Page 4 | Where did the 'fact' that puberty blockers are reversible come from?

WarriorN · 2023-08-25T13:52:27+00:00

Following the Roisin Murphy thread where a poster on a forum that was linked stated: "puberty blockers are reversible, fact" Does anyone know exactly what the evidence for that claim was based on originally? Bits I've read by Michael Biggs weave a tangled tale of clinicians saying It Is So but no real scientific evidence?

Original poster

WarriorN · 25/08/2023 19:21

Yes you're talking complete obvious sense.

It's just not happening. That would require funding and research resources and backing etc.

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Boomboom22 · 25/08/2023 19:20

But the kids are choosing to be on the blockers, more unethical to not use this quasi experimental group than to say it is unethical! Only if you randomly allocate teenagers to take them who otherwise wouldn't.

Or no experimental drug trials would ever happen!

Original poster

WarriorN · 25/08/2023 19:20

Don't forget no one wants to do that.

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Boomboom22 · 25/08/2023 19:18

If they know the teenage brain matures and that 25 year olds to 40 year olds are similar then this must be through scans not pure self report or cognitive tests. So it should be possible to scan a cohort who are still on blockers,detrans who were on padt natural critical period for puberty maybe 21?, and control who took no blockers and compare these to normal 25 to 40 year old and teenage brain scans from the control libraries.

Original poster

WarriorN · 25/08/2023 19:17

Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

I believe it's more complex than that, mainly as it would be conducting an experiment on children. issues like informed consent etc. (worth noting the Cass reformed GIDs proposals include a properly designed and data tracked study involving many children?)

I do remember a years ago they studied the impact on sheep brains; apparently a sheep's brain is the closest to our own in terms of puberty development (or something like that 🐑 )

There were permanent changes to the area of the brain for spatial awareness iirc, possibly also only studied in one sex? Id have to hunt them down.

I don't know if that's enough evidence to say "definitely" affects brain or they can only say "may."

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BonfireLady · 25/08/2023 19:14

Boomboom22 · 25/08/2023 19:07

Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

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Seems like a fair point.

We need a medic! Is there a doctor on (the) board?' I'm past the point of speaking from knowledge (acquired from lots of reading since I started researching this stuff to help my daughter) on that one.

BonfireLady · 25/08/2023 19:12

Boomboom22 · 25/08/2023 19:05

On a side note I though depo provera the contraceptive injection was used to treat sex offenders, interesting puberty blockers were used to try to treat homosexuality someone said earlier.

They were 😞 Chemical castration uses many of the same brands and/or types of drug that are used today as puberty blockers.
Alan Turing had this done to him 😞

Boomboom22 · 25/08/2023 19:07

BonfireLady · 25/08/2023 19:01

The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

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Unknown yes but logically the brain remains pre pubescent. Sue brain scan studies could be done?

Boomboom22 · 25/08/2023 19:05

On a side note I though depo provera the contraceptive injection was used to treat sex offenders, interesting puberty blockers were used to try to treat homosexuality someone said earlier.

Boomboom22 · 25/08/2023 19:04

I'm.sorry but utterly us not true to say they are safe and reversible even for precocious puberty. The bone density evidence is from girls with precocious puberty who stopped them went through puberty but are disabled at 40. Nit from trans, I don't know of any proper follow up studies at all on trans people who took or take them.
They are licensed despite long term side effects as going through very early puberty is considered more of a problem than the side effects. So now if early is like 8 not 3 then they do not prescribe much any more.

BonfireLady · 25/08/2023 19:03

BonfireLady · 25/08/2023 19:01

The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

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From talking to professionals in psychiatry (I'm not one), the general view seems to support what you say. That the brain goes through crucial development during adolescence until the age of 25. If you don't go through puberty this doesn't happen.

BonfireLady · 25/08/2023 19:01

AvengedQuince · 25/08/2023 18:47

Does no real puberty mean their brain does not mature normally? As I thought there are significant changes in adolescence?

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The NHS says that effect on brain development is unknown. That's as far as they will go.
Perhaps they are a little uncomfortable with going any further from their previous advice but it's more likely that nobody actually knows because there hasn't been any proper research in to their use. The lack of research on puberty blockers was the v number one priority to put right in the interim report of the Cass Review. It's why their use has been stopped in the UK as the standard approach.

AvengedQuince · 25/08/2023 18:47

BonfireLady · 25/08/2023 15:09

They are totally safe in this scenario. It's what they are licensed to treat.

They are used off-licence to stop puberty all together in "gender affirming care". When the child is old enough they are then given the option (98% take it) of going on to cross sex hormones. These are synthetic and won't lead to puberty of the opposite sex but will allow the body to great physical sexual characteristics that mimic the opposite sex. But the child goes through no puberty.

