Puberty Blockers
(also: hormone blockers)
Table of Contents
Introduction
Originally introduced in the 1990s as a treatment for precocious puberty, puberty blockers are used to pause puberty in adolecents. Precocious puberty is defined as when someone who was AFAB starts puberty at/before 8 years old and when someone who was AMAB starts puberty at/before 9 years old. In the context of this page, we will be discussing puberty blockers in their role as a gender-affirming treatment for transgender youth.
Puberty blockers are generally recommended for transgender kids as a way to help give them more time to figure out their gender identities before deciding whether or not they would like to go on to taking estrogen or testosterone as a teenager (or simply stopping the puberty blockers and not taking any further hormonal treatment, if the conclusion that the child has is that they are not actually transgender). Many transgender people know who they are at a very young age, puberty blockers help them avoid the trauma of undergoing puberty and being forced to experience the extreme gender dysphoria that comes from undegoing those unwanted hormonal changes.
Kids who take hormonal blockers are typically required to see a gender therapist to discuss their feelings regarding their gender, and obtain a diagnosis of gender dysphoria. This is done to ensure that the child truly is transgender before the child goes on to undergo HRT (and to reduce the potential risk of detransition). Informed consent is sometimes used depending on the age of the child.
General Information
Puberty blockers a fast acting treatment that is used to safely pause puberty in adolecents. They are not permanent and do not affect fertility. Very basically, puberty blockers tell the brain to slow the production of hormones.
The same medication is used regardless of AGAB.
General Effects
In those who were AFAB
Taking puberty blockers will cause those who were AFAB to decrease the production of estrogen.
This results in the following being stopped/limited/slowed;
- Breast tissue development
- Broadening of the hips
- Development of sex drive
- Growth in height
- Menstrual cycle
In those who were AMAB
Taking puberty blockers will cause those who those who were AMAB to decrease the production of testosterone.
This results in the following being stopped/limited/slowed;
- Broadening of the shoulders
- Deepening of the voice
- Development of sex drive
- Growth of Adam’s apple
- Growth of gonads and erectile tissue
- Growth in height
- Growth of facial and body hair
Negative Side Effects
A common negative side effect of puberty blockers is that the medication affects bone health. The accumulation of calcium in the bones will be limited.
For this, most healthcare professionals will prescribe a calcium supplement; and monitor for any negative changes.
If experiencing negative bone health, it will typically improve after stopping puberty blockers (and starting gender affirming hormones if desired).
Types of Medication
Lupron Depot
Belonging to a group of drugs called gonadotropin-releasing hormone (GnRH) agonists, this medication sends a signal to the brain to stop making sex hormones.
Some of the things that Lupron is use to treat include prostate cancer, endometriosis, uterine fibroids, and early-onset puberty.
Lupron was first approved by the FDA in 1993.
External Links
Puberty Blocker Resources
- Gender GP: 07/17/2024: Are Puberty Blockers Reversible? (https://www.gendergp.com/are-puberty-blockers-reversible/) - article regarding the necessity of puberty blockers, myths, and how bans are bad
- Gender GP: 11/07/2024: FAQ – Blocking Puberty (https://www.gendergp.com/blocking-puberty-faqs/) - list of facts about puberty blockers
- Healthline: Gabrielle Kassel: 01/28/2025: Are Puberty Blockers Permanent? What You Should Know Before Treatment (https://www.healthline.com/health/are-puberty-blockers-reversible) - article regarding effects of puberty blockers, safety, risks, benefits
- Healthline: Dr. Patricia Weiser & Stan Saji, PharmD, MBA, RPh: 05/16/2022: Lupron Depot Injection (https://www.healthline.com/health/drugs/lupron-depot) - article regarding a brand-name drug used to suppress puberty (among other things)
- Mayo Clinic: 06/14/2023: Puberty blockers for transgender and gender-diverse youth (https://www.mayoclinic.org/pubertal-blockers/art-20459075) - article regarding risks, benefits, etc of puberty blockers
- OHSU - GENDER CLINIC - About puberty blockers (https://www.ohsu.edu/sites/default/files/2020-12/Gender-Clinic-Puberty-Blockers-Handout.pdf) - pdf about puberty, puberty blockers (types, effects, etc)
