Category: Teenagers
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Around one in six young people treated with cross sex hormones ceased treatment.
An exploratory study1 of adolescents and young adults in Canada and the US found that 16.8% of those receiving “gender affirming medical treatment” (puberty blockers and cross sex hormones) stopped “treatment” within around five years of declaring a “trans” or “non binary” identity.
Of those who discontinued treatment, 37.3% did so for health reasons. 32% ended treatment due to a change in gender identity. 12% were persuaded by health professionals or a partner to explore different ways of approaching their gender dysphoria.
Stopping treatment was associated with having a “non binary” identity. Both continuing and non-continuing cohorts had a mean age of 16.1 when “coming out”, but those discontinuing treatment were slightly older (22.1 vs. 20.9.)
- MacKinnon KR, Jeyabalan T, Strang JF, Delgado-Ron JA, Lam JSH, Gould WA, Cooper A, Salway T. Discontinuation of Gender-Affirming Medical Treatments: Prevalence and Associated Features in a Nonprobabilistic Sample of Transgender and Gender-Diverse Adolescents and Young Adults in Canada and the United States. Journal of Adolescent Health. 2024 Oct;75(4):569-577. doi: 10.1016/j.jadohealth.2024.05.015. Epub 2024 Jun 28. PMID: 38944803. ↩︎
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Boys receiving puberty blockers for gender dysphoria experienced irreversible changes to their testes.
A histological analysis1 of testicular tissue taken from boys receiving puberty blockers for gender dysphoria showed that the tissue showed abnormal development that was likely to be irreversible.
Samples were gathered as part of “fertility preservation surgery,” in which testicular tissue is harvested and preserved in hope that it will be able to produce sperm later. Every boy with gender dysphoria in the study had elected for this surgery due to inability or reluctance to ejaculate. This suggests the possible presence of various psychological and physical conditions that are unexplored in the research.
- Murugesh V, Ritting M, Salem S, Aalam SMM, Garcia J, Chattha AJ, Zhao Y, Knapp DJ, Kalthur G, Granberg CF, Kannan N. Puberty Blocker and Aging Impact on Testicular Cell States and Function. bioRxiv [Preprint]. 2024 Mar 27:2024.03.23.586441. Doi: 10.1101/2024.03.23.586441. PMID: 38585884; PMCID: PMC10996503. ↩︎
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Psychological effects of puberty blockers on young people may be worse than placebo.
An analysis1 comparing psychological effects of puberty blockers on teenagers with gender dysphoria with existing research on placebo effects for various mental health conditions found that placebo effects appeared to be at least as strong as the effect of puberty blockers, if not stronger.
- https://sex-matters.org/wp-content/uploads/2022/12/Teenagers-medication-vs-placebo.pdf ↩︎
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Depression symptoms got worse in children taking puberty blockers.
In a study1 of 94 children with gender dysphoria, aged 8-16 and beginning to take puberty blockers, depression symptoms were more likely to get worse than to improve over two years of treatment. Scores on the Beck Depression Inventory (BDI-Y) went from 72% average, 10% mildly elevated, 10% moderately elevated, and 8% severely elevated at baseline to 75% average, 7% mildly elevated, 14% moderately elevated, and 9% severely elevated after 24 months.
This study was conducted from 2016 to 2021 by Dr. Johanna Olson-Kennedy. In 2024, the New York Times reported2 Dr. Olson-Kennedy saying that publication of this research had been delayed because she feared that research showing that puberty blockers did not improve patients’ mental health would be “weaponized” against the use of puberty blockers by opponents of the practice. The report appeared as a pre-print, not peer-reviewed, in May 2025.
