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

• 追蹤了在美國四家門診開始使用青春期阻斷劑的 94 名 8 至 16 歲青少年（平均 11 歲；52% 出生時為男性；多數處於青春期早期）2 年。
• 他們自己回報的憂鬱和情緒健康，以及家長回報的問題，在 2 年期間沒有可測量的改變；只有違反規則的行為稍微下降。
• 18% 在一開始有中度或重度憂鬱（88 人中的 16 人），2 年時為 23%（59 人中的 13 人）。
• 94 人中只有 59 人在 2 年時有憂鬱資料，因此 37% 缺失。
• 11 人在第一年內開始使用雌激素或睪固酮，第二年又有 20 人，所以三分之一的人在研究期間使用了跨性別荷爾蒙。
• 11 名青少年回報在開始前的 6 個月內有自殺想法，2 年時有 5 人；沒有自殺死亡。
• 作者的結論是阻斷劑「可能」預防心理健康惡化，不過由於沒有對照組，這項研究無法檢驗這點。
• NIH 的進度報告預期憂鬱、焦慮、創傷症狀、自傷和自殺想法會下降，身體形象和生活品質會改善；這些改善並沒有被顯示出來。

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.)