- Planned Parenthood - What are puberty blockers? (https://www.plannedparenthood.org/learn/teens/puberty/what-are-puberty-blockers) - blurb regarding different types of puberty blockers
- The Guardian: 03/15/2024: Ian Sample: Puberty blockers: what are they and what are the concerns about them? (https://www.theguardian.com/society/2024/mar/15/puberty-blockers-what-are-they-and-what-are-the-concerns-about-them) - article about history and usage of puberty blockers (and how they work)
- TransCareBC - Puberty blockers (https://www.transcarebc.ca/hormone-therapy/puberty-blockers) - article about puberty blockers; effects, criteria, risks, etc. additional resources about needle phobia
- Transgender Map - Hormone blockers for gender diverse youth (https://www.transgendermap.com/youth/medical/hormone-blockers/) - introductory blurb regarding puberty blockers
- Transgender Teen Survival Guide - Puberty Blockers (ftm) (https://transgenderteensurvivalguide.com/post/162915420935/im-a-13-year-old-trans-boy-so-ive-obviously?) - summary of how puberty blockers work and additional resources
- Transgender Teen Survival Guide - Puberty Blockers (mtf) (https://transgenderteensurvivalguide.com/post/175510606415/are-puberty-blockers-for-mtf-a-thing-if-it-is) - summary of how puberty blockers work and additional resources
- Trans Language Primer - Hormone Blockers (https://translanguageprimer.com/hormone-blockers/) - blurb about puberty blockers
- Wikipedia - Histrelin (https://en.wikipedia.org/wiki/Histrelin) - medication
- Wikipedia - Puberty Blocker (https://en.wikipedia.org/wiki/Puberty_blocker) - wikipedia article about puberty blockers
Studies/Journals/Papers/Etc
- American Academy of Pediatrics: Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents (https://publications.aap.org/pediatrics/article/142/4/e20182162/37381/Ensuring-Comprehensive-Care-and-Support-for) - Jason Rafferty, COMMITTEE ON PSYCHOSOCIAL ASPECTS OF CHILD AND FAMILY HEALTH, COMMITTEE ON ADOLESCENCE, SECTION ON LESBIAN, GAY, BISEXUAL, AND TRANSGENDER HEALTH AND WELLNESS, Michael Yogman, Rebecca Baum, Thresia B. Gambon, Arthur Lavin, Gerri Mattson, Lawrence Sagin Wissow, Cora Breuner, Elizabeth M. Alderman, Laura K. Grubb, Makia E. Powers, Krishna Upadhya, Stephenie B. Wallace, Lynn Hunt, Anne Teresa Gearhart, Christopher Harris, Kathryn Melland Lowe, Chadwick Taylor Rodgers, Ilana Michelle Sherer; Ensuring Comprehensive Care and Support for Transgender and Gender-Diverse Children and Adolescents. Pediatrics October 2018; 142 (4): e20182162. 10.1542/peds.2018-2162
- American Academy of Pediatrics: Kristina R. Olson, PhD: 03/01/2016: Mental Health of Transgender Children Who Are Supported in Their Identities (https://publications.aap.org/pediatrics/article-abstract/137/3/e20153223/81409/Mental-Health-of-Transgender-Children-Who-Are) - Kristina R. Olson, Lily Durwood, Madeleine DeMeules, Katie A. McLaughlin; Mental Health of Transgender Children Who Are Supported in Their Identities. Pediatrics March 2016; 137 (3): e20153223. 10.1542/peds.2015-3223
- American Academy of Pediatrics: Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation (https://publications.aap.org/pediatrics/article-abstract/145/2/e20191725/68259/Pubertal-Suppression-for-Transgender-Youth-and) - Jack L. Turban, Dana King, Jeremi M. Carswell, Alex S. Keuroghlian; Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation. Pediatrics February 2020; 145 (2): e20191725. 10.1542/peds.2019-1725
- JAACAP - Mental Health and Self-Worth in Socially Transitioned Transgender Youth (https://www.jaacap.org/article/S0890-8567(16)31941-4/fulltext) - TY - JOUR T1 - Mental Health and Self-Worth in Socially Transitioned Transgender Youth AU - Durwood, Lily AU - McLaughlin, Katie A. AU - Olson, Kristina R. Y1 - 2017/02/01 PY - 2017 N1 - doi: 10.1016/j.jaac.2016.10.016 DO - 10.1016/j.jaac.2016.10.016 T2 - Journal of the American Academy of Child & Adolescent Psychiatry JF - Journal of the American Academy of Child & Adolescent Psychiatry SP - 116 EP - 123.e2 VL - 56 IS - 2 PB - Elsevier SN - 0890-8567 M3 - doi: 10.1016/j.jaac.2016.10.016 UR - https://doi.org/10.1016/j.jaac.2016.10.016 Y2 - 2025/04/24 ER -
- JCEM - Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents Open Access - Michele A O’Connell, Thomas P Nguyen, Astrid Ahler, S Rachel Skinner, Ken C Pang, Approach to the Patient: Pharmacological Management of Trans and Gender-Diverse Adolescents, The Journal of Clinical Endocrinology & Metabolism, Volume 107, Issue 1, January 2022, Pages 241–257, https://doi.org/10.1210/clinem/dgab634
