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

• 米国の4か所のクリニックで思春期ブロッカーを開始した、8～16歳（平均11歳、52%が男性として生まれた、大半が思春期初期）の若者94人が2年間追跡されました。
• うつ病と情緒の健康についての本人の報告と、問題についての親の報告は、2年間で測定可能な変化を示さず、規則を破る行動だけがわずかに減りました。
• 開始時に中等度または重度のうつ病があったのは18%（88人中16人）、2年後は23%（59人中13人）でした。
• 2年後にうつ病のデータがあったのは94人中59人だけで、37%が欠けていました。
• 最初の1年に11人が、2年目にさらに20人がエストロゲンまたはテストステロンを開始したため、3分の1が研究中に異性ホルモンを使いました。
• 開始前の6か月に自殺念慮を報告した若者は11人、2年後に5人でした。自殺による死亡はありませんでした。
• 著者らは、ブロッカーはメンタルヘルスの悪化を防ぐ「可能性が高い」と結論づけましたが、比較群がないため、この研究でそれを検証することはできませんでした。
• NIHの進捗報告は、うつ病、不安、トラウマ症状、自傷、自殺念慮の減少と、ボディイメージと生活の質の改善を予想していましたが、これらの改善は示されませんでした。

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.)