Puberty blockers not proven safe or effective

According to a report by Florida Medicaid, there is “low to very low quality” evidence that so-called “puberty blockers” drugs protect the mental health of minors who wish to live as members of the opposite sex.

The 45-page report from Florida refutes claims by transgender and transgender-affirming groups that puberty blockers are a safe solution for children and teens who are dissatisfied with their male or female bodies.

These groups include the World Professional Association for Transgender Health (WPATH), the Endocrine Society and the American Academy of Pediatrics (AAP), and they are cited as experts by major hospitals, Democrats and the Biden administration, which wants to get the drugs to troubled kids.

The report concluded that puberty blockers, cross-sex hormones, and sex reassignment surgeries for adults and minors are against the Medicaid rule, which states that sex reassignment treatments, such as condition of coverage, must be “in accordance with Generally Accepted Professional Medical Standards (GAPMS) and not experimental or experimental. The report was completed by Florida Medicaid and requested by the Secretary of the Agency for Health Care Administration (AHCA ).

The report is important because it could be used to inform the rule-making process about what kinds of treatments state health care agencies will be able to cover through programs like Medicaid. Florida State Surgeon General Joseph Ladapo has previously sent a letter to the Florida Board of Medicine citing the report’s findings and asking the board to establish “a standard of care for these complex and irreversible procedures.”

Main findings on puberty blockers

A section of the report titled “Literature Review: Abandoning Gender Dysphoria and Puberty” examines claims by clinical organizations that puberty blockers are an effective mental health treatment for minors with gender dysphoria. gender. The report also addresses the lack of long-term research on the potential side effects of puberty blockers, which have not been approved by the Food and Drug Administration (FDA) to treat gender dysphoria.

Deciding not to transition

WPATH and the Endocrine Society state that in addition to being safe and fully reversible, puberty blockers can give teens more time to explore the sex they choose to live in. The organizations also claim that puberty blockers can prevent the development of “difficult or impossible to reverse” sex characteristics if minors later decide to change sex.

The Florida Medicaid report contradicts these claims, stating that “some studies provide weak support for this treatment, but leave too many questions about its effectiveness and medical necessity, especially given the number of children who choose not to make the transition.

“Furthermore, puberty blockers arrest the development of primary and secondary sex characteristics and prevent adolescents from adjusting to and feeling comfortable with their natal sex,” the report states. “Instead, puberty blockers may serve as a potential ‘entrance drug’ for cross-sex hormones by denying them the experience of physical maturation.”

The report cites a 2013 study of 127 minors, with an average age of 15, who were referred to a Dutch gender dysphoria clinic. Of the cohort, 47 (37% – including 23 boys and 24 girls) “continued to suffer from the disease and requested sex reassignment treatment”. The other 80 miners never returned to the clinic. The study noted that older teens were more likely to persist with the transition, while younger minors “tended to lag behind.”

“While the study focuses on the factors that contribute to the persistence or cessation of the disease, it raises the question of whether puberty suppression is necessary when age plays such a large role in the transition decision,” the report said.

“Low quality” search

The report also refuted claims by clinical organizations and the media that these treatments have large swathes of quality research proving the effectiveness of puberty blockers as a mental health treatment. For example, an article published in Scientific American in May 2022 claimed that “laws banning gender-affirming treatments ignore the wealth of research demonstrating its health benefits for trans people.”

The Medicaid report counters that existing studies showing that puberty blockers are an effective treatment for minors with gender dysphoria are of “low or very low quality.” The report says these studies are characterized by small sample sizes, often lack control groups, involve self-reports, and are conducted over short periods of time. The report even points to a recent acknowledgment by the acting director of the National Institutes of Health (NIH), Lawrence Tabak, that there are no long-term studies available evaluating the effects of puberty blockers when used for gender dysphoria.

The report further notes that the current body of research lacks randomized controlled trials (RCTs). The report calls RCTs the “gold standard” of medical studies because they use large sample sizes, have blinded test groups, and use objective controls.

“Because RCTs use large sample sizes, have blinded test groups (i.e. placebos), and use objective controls, they can offer actionable conclusions and shape the range of established treatments” , says the report. “Furthermore, RCTs require comparisons between cohort outcomes and ensure that participants are randomly assigned to each group. These measures further reduce the potential for bias and subjectivity.

Potential side effects

The report adds that “aside from questionable research methods”, information regarding “the full physical effects of puberty suppression is incomplete”.

The report cites a 2020 study in which 44 experts in neurodevelopment, gender development, and puberty/adolescence come to the conclusion that “the effects of pubertal suppression warrant further study.” Specifically, experts have raised questions about whether suppressing natural hormones could stifle brain development in addition to sexual maturation.

“Because this question remains unanswered, it casts doubt on the veracity of organizations’ claims that puberty suppression is ‘fully reversible,'” the report states.

The report also points to a 2019 literature review which found that while most side effects associated with puberty blockers “are mild”, clinicians have linked the drug (GnRHa) to “long-term conditions such as polycystic ovary syndrome, obesity, hypertension and reduced bone mineral density.

“[T]This review raises questions about whether off-label use to treat a psychological condition is worth the risks,” the report read, adding that “no long-term research has been done on how suppression of puberty affects bone growth”.

Countering the Biden administration

Overall, the Medicaid report concluded that “further evidence is needed to establish puberty suppression as the standard treatment for gender dysphoria.” It further states that sex reassignment surgeries, puberty blockers, and cross-sex hormone treatments for people with gender dysphoria are not proven to be “safe or effective” treatments and are “experimental and experimental.”

The Florida Medicaid report is one of Florida Gov. Ron DeSantis’ latest pushback efforts against the Biden administration’s efforts to force the state to conform to radical left-wing gender ideology. In April, the Florida Department of Health released guidance on how to treat gender dysphoria in children and teens in response to the Biden administration’s call for what it calls care “affirming gender,” making it clear that social gender transition, as well as gender reassignment surgery, “should not be a treatment option for children or adolescents.”

Katherine Hamilton is a political reporter for Breitbart News. You can follow her on Twitter.


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