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Studiul blocantelor finanțat de NIH: nicio îmbunătățire a sănătății mintale în 2 ani; fără control, 37% date lipsă

Sănătatea mintală și emoțională a tinerilor după 24 de luni de îngrijire medicală de afirmare a genului începută cu supresia pubertății

Studii de cohortă și registreBlocante pubertaleSănătate mintală și suicid
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 de tineri cu vârste între 8 și 16 ani (media 11; 52% născuți de sex masculin; majoritatea la începutul pubertății) care începeau blocante ale pubertății la patru clinici din SUA au fost urmăriți timp de 2 ani.
  • Propriile lor raportări de depresie și sănătate emoțională și raportările părinților despre probleme nu au arătat nicio schimbare măsurabilă în 2 ani; doar comportamentul de încălcare a regulilor a scăzut ușor.
  • 18% aveau depresie moderată sau severă la început (16 din 88) și 23% la 2 ani (13 din 59).
  • Doar 59 din 94 aveau date despre depresie la 2 ani, deci 37% lipseau.
  • 11 au început estrogen sau testosteron în primul an și încă 20 în al doilea, deci o treime au luat hormoni de sex opus în timpul studiului.
  • 11 tineri au raportat gânduri suicidare în cele 6 luni dinainte de început și 5 la 2 ani; nu au existat decese prin sinucidere.
  • Autorii au concluzionat că blocantele „probabil” previn înrăutățirea sănătății mintale, deși, fără un grup de comparație, studiul nu a putut testa acest lucru.
  • Raportul de progres NIH aștepta scăderi ale depresiei, anxietății, simptomelor de traumă, autovătămării și gândurilor suicidare și o imagine corporală și o calitate a vieții mai bune; aceste îmbunătățiri nu au fost demonstrate.

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.)