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Why Puberty Blockers Are A Clear Danger To Children’s Health

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I have written (see here and here) about physicians who push the boundaries of ethical practice by administering untested medical treatments to children and adolescents suffering from gender dysphoria (or transgender patients). Such treatments include puberty blockers, cross-sex hormones, and so-called sex-reassignment surgery.

Citing guidelines issued by the political advocacy group World Professional Association for Transgender Health (WPATH), these physicians admit that the effects of cross-sex hormones are generally irreversible. Vulnerable patients who agree to this treatment are thus crossing the Rubicon into permanent bodily impairment.

However, most doctors insist that puberty blockers are safe and fully reversible, so that patients who decide not to continue with the “transition” can get their healthy bodies back. But mounting medical evidence shows the fallacy of the cavalier implication that puberty blockers are as harmless as aspirin and can be discontinued with as little effect.

Time To ‘Explore Their Identity,’ But At What Cost?

One of the puberty blockers frequently administered to girls who identify as boys (female-to-male, or FtM) is called Lupron. Lupron belongs to a class of drugs called gonadotrophin hormone-releasing (GnRH) agonists and is used to suppress estrogen production, thereby delaying the physical changes of puberty in a pre-pubescent female patient.

The argument is that this will give the girl more time to “explore her identity,” an easier path to physical transitioning before her body matures, and a chance to decide if she wants to pursue more serious measures such as cross-sex hormones and surgery. (More on that later.) The first claim is that Lupron is safe. But thousands of patients who have been treated with Lupron for non-sex-related conditions would disagree.

Lupron was originally Food and Drug Administration (FDA) approved to treat prostate cancer, but it’s now routinely prescribed for other conditions such as endometriosis and “precocious puberty” — i.e., puberty that begins too early (generally considered under age eight for girls, under age nine for boys). Many of these patients have experienced extreme side effects that shattered their health and their lives, including severe joint pain, osteoporosis, compromised immune systems, and mental health issues such as severe depression and even suicidal ideation. The FDA has received 24,000 reports of adverse reactions, about half of which the agency has deemed serious.

Lupron manufacturer AbbVie has been fighting lawsuits over the drug for years. In one case pending in federal court in Illinois, 60-year-old Terry Paulsen claims she has endured severe medical problems related to receiving two injections of Lupron for endometriosis 14 years ago. “My body is on fire,” she said. “My joints have arthritis everywhere.” Since her Lupron treatment, Paulsen has suffered not only constant pain but strange rashes, severe osteoporosis, and multiple surgeries.

In another lawsuit, gynecologist David Redwine testified as an expert witness about the adverse effects of Lupron he has observed over 31 years of medical practice. Noting that Lupron’s suppression of the pituitary-gonadal system may affect a body’s immune response, Redwine concluded that the plaintiff in that case suffered extreme bone density loss and other symptoms as a result of being administered Lupron beginning at the age of 17.

Many Patients Suffer From Lupron-Related Side Effects

Tragically, many other young patients have endured similar adverse effects. The Atlanta Journal-Constitution reported on a younger patient’s trauma after receiving Lupron treatment for precocious puberty. Now 22, Brooklyn Harbin was injected with Lupron at the age of 10, and soon found herself in such severe pain that she ended up a wheelchair while still in fifth grade.

Dr. Ken Sinervo, an Atlanta-area gynecologist who specializes in endometriosis surgery, reports having seen many women suffering memory loss and joint pain after Lupron treatment. He was quoted as warning that “Lupron or any of the similar types of medications should never be used in someone under the age of 21.”

But of course, all gender dysphoric patients who might be placed on Lupron to delay puberty are years younger than 21. Plus, there’s a serious added danger to using Lupron merely to stop normal puberty in a gender dysphoric child. Such treatment is “off label,” meaning the FDA hasn’t approved the drug for this purpose, nor is there reliable research showing the safety of such use.

The research and consulting firm Hayes, Inc. warned that “the literature is too sparse and the studies [that exist are] too limited to suggest conclusions” about safety and effectiveness of using Lupron and other GnRH agonists on healthy children to prevent normal puberty. The American College of Pediatricians (ACPeds) points out that puberty blockers alter a patient’s body in myriad ways:

In addition to preventing the development of secondary sex characteristics, GnRH agonists arrest bone growth, decrease bone accretion, prevent the sex-steroid dependent organization and maturation of the adolescent brain, and inhibit fertility by preventing the development of gonadal tissue and mature gametes for the duration of treatment.