- Johanna Olson-Kennedy, Liyuan Wang, Carolyn F. Wong, Diane Chen, Diane Ehrensaft, Marco A. Hidalgo, Amy C. Tishelman, Yee-Ming Chan, Robert Garofalo, Asa E. Radix, Stephen M. Rosenthal, Emotional Health of Transgender Youth 24 Months After Initiating Gender-Affirming Hormone Therapy, Journal of Adolescent Health, Volume 77, Issue 1, 2025, Pages 41-50, ISSN 1054-139X, https://doi.org/10.1016/j.jadohealth.2024.11.014. ↩︎
- https://www.nytimes.com/2024/10/23/science/puberty-blockers-olson-kennedy.html
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More patients on puberty blockers saw their distress deteriorate than improve.
A study1 of children from 12-15 receiving puberty blockers via the Gender Identity and Development Service showed that 37-70% of patients showed no improvement in levels of distress. 15-34% showed deterioration, while only 9-29% showed improvement.
The highest rate of deterioration (34%) was recorded at the 12 month evaluation, when the sample size was at its largest. Evaluations at 24 and 36 months were affected by significant loss to follow-up, which compromises the data.
- McPherson, S., & Freedman, D. E. P. (2023). Psychological Outcomes of 12–15-Year-Olds with Gender Dysphoria Receiving Pubertal Suppression in the UK: Assessing Reliable and Clinically Significant Change. Journal of Sex & Marital Therapy, 50(3), 315–325. https://doi.org/10.1080/0092623X.2023.2281986 ↩︎
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Rates of suicidality and self-harm did not improve in teenagers taking puberty blockers.
In a prospective study1 of patients aged 12-15 referred to University College Hospital, London by the Gender Identity Development Service, patients on puberty blockers showed no change in rates of suicidality or self-harm.
This study is compromised by the lack of follow-up once patients reached the age of 16, meaning there were significant effective drop-out rates at 24 and 36 months.
- Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, Viner RM. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 2021 Feb 2;16(2):e0243894. doi: 10.1371/journal.pone.0243894. PMID: 33529227; PMCID: PMC7853497. ↩︎
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The height of teenagers taking puberty blockers did not increase at an age-appropriate rate.
In a prospective study1 of patients aged 12-15 referred to University College Hospital, London by the Gender Identity Development Service, patients on puberty blockers did grow taller, but not by as much as others in their age group.
- Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, Viner RM. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 2021 Feb 2;16(2):e0243894. doi: 10.1371/journal.pone.0243894. PMID: 33529227; PMCID: PMC7853497. ↩︎
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Teenagers taking puberty blockers report more negative mood changes over time.
In a prospective study1 of patients aged 12-15 referred to University College Hospital, London by the Gender Identity Development Service, patients reported increases in negative mood and decreases in positive mood over time since beginning puberty blockage.
This study is compromised by the lack of follow-up once patients reached the age of 16, meaning there were significant effective drop-out rates at 24 and 36 months.
- Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, Viner RM. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 2021 Feb 2;16(2):e0243894. doi: 10.1371/journal.pone.0243894. PMID: 33529227; PMCID: PMC7853497. ↩︎
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The bone mineral density of teenagers taking puberty blockers did not increase to age-appropriate levels
In a prospective study1 of patients aged 12-15 referred to University College Hospital, London by the Gender Identity Development Service, bone mineral density (BMD) in the hip showed no change from baseline over 36 months. Spinal BMD showed some increase at 24 months, but at no point did BMD show an age-appropriate increase.
This study is compromised by the lack of follow-up once patients reached the age of 16, meaning there were significant effective drop-out rates at 24 and 36 months.
- Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, Viner RM. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 2021 Feb 2;16(2):e0243894. doi: 10.1371/journal.pone.0243894. PMID: 33529227; PMCID: PMC7853497. ↩︎
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Puberty blockers did not improve psychological functioning of GIDS patients.
In a prospective study1 of patients aged 12-15 referred to University College Hospital, London by the Gender Identity Development Service, psychological functioning (measured using the Child Behaviour Checklist) was not shown to improve 12, 24 or 36 months after beginning puberty blockage.
This study is compromised by the lack of follow-up once patients reached the age of 16, meaning there were significant effective drop-out rates at 24 and 36 months.
