suggests 34% saw their mental health deteriorate, while 29% improved.

The authors of the original report have welcomed the new evidence.

The re-analysis, which has been seen by BBC Newsnight, questions some of the conclusions from the 2021 study about the potential mental health impact of puberty blockers on under 16s. It also sheds some light on this much-debated, but little understood, area of children's medicine.

https://www.bbc.com/news/health-66842352

[Warpy]

1. Interesting, I had expected more problems to be reported, honestly.

Sex hormones can have profound effects on the brain as well as the body, so that first study seemed just a little to sunny to me.

I'm not surprised by this analysis, in other words.

Should the drugs be banned? Of course not. Therapists do need to be more alert to mental health issues, since it looks like one in three children will start to have them. Withdrawing the drugs has to be done on an individual basis, if at all, to make sure the mental health problems are due to the drugs and not to things like intense bullying at school by kids with good Christian family values.

Puberty sucked for most of us. I can't imagine what trans kids go through. Anything that can help them is god, as long as therapists and parents are aware it might not all be smooth sailing.

[Voltaire2]

2. Did they compare against a set of trans kids

denied access to puberty blockers?

[Think. Again.]

4. Excellent, excellent point.

[Think. Again.]

3. Sounds like this study....

...had some serious flaws and I wonder if other influences on the affected patient's mental health have been entirely ruled out.

[LetMyPeopleVote]

5. A randomized controlled trial has been published regarding gender affirming care.

Gender affirming care saves lives by reducing suicides. When the GOP bans gender affirming care, they are in effect trying to kill young people who they do not like

Link to tweet

In order to get around the ethical problems of withholding care, the researchers studied only adults, and opted for a shorter follow-up period. The researchers point out that by doing this, the control group would not be disadvantaged for very long, and that such a wait period would be deemed acceptable for transgender people who want to contribute to such important research. This means that such a trial could be conducted ethically.

See their statement on this decision:

This short period was designed for participant acceptability and feasibility so that transgender and gender-diverse participants would not be disadvantaged by waiting longer than standard care waiting times of 3 months for an initial consultation. Second, participants were not blinded to their intervention group. Therefore, it is possible that the effect of testosterone or patient knowledge of treatment has been evaluated. However, randomization of participants to no treatment or placebo over longer follow-up is unethical, particularly given preexisting barriers to accessing GAHT

The improvement in depression and suicidality underscores the substantial benefits of gender-affirming care. The reduction scores align with the much longer observational studies, which typically report a 40-73% decrease in suicidality. While this study alone doesn't confirm long-term advantages, when viewed alongside the extensive clinical experiences of physicians and numerous other studies indicating long-term benefits of such care, it establishes the importance of this care.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2809058

Question What is the effect of testosterone therapy compared with no treatment on gender dysphoria, depression, and suicidality in transgender and gender-diverse adults seeking masculinization?

Findings In this 3-month open-label randomized clinical trial of 64 transgender and gender-diverse adults, there was a statistically significant decrease in gender dysphoria in individuals with immediate compared with delayed initiation of testosterone therapy. A clinically significant decrease in depression and a decrease in suicidality also occurred with immediate testosterone therapy.

Meaning The findings of this trial suggest that testosterone therapy significantly decreases gender dysphoria, depression, and suicidality in transgender and gender-diverse individuals desiring testosterone therapy.