Are Lupron’s Effects Really Reversible?

Despite all these warning flags about administering these drugs to healthy children, ideologues such as Dr. Stephen Rosenthal (who receives federal tax dollars to produce research supporting transgender-affirming treatment) see no problem with this experimentation. Rosenthal declares himself a “firm believer” in using GnRH agonists to stop normal body development in gender-confused children.

Rosenthal also insists that the effects of Lupron and other such drugs are “100 percent reversible,” a claim the true believers at WPATH support. Is this true? Mounting evidence suggests the answer is no.

The thousands of complaints about Lupron, mentioned above, show that many adverse side effects can be long-lasting, if not permanent. But even in a patient who doesn’t suffer those effects––that is, when the drug simply delays puberty without causing additional harm––the effect may not be fully reversible.

Reversibility must be considered from both a physical and a psychological perspective. Physically, a particularly problematic result is the direct effect on the pituitary gland. Redwine, the expert witness on the dangers of Lupron mentioned above, cited a study of impaired pituitary function: “The most important finding of this review comes from study M84-042. The study provides the evidence that 62.5% of patients [treated with Lupron for endometriosis] had not regained baseline estrogen levels by one year after stopping Lupron.”

In other words, the effect on the pituitary was not reversible for the majority of those patients. Endocrinologist Michael Laidlaw also warns that bone density may never recover from use of puberty blockers:

There is an exquisitely timed release and change of multiple hormones during normal puberty. Among these are growth hormone and the sex hormones which account for the growth spurt including bone growth and development. It has been shown that puberty blockers interfere with the expected increase in bone density in adolescence such that the bones are not as strong as they would be had normal pubertal development been allowed. This is due to the effect of dropping sex hormone levels to subnormal levels. These lost years of bone development cannot be regained.

Outgrowing Dysphoria Naturally

If this weren’t enough reason for parents to refuse such treatment for their minor children, Laidlaw says that “what parents should find truly terrifying is the psychological effect of this medication.” Under the traditional treatment for gender dysphoria, which involves “watchful waiting or pursuit of family and individual psychotherapy,” between 80 and 95 percent of adolescent patients outgrow their dysphoria naturally.

In other words, only 5 to 10 percent of those children remain dysphoric and go on to request further treatments. But a major study of dysphoric children who were administered puberty blockers found that 100 percent went on to request cross-sex hormones.

Why would a child whose normal puberty is short-circuited be more likely to move on to radical treatment with cross-sex hormones and perhaps surgery? Laidlaw attributes this phenomenon to “a very strong psychologically addictive component to this medication, so that once children begin taking these blockers, they never leave the road of high-dose synthetic hormones and irreversible surgeries.”

ACPeds agrees, offering a theory grounded in neuroscience and social science:

There is an obvious self-fulfilling nature to encouraging a young child with GD to socially impersonate the opposite sex and then institute pubertal suppression. Purely from a social learning point of view, the repeated behavior of impersonating and being treated as the opposite sex will make identity alignment with the child’s biologic sex less likely. This, together with the suppression of puberty that prevents further endogenous masculinization or feminization of the entire body and brain, causes the child to remain either a gender non-conforming pre-pubertal boy disguised as a pre-pubertal girl, or the reverse. Since their peers develop normally into young men or young women, these children are left psychosocially isolated. They will be less able to identify as being the biological male or female they actually are.

ACPeds concludes: “A protocol of impersonation and pubertal suppression that sets into motion a single inevitable outcome (transgender identification) that requires lifelong use of toxic synthetic hormones, resulting in infertility, is neither fully reversible nor harmless.”

Rosenthal, Dr. Johanna Olson-Kennedy, and the other medical ideologues who plow ahead with these therapies haven’t refuted these concerns. They seem to simply ignore them. That such behavior is allowed by the medical establishment, and even funded by federal tax dollars, is a travesty. Can we sink any lower than to sacrifice children to political ideology?