Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation

Abstract

BACKGROUND AND OBJECTIVES: Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment. Our objective for this study was to examine associations between access to pubertal suppression during adolescence and adult mental health outcomes. METHODS:Using a cross-sectional survey of 20 619 transgender adults aged 18 to 36 years, we examined self-reported history of pubertal suppression during adolescence. Using multivariable logistic regression, we examined associations between access to pubertal suppression and adult mental health outcomes, including multiple measures of suicidality. RESULTS:Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2-0.6).

Mental Health and Timing of Gender-Affirming Care

“…To our knowledge, these are the first quantitative data relating pubertal stage to mental health problems among GI youth presenting to care, supporting clinical observations that pubertal development, menses, and erections are distressing to these youth and consistent with the beneficial role of pubertal suppression, even when used as monotherapy without gender-affirming hormones. 13,28 Although the median age of youth presenting to our clinic is slightly lower than we have described previously, 4 61% of this cohort were $15 years of age, and 83% were in late puberty at the time of presentation, consistent with literature describing clinical populations of GI youth seeking GAMC. 2,3,5,14 Within this population, it is not clear why YPY presented to care earlier than OPY.…”

Transgender Youths' Perspectives on Telehealth for Delivery of Gender-Affirming Care

“…Nearly 2% of high school and college-aged students in the U.S. identify as transgender [ [1] , [2] , [3] ], and this group experiences significant mental health disparities, including a four times higher rate of attempting suicide [ 3 ]. They also face barriers to accessing gender-affirming medical care, such as puberty blocking medications and gender-affirming hormones, which have been associated with improved mental health and quality of life [ [4] , [5] , [6] , [7] , [8] ]. One significant barrier is the paucity of clinicians with expertise in providing gender-affirming care for minors; because these specialists often practice in academic medical centers, many youth also face transportation challenges [ 9 , 10 ].…”

Pädiatrie aktuell – Forschung kurz notiert

“…Gonadotropin-Releasing-Hormone (GnRH) werden bei Transgenderjugendlichen häufig verordnet, um die Pubertät zu unterdrücken. Eine Befragung von 20.619 Transgenderpersonen (Alter 18 bis 36 Jahre) untersuchte den Einfluss medikamentöser Pubertätssuppression auf spätere Suizidalität [5]. 16,9 % der Befragten hatten irgendwann im Verlauf eine derartige Medikation in Betracht gezogen, nur bei 2,5 % wurde sie aber tatsächlich zur Anwendung gebracht.…”