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 jeunes de 8 à 16 ans (11 ans en moyenne ; 52 % nés garçons ; la plupart au début de la puberté) commençant des bloqueurs de puberté dans quatre cliniques américaines ont été suivis pendant 2 ans.
- Leurs propres rapports de dépression et de santé émotionnelle, et les rapports de problèmes par les parents, n'ont montré aucun changement mesurable sur 2 ans ; seul le comportement de non-respect des règles a légèrement baissé.
- 18 % avaient une dépression modérée ou sévère au départ (16 sur 88) et 23 % à 2 ans (13 sur 59).
- Seuls 59 des 94 avaient des données de dépression à 2 ans, soit 37 % de données manquantes.
- 11 ont commencé des œstrogènes ou de la testostérone la première année et 20 de plus la seconde, si bien qu'un tiers a pris des hormones du sexe opposé pendant l'étude.
- 11 jeunes ont rapporté des pensées suicidaires dans les 6 mois précédant le début et 5 à 2 ans ; il n'y a pas eu de décès par suicide.
- Les auteurs ont conclu que les bloqueurs empêchent « probablement » la santé mentale de se détériorer, bien que, faute de groupe de comparaison, l'étude n'ait pas pu le tester.
- Le rapport d'avancement du NIH attendait des baisses de la dépression, de l'anxiété, des symptômes de traumatisme, de l'automutilation et des pensées suicidaires, ainsi qu'une meilleure image corporelle et qualité de vie ; ces améliorations n'ont pas été démontrées.
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.)