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NIH 지원 억제제 연구, 2년간 정신 건강 개선 없음: 대조군 없음, 24개월에 37% 결측

사춘기 억제로 시작한 성별 확정 의료 24개월 후 청소년의 정신적·정서적 건강

코호트 및 등록 연구사춘기 지연제정신 건강과 자살
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

  • 미국 클리닉 네 곳에서 사춘기 차단제를 시작한 8~16세(평균 11세, 52%가 출생 시 남성, 대부분 사춘기 초기) 청소년 94명을 2년 동안 추적했습니다.
  • 우울과 정서 건강에 대한 본인의 보고와 문제에 대한 부모의 보고는 2년 동안 측정 가능한 변화가 없었고, 규칙을 어기는 행동만 약간 줄었습니다.
  • 시작 시 18%가 중등도 또는 심한 우울이 있었고(88명 중 16명), 2년 시점에는 23%였습니다(59명 중 13명).
  • 94명 중 59명만 2년 시점의 우울 자료가 있었으므로 37%가 빠졌습니다.
  • 첫해에 11명이 에스트로겐이나 테스토스테론을 시작했고 둘째 해에 20명이 더 시작했으므로, 연구 중 3분의 1이 반대 성 호르몬을 썼습니다.
  • 시작 전 6개월에 11명이 자살 생각을 보고했고 2년 시점에는 5명이었으며, 자살 사망은 없었습니다.
  • 저자들은 차단제가 정신 건강이 나빠지는 것을 ‘아마도’ 막는다고 결론지었지만, 비교 집단이 없어 연구가 이를 검증할 수 없었습니다.
  • NIH 진행 보고서는 우울, 불안, 트라우마 증상, 자해, 자살 생각의 감소와 더 나은 신체상과 삶의 질을 예상했지만, 이런 개선은 나타나지 않았습니다.

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.)