- Carmichael P, Butler G, Masic U, Cole TJ, De Stavola BL, Davidson S, Skageberg EM, Khadr S, Viner RM. Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One. 2021 Feb 2;16(2):e0243894. doi: 10.1371/journal.pone.0243894. PMID: 33529227; PMCID: PMC7853497. ↩︎
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More than 80% of trans-identified young people experienced depressive mood, and more than half had considered suicide.
In a national quantitative cross-sectional survey1 of more than 25,000 “LGBQ” people, aged between 13 and 24 years, in the U.S., 82% reported experiencing depressive mood. 54% said they had seriously considered suicide, and 28% reported attempting suicide, in the last 12 months. Across all groups, females were more likely to experience depression, suicidality and attempted suicide than males. Participants with “trans” and “non-binary” identities were about twice as likely to report depressive mood and having considered suicide, and about one and a half times as likely to report a suicide attempt.
- Price-Feeney, Myeshia et al., Understanding the Mental Health of Transgender and Nonbinary Youth, Journal of Adolescent Health, Volume 66, Issue 6, 684 – 690 ↩︎
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“Gender questioning” adolescents may have very high rates of disordered eating.
In a cross-sectional study1 of 660 Australian adolescents described as “trans,” “non-binary” and “gender questioning,” adolescents who reported feeling unsure about their “gender identity” had the highest rates of nearly all symptoms of anorexia and bulimia.
- Kerr JA, Paine J, Thrower E, Hoq M, Mollica C, Sawyer SM, Azzopardi PS, Pang KC. Prevalence of Eating Disorder Symptoms in Transgender and Gender Diverse Adolescents Presenting for Gender-Affirming Care. Journal of Adolescent Health. 2024 Apr;74(4):850-853. doi: 10.1016/j.jadohealth.2023.11.396. Epub 2024 Jan 9. PMID: 38206224.
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- Kerr JA, Paine J, Thrower E, Hoq M, Mollica C, Sawyer SM, Azzopardi PS, Pang KC. Prevalence of Eating Disorder Symptoms in Transgender and Gender Diverse Adolescents Presenting for Gender-Affirming Care. Journal of Adolescent Health. 2024 Apr;74(4):850-853. doi: 10.1016/j.jadohealth.2023.11.396. Epub 2024 Jan 9. PMID: 38206224.
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Nearly a quarter of adolescents seeking “gender-affirming care” report symptoms of anorexia.
In a cross-sectional study1 of 660 Australian adolescents described as “trans,” “non-binary” and “gender questioning,” 23.9% reported symptoms of anorexia. Prevalence of disordered eating was more common in female patients than in male, regardless of whether they identified as trans or non-binary.
- Kerr JA, Paine J, Thrower E, Hoq M, Mollica C, Sawyer SM, Azzopardi PS, Pang KC. Prevalence of Eating Disorder Symptoms in Transgender and Gender Diverse Adolescents Presenting for Gender-Affirming Care. Journal of Adolescent Health. 2024 Apr;74(4):850-853. doi: 10.1016/j.jadohealth.2023.11.396. Epub 2024 Jan 9. PMID: 38206224. ↩︎
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Young people with “trans” identities are much more likely to have an eating disorder.
A study1 of data concerning 289,024 students from 223 U.S. universities found that students with a “trans” identity were almost four times more likely to have a self-reported eating disorder (OR: 4.62, 95% CI: 3.41-6.26) than their straight female peers. They were also about twice as likely to report past month use of diet pills (OR: 2.05, 95% CI: 1.48-2.83) and vomiting or laxatives (OR: 2.46, 95% CI: 1.83-3.30).
- Diemer EW, Grant JD, Munn-Chernoff MA, Patterson DA, Duncan AE. Gender Identity, Sexual Orientation, and Eating-Related Pathology in a National Sample of College Students. Journal of Adolescent Health. 2015 Aug;57(2):144-9. doi: 10.1016/j.jadohealth.2015.03.003. Epub 2015 Apr 28. PMID: 25937471; PMCID: PMC4545276. ↩︎
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Up to half of trans-identified children show disordered eating.
