The combination of puberty blockers followed by cross-sex hormones leads to permanent loss of fertility

A 2024 systematic review notes that puberty suppression alone does not necessarily eliminate future fertility, as endogenous puberty may resume after treatment stops. However, when puberty blockers are followed by cross-sex hormones, fertility potential may be significantly impaired or permanently lost, particularly if fertility preservation has not occurred beforehand. This review therefore highlights that fertility risks emerge through the sequential treatment pathway from puberty suppression to cross-sex hormones.

^{Zepf, F.D. et al. (2024). Beyond NICE: Aktualisierte systematische Übersicht zur Evidenzlage der Pubertätsblockade und Hormongabe bei Minderjährigen mit Geschlechtsdysphorie. Zeitschrift für Kinder- und Jugendpsychiatrie und Psychotherapie, 1-21. DOI: 10.1024/1422-4917/a000972
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