Puberty blockers

[Violet9]

Hi, can anyone help me with any info on what was said about puberty blockers and precocious puberty in the recent Tavistock court case? My 7 year old daughter has had precious puberty since she was 3, but only started having Triptorelin injections just after she turned 7 because of how advanced puberty was suddenly getting for her aged 6-7. The plan is for her to be monitored regularly and to stop treatment at age 9, she will likely start her periods 6-12 months later.

My daughter's Paediatrician told us that the treatment was safe and had no long term side effects. She said it's been safely used to treat PP around the world for 30 years and that studies had shown no lasting side effects. From what I've read online this is all stated in many different medical research articles.

I'm now panicking that I've missed something, because all I keep seeing in the news coverage of the Tavistock case is that puberty blockers are unsafe, they cause long term damage and effect fertility. I assumed this was specifically just regarding when they are used off label for children who are transitioning. I assumed that none of that applied to when they are being used as a standard licensed treatment for Precocious Puberty. Now I'm worrying I'm wrong, because nobody in the media is pointing out any difference between the two scenarios, nobody is saying "this is the case when puberty blockers are used off label for children who are transitioning or want to transition and stop puberty progressing, but this is not the case for children who are treated with puberty blockers for diagnosed Central Precious Puberty". So I'm worrying myself sick now, can anyone give me any info on this? There are different medications used as puberty blockers, which one are they saying this about in the court case? Or is it about all of the different medicines? Is it just the puberty blockers causing the long term issues or is it the hormone treatment that follows when transitioning? Surely the child's age is a factor? They wouldn't usually be used for normal aged puberty or teenagers, is that the issue? Didn't someone speaking in defence of the Tavistock say that the ruling will now effect children with precious puberty being able to have treatment? Any info would be appreciated!

Sorry to hear of your daughter's situation.

A feminist board on a parenting site seems a strange place to be seeking medical advice though? Would you like some support in signposting to somewhere that could help you?

The protocol for using puberty blockers for precocious puberty is different to the protocol for treatment for "transgender" children.

This case has no bearing on your daughter's treatment, ignore anyone who says that it does. I suggest you talk with your doctor if you are worried.

You can read the judges' ruling in full here:

www.judiciary.uk/wp-content/uploads/2020/12/Bell-v-Tavistock-Judgment.pdf

They considered a huge amount of evidence to come to their decision. As you can see, the issue is with giving them to gender dysphoric adolescents, not to young children with precocious puberty.

I’m sure your child’s doctor would be very happy to put your mind at ease. It’s a terrible thing to have a legitimate drug protocol lumped in with an illegitimate one by those who don’t see the difference.

From a quick check it appears that girls with precocious puberty are typically only prescribed puberty blockers for two years or less. However even for this brief time there have been reports of damage.

The puberty blocker Lupron is used in the US and there have been lawsuits. Parents and patients (now adult) have concerns. Here's a link: www.statnews.com/2017/02/02/lupron-puberty-children-health-problems/

And another www.hormonesmatter.com/lupron-precocious-puberty-parents-patients-speak/

I think it's something you might do well to check out, but the Feminism section of Mumsnet is not really an appropriate place. You'll do far best in a medical forum.

Didn't someone speaking in defence of the Tavistock say that the ruling will now effect children with precious puberty being able to have treatment?

These people are not any sort of experts in precocious puberty. It is just another condition they use to prop up the arguments to achieve what they want.

They have also said the judgement affects other things, like consent for abortions, which were not true. It is a shame these things are given publicity without fact checking.

for you and your DD.

Welcome to Mumsnet, OP.

You should definitely check with your paediatric consultant if you have any concerns.

There is some evidence of blockers causing harm when used for precious puberty - there is a class action in America from women with brittle bones who had taken lupron, BUT there are some key differences to being used to stop natural puberty

• they are usually taken for much longer when blocking natural puberty
• children not allowed to go through puberty inevitably progress on to cross sex hormones. It is this combination that leaves children sterile and asexual, with greater risk of heart disease and various cancers

My understanding is most endocrinologists are very aware of potential side effects and very carefully balance the age of the child and the severity of the condition against possible side effects. From what I've read 3vis very, very early, so it's reasonable for doctors to have decided in this instance that the benefits outweigh the risks. But I agree with others upthread - you'd be better off on a specialist forum.

But the use of puberty blockers in very young children with a genuine medical need for them is totally different from their use in perfectly healthy tweens in need of mental health support.

Bone density is a problem because the teen years are the time when bone density increases.

They usually use blockers for precocious puberty for the minimum time and they are stopped well before children at the Tavistock even start them. So there is no cross-over.

The main difference is that your daughter will eventually go through puberty whereas the children the court case was referring to won't go through puberty and that will have lifelong consequences.

You don't need to panic.

The main issue WRT gender nonconforming children is they go onto cross sex hormones. That's the cause of infertility; puberty blockade coupled with opposite sex hormones. This obviously leads to medical issues, infertility and lack of sexual function.

We don't really know what happens to children who have blockers and then allow puberty to resume as there's no long term studies. If you're worried, talk to your paediatric endocrinologist about outcomes. Precocious puberty is not, in itself, a disease, simply an example of one of the extreme ends of a normal distribution.

Good luck to you and your daughter

Please don’t panic. It’s really different in medical terms and the judges’ ruling made it clear that their decision on one does not affect the other.

The main difference is that your daughter will definitely go on to complete her natural natal puberty, rather than a pseudo cross sex puberty, artificially induced using exogenous hormones.

All drugs have potential side effects but your daughter’s clinician should be aware of risk v
benefit and unlike in adolescents with gender dysphoria, there is a well established evidence base for GnRHa use in precocious puberty.

Do discuss it with you doctor though.

Sending best wishes to you and your daughter

the risk of "doing nothing" is different too because they are different conditions.

Gosh that's remarkable. She must be one of the youngest ever children to experience puberty. I'm sure you have excellent paediatricians who can advise you, given her condition is vanishingly rare.

Yes. Seems unusual that doctors didn’t prescribe blockers at the start of puberty too - 4 years in and menses have long begun and breast development is notable.

Need to start blockers early in precocious puberty if they are to help the child reach anywhere near the adult height range too.

Fingers crossed that puberty that early wasn’t caused by a brain tumour or anything similarly serious. Always the biggest concern in these rarest of the rare circumstances.

This is something you should definitely ask your consultant, OP. All the best to your wee girl.