In an analysis1 of research conducted in 2022-23, 20-50% of children expressing a “trans” identity reported engaging in some form of disordered eating. More than 30% screened positive for eating disorder symptoms, and up to 12% had received an eating disorder diagnosis.
- Keski-Rahkonen A. Eating disorders in transgender and gender diverse people: characteristics, assessment, and management. Current Opinion in Psychiatry. 2023 Nov 1;36(6):412-418. doi: 10.1097/YCO.0000000000000902. Epub 2023 Aug 29. PMID: 37781981.
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- Keski-Rahkonen A. Eating disorders in transgender and gender diverse people: characteristics, assessment, and management. Current Opinion in Psychiatry. 2023 Nov 1;36(6):412-418. doi: 10.1097/YCO.0000000000000902. Epub 2023 Aug 29. PMID: 37781981.
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ADHD symptoms are more common in children with trans identities.
In an analysis of cross-sectional data from the Adolescent Brain Cognitive Development Study1, covering 10,227 children, children who answered “yes” or “maybe” to the question “are you transgender?” were more likely to show ADHD symptoms than those who answered “no.”
- Elizaveta Ignatova, Priyadharshini Balasubramanian, Julia H. Raney, Kyle T. Ganson, Alexander Testa, Jinbo He, Fiona C. Baker, Jason M. Nagata,
Transgender Identity and Attention Deficit Hyperactivity Disorder Symptoms: Findings From the Adolescent Brain Cognitive Development Study, Journal of Adolescent Health,
Volume 76, Issue 3, 2025. https://doi.org/10.1016/j.jadohealth.2024.10.015. ↩︎
- Elizaveta Ignatova, Priyadharshini Balasubramanian, Julia H. Raney, Kyle T. Ganson, Alexander Testa, Jinbo He, Fiona C. Baker, Jason M. Nagata,
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Autistic traits are more common in trans-identified girls than trans-identified boys.
A cohort study of Australian children with trans identities1 found that 74.5% of the autistic group were female, compared to 64% of the non-autistic group. Females formed a significant majority of both groups.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084 ↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Autistic children with gender dysphoria were also more likely to be dissatisfied with other parts of their bodies.
A cohort study of Australian children with trans identities1 found that children with autistic traits were more likely to express dissatisfaction with body parts unrelated to sex (e.g. nose, feet.) The study also found that frequency of voice dysphoria was higher in the autistic trait group.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084
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- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Autistic young people are more likely to socially transition than those without autistic traits.
A cohort study of Australian children with trans identities1 found that the difference in rates of social transition between “trans” children with and without autistic traits was 11.7%.
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
Tollit, Michelle A. et al.
The Lancet Regional Health – Western Pacific, Volume 47, 101084 ↩︎
- A comparison of gender diversity in transgender young people with and without autistic traits from the Trans 20 cohort study
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Rates of gender-affirming surgeries in the US tripled from 2016-2019.
A cohort study1 of data from the Nationwide Ambulatory Surgery Sample and the National Inpatient Sample showed that 48019 patients in the US received some kind of “gender-affirming” surgery between 2016 and 2020. Numbers peaked at 13011 in 2019 then fell slightly to 12818 in 2020. The study’s authors attribute this decline to the impact of the COVID-19 pandemic though, meaning the historical peak may not have been reached by then. 7.7% of all patients (3678 of the total) were aged 12-18 at the time of their surgery. 405 of these surgeries on minors (2.4% of the whole study) were genital surgeries. More than half (52.3%, or 25099 patients) were aged 19-30.
- Wright JD, Chen L, Suzuki Y, Matsuo K, Hershman DL. National Estimates of Gender-Affirming Surgery in the US. JAMA Network Open. 2023;6(8):e2330348. doi:10.1001/jamanetworkopen.2023.30348 ↩︎