Puberty blockers and hormones
Puberty blockers are medications that suppress the sex hormones that are produced by the body. These medications may be started soon after puberty begins. They put puberty on pause and can prevent changes such as voice lowering, breast growth and periods. Effects will vary, depending on how far puberty has progressed before starting the blockers. There are no known irreversible effects of puberty blockers, so if your child were to stop taking them their body would continue through puberty, picking up where it left off. These medications have been safely used for decades to treat children with precocious puberty, and were first used with trans youth in the 1990's.
There are three main reasons that youth use puberty blockers:
- The onset of puberty and the idea or reality of developing secondary sex characteristics that do not fit with their gender identity can be very distressing. Puberty blockers can help alleviate this distress.
- If a child is still exploring their gender, puberty blockers allow additional time to explore without worrying about unwanted physical changes.
- Preventing unwanted physical changes can eliminate the need for some surgeries and procedures later on, such as male chest contouring and electrolysis.
Puberty blockers are often prescribed by a pediatric endocrinologist. However pediatricians and family physicians who are knowledgeable about trans care may provide this care as well. For more detailed information, see our Puberty Blockers page.
Some youth who take puberty blockers early in adolescence go on to start hormone therapy. Youth who have not taken puberty blockers may also take hormones.
Hormone therapy allows people to develop secondary sex characteristics that are in line with their gender identity, such as breast growth, softer skin, facial hair, or deeper voice. While not all trans and gender diverse youth will need hormone therapy, it is important that youth who do require this care have access to it.
Like puberty blockers, hormone therapy can be effective in alleviating a person's distress about their body and how they are perceived by others. Research shows that youth who have access to needed hormone therapy have mental health outcomes similar to their cisgender peers, and a recent study documented that suicide attempts and emergency room visits decreased after trans youth had their first appointment with the pediatric endocrinology team at BC Children's Hospital.
Younger youth and their families or caregivers may work with a pediatric endocrinologist for their hormone therapy. Youth, especially those who are older, may be able to access this care through a knowledgeable family doctor. Family doctors can provide care planning, prescribing and monitoring of hormones if they have training in this area.