Drugs That Delay Puberty May Help Gender-confused Teens

by VR Sreeraman on Dec 7 2008 12:35 PM

Young teenagers who have extreme gender identity disorder should be given puberty-blocking drugs to save them from experiencing distressing changes to their bodies which they perceive to be out of line with their true gender.

This is for the first time that the Endocrine Society has drafted international guidelines on the controversial issue, with the hope that delaying puberty would provide young teens with valuable thinking time, where they can decide if they want to begin gender reassignment using cross-sex hormones at the age of 16.

And thus, the strategy would make it easier for them to live in their chosen gender. For example, potential male-to-female transsexuals will not have developed the deep voice, facial changes and body hair associated with adult masculinity.

The guidelines also noted that gender-reassignment surgery should be avoided until the age of 18.

"We recommend that adolescents who fulfill eligibility and readiness criteria for gender reassignment initially undergo treatment to suppress pubertal development," New Scientist quoted the guidelines as saying.

According to the guidelines, treatment should not begin before Tanner stage 2 or 3: when female breasts have begun to bud, and boys have experienced a slight enlargement of the penis and scrotum.

The reason-because the teenager's emotional reaction to these first physical changes can help predict if they will persist in wanting to change their sex.

All the recommends have come in line with the experience of a clinic in the Netherlands where doctors have so far prescribed puberty blockers to more than 70 under-16s. The youngest they have treated is 11, although the majority are 12 or over.

"We don't have any patient who has regretted their decision on the treatment," said Henriette Delemarre-van de Waal of Leiden University Medical Centre who has helped treat them.

However, many fear that teenagers will change their minds. For example, previous studies have suggested that just 20 percent of boys who show signs of gender identity disorder in childhood continue to show it into adulthood.

But despite the fact that the effects of puberty-blockers are reversible, there have been few trials exploring the long-term effects of delaying puberty in this way.

Another problem is of fertility-blocking puberty in boys before mature sperm have had the chance to develop removes the option of freezing sperm in case they later decide they want to start a family after undergoing gender-reassignment surgery.

However, enduring puberty with the feeling that you are in the wrong body can cause intense distress, and has even driven some teenagers to contemplate suicide.