What are puberty blockers and why are they prescribed for transgender and gender-diverse teens?

“When a teen has gender dysphoria, a condition in which they are conflicted between the gender assigned at birth and the gender they want to assume, the medication is prescribed to pause sex hormones,” Dr Subhash Kumar Wangnoo, senior consultant, endocrinologist, and diabetologist at Indraprastha Apollo Hospitals, said.

The biological changes may add to the anxieties of adolescents who are not comfortable about their identity, Dr Wangnoo said. “They might feel that their bodies are betraying them because the developmental changes they’re experiencing don’t line up with how they identify. That’s why doctors halt physiological processes that act as stressors and threaten their mental health,” he said.

How do these drugs work?

The medicines are called gonadotropin-releasing hormone (GnRH) analogues, which stop the body from making sex hormones. In people assigned male at birth, these slow the growth of facial and body hair, prevent voice deepening, and limit the growth of the penis, scrotum, and testicles. In people assigned female at birth, the drugs limit or stop breast development, and stop menstruation, Dr Wangnoo said.

Puberty blockers are also used in cases of precocious puberty, a condition in which a child’s body begins changing too soon, before the age of eight for girls and before the age of nine in boys.

Are puberty blockers commonly prescribed in India?

They are prescribed mostly for precocious puberty in India, Dr Wangnoo said. They are also prescribed for those who seek gender reassignment surgery, but those are not conducted before the age of 18, he said.

How are puberty blockers administered?

A shot has to be given monthly, or every three months, or every six months. The medication may be given also through an implant placed under the skin of the upper arm. The implant usually needs to be replaced every 12 months, Dr Wangnoo said.

Side effects include insomnia, weight gain, muscle aches, fatigue, mood shifts, changes in breast tissue, and irregular periods or spotting in women. They may also cause depression or self-harm tendencies.