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NIH-finanzierte Blockerstudie: keine bessere psychische Gesundheit nach 2 Jahren; keine Kontrollgruppe, 37 % Ausfall

Psychische und emotionale Gesundheit von Jugendlichen nach 24 Monaten geschlechtsbejahender medizinischer Versorgung, begonnen mit Pubertätssuppression

Kohorten- & RegisterstudienPubertätsblockerPsychische Gesundheit & Suizidalität
Authors
Johanna Olson-Kennedy, Ramon Durazo-Arvizu, Liyuan Wang, Carolyn F. Wong, Diane Chen, Diane Ehrensaft, Marco A. Hidalgo, Yee-Ming Chan, Robert Garofalo, Asa E. Radix, Stephen M. Rosenthal
Journal
medRxiv (preprint)
Year
2025
Source
https://doi.org/10.1101/2025.05.14.25327614

Summary

This NIH-funded study followed 94 children and young teens (average age 11) who started puberty blockers at four large US gender clinics. Over two years, their own reports of depression and emotional wellbeing, and parents' reports of behaviour, did not measurably improve. Average scores were normal from the start. The authors read this as a sign blockers probably prevented a decline, but with no comparison group that claim is untested. More than a third of depression data were missing at two years, about a third started cross-sex hormones during the study, and the results reported differ from those first planned. In 2024 the lead author told The New York Times she had delayed publishing for fear the results would be "weaponized"; they appeared as an unreviewed preprint (early version) in May 2025. It shows no measurable mental health benefit.

Key findings

  • 94 Jugendliche im Alter von 8 bis 16 (Durchschnitt 11; 52 % männlich geboren; die meisten in früher Pubertät), die an vier US-Kliniken Pubertätsblocker begannen, wurden 2 Jahre lang verfolgt.
  • Ihre eigenen Berichte zu Depression und emotionaler Gesundheit sowie die Berichte der Eltern zu Problemen zeigten über 2 Jahre keine messbare Veränderung; nur regelverletzendes Verhalten ging leicht zurück.
  • 18 % hatten zu Beginn eine mittlere oder schwere Depression (16 von 88) und 23 % nach 2 Jahren (13 von 59).
  • Nur 59 von 94 hatten nach 2 Jahren Depressionsdaten, es fehlten also 37 %.
  • 11 begannen im ersten Jahr Östrogen oder Testosteron und 20 weitere im zweiten, ein Drittel nahm also während der Studie gegengeschlechtliche Hormone.
  • 11 Jugendliche berichteten Suizidgedanken in den 6 Monaten vor dem Start und 5 nach 2 Jahren; es gab keine Suizidtodesfälle.
  • Die Autoren folgerten, Blocker verhinderten „wahrscheinlich“, dass sich die psychische Gesundheit verschlechtert, obwohl die Studie dies ohne Vergleichsgruppe nicht prüfen konnte.
  • Der NIH-Fortschrittsbericht erwartete Rückgänge bei Depression, Angst, Traumasymptomen, Selbstverletzung und Suizidgedanken sowie ein besseres Körperbild und bessere Lebensqualität; diese Verbesserungen wurden nicht gezeigt.

Abstract

BACKGROUND AND OBJECTIVES: Medical interventions for youth with gender dysphoria can include the use of gonadotropin releasing hormone analogs (GnRHas) for suppression of endogenous puberty. This analysis aimed to understand the impact of medical intervention initiated with GnRHas on psychological well-being among youth with gender dysphoria over 24 months.

METHODS: Participants were enrolled as part of the Trans Youth Care United States Study. Eligibility criteria for youth included a diagnosis of Gender Dysphoria and pubertal initiation. Youth with precocious puberty or pre-existing osteoporosis were ineligible. Youth reported on depressive symptoms, emotional health and suicidality at baseline, 6, 12, 18 and 24 months after initiation of GnRHas. Parent/caretaker completed the Child Behavior Checklist at baseline, 12 and 24 months after initiation of GnRHas. Latent Growth-Curve Models analyzed trajectories of change over the 24-month period.

RESULTS: Ninety-four youth aged 8-16 years (mean=11.2 y) were predominately Non-Hispanic White (56%), early pubertal (86%) and assigned male at birth (52%). Depression symptoms, emotional health and CBCL constructs did not change significantly over 24 months. At no time points were the means of depression, emotional health or CBCL constructs in a clinically concerning range.

CONCLUSION: Participants initiating medical interventions for gender dysphoria with GnRHas have self- and parent-reported psychological and emotional health comparable with the population of adolescents at large, which remains relatively stable over 24 months. Given that the mental health of youth with gender dysphoria who are older is often poor, it is likely that puberty blockers prevent the deterioration of mental health.

Conclusion

Participants initiating medical interventions for gender dysphoria with GnRHas have self- and parent-reported psychological and emotional health comparable with the population of adolescents at large, which remains relatively stable over 24 months. Given that the mental health of youth with gender dysphoria who are older is often poor, it is likely that puberty blockers prevent the deterioration of mental health. (Full-text conclusion: the average mental health as reported by both the youth and parents remains in a clinically non-significant range over two years.)