- National Library of Medicine: 03/20/2018: Gonadotropin Releasing Hormone (GnRH) Analogues (https://www.ncbi.nlm.nih.gov/books/NBK547863/) - LiverTox: Clinical and Research Information on Drug-Induced Liver Injury [Internet]. Bethesda (MD): National Institute of Diabetes and Digestive and Kidney Diseases; 2012-. Gonadotropin Releasing Hormone (GnRH) Analogues. [Updated 2018 Mar 20]. Available from: https://www.ncbi.nlm.nih.gov/books/NBK547863/
- PubMed - Association of Pubertal Blockade at Tanner 2/3 With Psychosocial Benefits in Transgender and Gender Diverse Youth at Hormone Readiness Assessment (https://pubmed.ncbi.nlm.nih.gov/38099903/) - McGregor, Kerry et al. “Association of Pubertal Blockade at Tanner 2/3 With Psychosocial Benefits in Transgender and Gender Diverse Youth at Hormone Readiness Assessment.” The Journal of adolescent health : official publication of the Society for Adolescent Medicine vol. 74,4 (2024): 801-807. doi:10.1016/j.jadohealth.2023.10.028
- PubMed - Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review (https://pubmed.ncbi.nlm.nih.gov/38594047/) - Taylor, Jo et al. “Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review.” Archives of disease in childhood vol. 109,Suppl 2 s33-s47. 30 Oct. 2024, doi:10.1136/archdischild-2023-326669
- PubMed - Psychological Functioning in Transgender Adolescents Before and After Gender-Affirmative Care Compared With Cisgender General Population Peers (https://pubmed.ncbi.nlm.nih.gov/32273193/) - van der Miesen, Anna I R et al. “Psychological Functioning in Transgender Adolescents Before and After Gender-Affirmative Care Compared With Cisgender General Population Peers.” The Journal of adolescent health : official publication of the Society for Adolescent Medicine vol. 66,6 (2020): 699-704. doi:10.1016/j.jadohealth.2019.12.018
- PubMed: Guss C, Gordon CM. Pubertal Blockade and Subsequent Gender Affirming Therapy: True, True and Unrelated? (https://pmc.ncbi.nlm.nih.gov/articles/PMC9793415/) - Guss, Carly, and Catherine M Gordon. “Pubertal Blockade and Subsequent Gender-Affirming Therapy.” JAMA network open vol. 5,11 e2239763. 1 Nov. 2022, doi:10.1001/jamanetworkopen.2022.39763
- PubMed: Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis (https://pubmed.ncbi.nlm.nih.gov/39855724/) - Miroshnychenko, Anna et al. “Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis.” Archives of disease in childhood vol. 110,6 429-436. 16 May. 2025, doi:10.1136/archdischild-2024-327909
- PubMed: Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent (https://pubmed.ncbi.nlm.nih.gov/9879847/) - Cohen-Kettenis, P T, and S H van Goozen. “Pubertal delay as an aid in diagnosis and treatment of a transsexual adolescent.” European child & adolescent psychiatry vol. 7,4 (1998): 246-8. doi:10.1007/s007870050073
- PubMed: Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation (https://pmc.ncbi.nlm.nih.gov/articles/PMC7073269/) - Turban, Jack L et al. “Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation.” Pediatrics vol. 145,2 (2020): e20191725. doi:10.1542/peds.2019-1725
- T & F - Is puberty delaying treatment ‘experimental treatment’? (https://www.tandfonline.com/doi/full/10.1080/26895269.2020.1747768#d1e129) - Giordano, S., & Holm, S. (2020). Is puberty delaying treatment ‘experimental treatment’? International Journal of Transgender Health, 21(2), 113–121. https://doi.org/10.1080/26895269.2020.1747768
- Sage Journals - Experiences of Puberty and Puberty Blockers: Insights From Trans Children, Trans Adolescents, and Their Parents - Horton, C. (2022). Experiences of Puberty and Puberty Blockers: Insights From Trans Children, Trans Adolescents, and Their Parents. Journal of Adolescent Research, 39(1), 77-103. https://doi.org/10.1177/07435584221100591 (Original work published 2024)
- Sage Journals - Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors (https://journals.sagepub.com/doi/10.1177/0886260520915554) - Austin, A., Craig, S. L., D’Souza, S., & McInroy, L. B. (2020). Suicidality Among Transgender Youth: Elucidating the Role of Interpersonal Risk Factors. Journal of Interpersonal Violence, 37(5-6), NP2696-NP2718. https://doi.org/10.1177/0886260520915554 (Original work published 2022)
- The New England Journal of Medicine - Psychosocial Functioning in Transgender Youth after 2 Years of Hormones (https://www.nejm.org/doi/full/10.1056/NEJMoa2206297) - Diane Chen, Ph.D. https://orcid.org/0000-0002-7302-9248, Johnny Berona, Ph.D., Yee-Ming Chan, M.D., Ph.D. https://orcid.org/0000-0003-0554-8502, Diane Ehrensaft, Ph.D., Robert Garofalo, M.D., M.P.H., Marco A. Hidalgo, Ph.D., Stephen M. Rosenthal, M.D., Amy C. Tishelman, Ph.D., and Johanna Olson-Kennedy, M.D. Published January 18, 2023
Debunking Myths
Non-Transgender Use of Hormone Blockers Resources
Additional Resources