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Does no real puberty mean their brain does not mature normally? As I thought there are significant changes in adolescence?

Helleofabore · 25/08/2023 18:42

gogomoto · 25/08/2023 18:15

They are routinely used for girls with precocious puberty and they are not causing issues so yes they are reversible because all they do is hold puberty in stasis. My dps dd was on them for sen/precocious puberty reasons

Can I ask how long ago she stopped taking them?

stickygotstuck · 25/08/2023 18:40

DNiece underwent investigations for precocious puberty about 7 years ago.

According to SIL, the endocrinologist said the they avoid using blockers unless in very extreme cases, and then only for as short a period as posible, and never more than a few months.

DN was considered not to be extreme according to tests, so no blockers were given, which the endo was very pleased about (ND was around 7 at the time, doctor said that periods starting after the age of 8 was very early but still within the normal/healthy range).

I always read the endocrinologist's relief as 'avoid like the plague (in children) unless we are talking major, major future health issues'.

Original poster

WarriorN · 25/08/2023 18:24

gogomoto · 25/08/2023 18:15

They are routinely used for girls with precocious puberty and they are not causing issues so yes they are reversible because all they do is hold puberty in stasis. My dps dd was on them for sen/precocious puberty reasons

Unfortunately it's not completely true that it definitively doesn't cause issues for girls who use them.

There seems to be a sex based difference.

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Original poster

WarriorN · 25/08/2023 18:22

I should have added the context in the thread; for transgender medical intervention.

The context completely changes the impact.

It seems that they took what they'd seen happen with the drug when used off licence for precocious puberty and applied it to teens questioning their "gender," also off licence.

However the dose timing and length of time they're used for with children questioning their sex, changes the impact considerably.

Key difference being:

They don't go through puberty at all.
98% go onto cross sex hormones, so it's not a pause that's reversed. It's early stage transition.

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gogomoto · 25/08/2023 18:15

They are routinely used for girls with precocious puberty and they are not causing issues so yes they are reversible because all they do is hold puberty in stasis. My dps dd was on them for sen/precocious puberty reasons

Original poster

WarriorN · 25/08/2023 17:47

It's still chilling how it slipped in on the way it did.

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MrsOvertonsWindow · 25/08/2023 17:46

The completely trans captured NHS (to the extent that staff place male rapists on women's wards and lie to woman raped on said wards that it was impossible as no man was present), even that NHS now states that
"Little is known about the long-term side effects of hormone or puberty blockers in children with gender dysphoria. Although GIDS advises this is a physically reversible treatment if stopped, it is not known what the psychological effects may be"

https://www.nhs.uk/conditions/gender-dysphoria/treatment/

Gender dysphoria - Treatment

Treatment for gender dysphoria aims to help people live the way they want to, in their preferred gender identity or as non-binary.

https://www.nhs.uk/conditions/gender-dysphoria/treatment

Signalbox · 25/08/2023 16:50

The NHS website used to state that PBs were fully reversible. Also no mention of the side effects of these drugs. Here's an archived page from 2019...

https://archive.ph/LkOew

"The effects of treatment with GnRH analogues are considered to be fully reversible, so treatment can usually be stopped at any time after a discussion between you, your child and your MDT."

Original poster

WarriorN · 25/08/2023 16:37

Cross post Dev, my point still stands that children understand these terms completely differently.

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Original poster

WarriorN · 25/08/2023 16:36

I'm at the point where everyone who makes that statement should also be willing to commit to taking them themselves for 4 years.

Because for the level of scientific understanding a child has, reversible relates to their experience of primary school science.

Around reversible and irreversible changes.

They generally learn that cooking eggs is an irreversible change (Except I believe a particular high level scientific method can possibly reverse the effect, but it won't look like a full egg again) As is toast. And making a cake.

They learn that a reversible change is ice to water to steam to water and back to ice is reversible. Or chocolate melting and hardening.

But even the reversible change is quantified with a few points that the shape changes and it's never quite the same. They tend not remember that detail enough to explain properly.

It's generally "it goes back to what it was."

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DevilinaCardigan · 25/08/2023 16:32

Reversible and irreversible have specific pharmacological definitions.

“A reversible antagonist binds non-covalently to the receptor, therefore can be “washed out”. An irreversible antagonist binds covalently to the receptor and cannot be displaced by either competing ligands or washing.”
https://www.tocris.com/resources/pharmacological-glossary

I wonder if this has been (purposely?) misunderstood. It doesn’t mean that when you stop taking a drug everything goes back to what it was before.

Pharmacological Glossary

Our Pharmacological Glossary lists definitions and descriptions of common pharmacological terms used throughout this site.

https://www.tocris.com/resources/pharmacological-glossary

Original poster

WarriorN · 25/08/2023 16:28

Looootttss of context, words and details missing there mate.

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