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Journalism of Courage
Ever since US businessman Elon Musk revealed how he was “tricked” by his transgender child into giving consent for the use of puberty blockers, conversation has veered around the role of these drugs and the crisis of gender identity.
As Dr Subhash Kumar Wangnoo, senior consultant, endocrinologist and diabetologist, Indraprastha Apollo Hospitals, says puberty blockers have a cascading impact on hormones in transgender children and could affect them both physically and mentally.
What are puberty blockers and who needs them?
Puberty blockers are injectable drugs that delay the changes of puberty in transgender and gender-diverse teens. During puberty, the child’s body goes through physical changes in the process of becoming a sexually mature adult. It is initiated by hormonal signals from the brain to the gonads: the ovaries in a female, the testicles in a male.
When teens have gender dysphoria, a condition where they are conflicted between the gender assigned at birth and the gender they want to assume, the medication is prescribed to pause sex hormones. Doctors believe that natural biological changes may add to the anxieties of adolescents who are not comfortable about their own identity. They might feel like their bodies are betraying them because the developmental changes they’re experiencing don’t line up with how they identify. That’s why doctors halt physiological processes that act as stressors and threaten their mental health.
The medicines are called gonadotropin-releasing hormone (GnRH) analogues, which stop the body from making sex hormones. In people assigned male at birth, these slow the growth of facial and body hair, prevent voice deepening and limit the growth of the penis, scrotum and testicles. In people assigned female at birth, this treatment limits or stops breast development and stops menstruation.
Other than gender identity issues, are there other medical conditions where such drugs are used?
Puberty blockers are also used in cases of precocious puberty, a condition in which a child’s body begins changing into that of an adult all too soon, before the age of eight for girls and before the age of nine in boys. Then doctors recommend suppressing the hormones.
Sometimes in such cases, an early growth spurt may help the children gain height but then once puberty sets in, they may stop growing taller. This is because bones stop growing once exposed to estrogen or testosterone. Girls stop gaining height 18 months after puberty, boys after two years. So if their physical development cannot keep pace with early puberty, blockers are the only option.
How do these drugs benefit transgenders and non-binary kids?
These drugs improve their mental well-being, ease depression and anxiety, improve social interactions, help them understand themselves better and definitely veer them away from self-harm. However, taking puberty blockers alone, without other medical or behavioural treatment, might not be enough to ease gender dysphoria. Parental consent is needed for drug use.
What are the side effects of using puberty blockers?
These include insomnia, weight gain, low concentration, self-harm-induced depression, muscle aches, fatigue, shifts in mood, changes in breast tissue, irregular period or spotting in women. It can lead to deep vein thrombosis and even affect liver function.
However, these symptoms are temporary as they last till the time one is on puberty blockers. The body resumes its normal processes once the drugs are stopped.
