There is no high-quality evidence supporting the use of puberty blockers for gender distress

Medical transition   Puberty blockers   Research quality  

A 2024 systematic review by Taylor et al. at the University of York1 was commissioned by the Cass Review to rigorously assess the safety and effectiveness of puberty suppression in adolescents with gender dysphoria. Analyzing studies up to April 2022, the review included 11 cohort, 8 cross-sectional, and 31 pre-post studies, but only one cross-sectional study met high-quality standards. The meta-analysis of moderate to high-quality studies showed limited and inconsistent evidence of benefits in areas like gender dysphoria, mental health, and body satisfaction.

This finding aligns with the previous 2020 review by the British National Institute for Clinical Excellence (NICE) on puberty blockers2, which described the supporting evidence as “very low” quality. The review noted minimal changes in key outcomes like gender dysphoria, mental health, and quality of life due to small, uncontrolled observational studies. Furthermore, a 2024 review from Germany by Zepf et al.3, adhering to NICE criteria, confirmed the absence of new studies on puberty blockers for gender dysphoria since the NICE review.

  1. Taylor, J., Mitchell, A., Hall, R., Heathcote, C., Langton, T., Fraser, L., & Hewitt, C. E. (2024). Interventions to suppress puberty in adolescents experiencing gender dysphoria or incongruence: a systematic review. Archives of disease in childhood, archdischild-2023-326669. [Link]  ↩︎
  2. National Institute for Health and Care Excellence (2021). Evidence review: Gonadotrophin releasing hormone analogues for children and adolescents with gender dysphoria. National Institute for Health and Care Excellence (NICE); NHS England; NHS Improvement. [Link] ↩︎
  3. Zepf, F. D., König, L., Kaiser, A., Ligges, C., Ligges, M., Roessner, V., … & Holtmann, M. (2024). Beyond NICE: Aktualisierte systematische Übersicht zur Evidenzlage der Pubertätsblockade und Hormongabe bei Minderjährigen mit Geschlechtsdysphorie. Zeitschrift für Kinder-und Jugendpsychiatrie und Psychotherapie. [Link] ↩︎
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