Puberty Blockers - impact on the brain

[Triffiddealer]

Hi all

I'm well aware about the arguments about lack of evidence re. long term effects of PB on physical health / infertility etc, however I never see any discussion of how they may impact brain development.

Part of my PhD was looking at issues affecting specific teenagers and I found the research on cognitive development during puberty really interesting (Sarah Jayne Blakemore has published a lot and there is a TED talk here www.ted.com/talks/sarah_jayne_blakemore_the_mysterious_workings_of_the_adolescent_brain)

Have any cognitive neuroscientists or biologists studied this - are there implications for cognitive development / ability? I would assume that the PBs also inhibit cognitive development related to puberty, but is this true or does it only impact physical development?

I think those cases are from the US.

Thanks for doing that Helle

I am a layperson but I would hope that if medical professionals were going to prescribe a drug treatment which they know will have a significant effect on a child's development they would do everything in their power first of all to try to look at what might happen both if they do and don't prescribe it.

In the case of PBs, they have research to consider on how PBs affect children given them for precocious puberty. Are children given PBs for gender dysphoria put on the same dose? Do they take PBs for a longer or shorter time? I assume they start them much later than children suffering from PP. Does that affect how they work?

What happens in normal puberty? There must be research about that, and about all sorts of conditions known and studied where something has gone wrong.

Break it down as much as possible. One detailed list of changes that normally happen in female bodies during puberty, another for male bodies. Which of these would be affected by PBs? If the PBs are stopped, does the process that was halted/prevented get going again? Does it happen as you would normally expect if no PBs have been taken? How important is the change?

Set against all of this the outcomes for children with gender dysphoria who have not had any hormone treatment. Separate out those who got no help or support at all from those who got counselling/therapy/psychiatric drugs for depression, anxiety etc. Make sure you look at girls and boys separately. Look at co-morbid conditions. E.g. how does a child on the autism spectrum disorder cope with puberty where there are no gender issues?

Having done all of that, specialist clinicians could have an informed debate to decide whether the problems resulting from taking PBs are all outweighed by the problems from not taking them.

I genuinely have no idea how much of this work has been done. I have the impression that research in this area has been limited because of fear of claims of transphobia, bigotry etc etc. Also, the numbers of children involved have increased hugely in the last 20 years - have the characteristics of the group changed? Is the older research still relevant?

James Caspian at Bath Spa University was prevented from doing research into detransitioners. Have there been others?

I agree but go one step further; I don't think that normal biological processes should be routinely pathologised or medicated.

I agree on that too, @Thelnebriati. It all hinges on whether gender dysphoria is treated as an illness or not. As with so many psychological issues, where do we draw the line and decide that something is causing so many problems that it's now an illness rather than a normal life experience?

If we don't treat it as an illness or other medical problem, why is it getting a medical solution?

Well, in order to analyse dysphoria we'd first have to define it.

And, that appears to be a bit tricky.

For research to be ethical there is only a narrow window in which it can be carried out - where you do not know whether the benefits of the treatment outweigh the harms and whether these are better than the alternatives. Your research should them be designed to answer this question and monitored so it can be stopped early if harms are too high.
When the Tavistock study was placed before a neutral ethics committee it was found to be unethical. Not least because despite placing children at risk it could not answer the question of whether PB help.

Trans men have normal bone density
www.ncbi.nlm.nih.gov/pmc/articles/PMC6709704/

Um, if you actually read this through to the end, that is not what it says at all.
In fact, it says that the effects of puberty blockers on bone are deleterious and well known, and says that bone density decreases across all groups. It calls for more research. This doesn't say what you're claiming at all.

JustTurtlesAllTheWayDown

Yes, not sure that link was read properly at all. Even at the start there was a disclaimer about puberty blockers and the unknown effects.

Ah, I should have rtft. I just saw that link posted and responded off the bat. I see a few of you pointed that out.
Ridiculous how often that happens though. 'Proof' of something is posted and when you read it, it says nothing of the sort. Sums up the state of the 'debate' really.

No. The more people that point it out, maybe the poster will be better able to understand it and understand that it is an own goal for some of the other posts they have recently posted as well, or.... to actually read it.

it's all good.

It seems to be standard TRA practice to link to scientific studies to back up their arguments; presumably in the hope/assumption that most people won't read it and realise it says the opposite of what they claim.

@Triffiddealer

Hi all

I'm well aware about the arguments about lack of evidence re. long term effects of PB on physical health / infertility etc, however I never see any discussion of how they may impact brain development.

Part of my PhD was looking at issues affecting specific teenagers and I found the research on cognitive development during puberty really interesting (Sarah Jayne Blakemore has published a lot and there is a TED talk here www.ted.com/talks/sarah_jayne_blakemore_the_mysterious_workings_of_the_adolescent_brain)

Have any cognitive neuroscientists or biologists studied this - are there implications for cognitive development / ability? I would assume that the PBs also inhibit cognitive development related to puberty, but is this true or does it only impact physical development?

What people usually mean is there isnt any research that meets their ideology on puberty blockers. If you search for puberty blockers and IQ levels you struggle to find meaningful data showing IQ is impacted. Google IQ and birth control pills though and there's more research on the negative mental function impact yet we still give them to 12 year olds to stop acne. .

you struggle to find meaningful data showing IQ is impacted

If you've got any studies showing lack of impact, we'd be happy to take a look at them. This is the thread. Go for it.

The is however a lot of data about ten impact of the drug for other medical needs:

Eg

nwhn.org/lupron-what-does-it-do-to-womens-health/

*The

So you’re refuting all of the studies linked upthread that potentially do show the impact on cognitive function, disgusted?

Which ones? On which grounds? Like necessary said, if you’ve got the studies that prove that GnRH agonists used as hormoneblockers don’t have any impact, and these studies are wrong, then go for it, let’s have a look at them.

Yes, misread the post, I've also posted studies that outline loss of IQ as others have.

@JustTurtlesAllTheWayDown

Trans men have normal bone density *www.ncbi.nlm.nih.gov/pmc/articles/PMC6709704/*

Um, if you actually read this through to the end, that is not what it says at all.
In fact, it says that the effects of puberty blockers on bone are deleterious and well known, and says that bone density decreases across all groups. It calls for more research. This doesn't say what you're claiming at all.

Here's what it actually says:

"Studies to date show the baseline bone density in trans men is similar to the general population. When estrogen is initiated in trans women, there are positive changes in BMD and some measures of bone quality; however, the effect on fracture rates is not fully known as studies have not been powered to examine this end point. When testosterone is initiated in trans men, the changes in BMD are not as robust, but body composition changes and direct effects of testosterone on the bone likely protect BMD."

@NecessaryScene1

you struggle to find meaningful data showing IQ is impacted

If you've got any studies showing lack of impact, we'd be happy to take a look at them. This is the thread. Go for it.

www.frontiersin.org/articles/10.3389/fpsyg.2016.01053/full

"Neuropsychological Findings: Table 2 summarizes the results of the neuropsychological assessment. The mean estimated IQ was 94 (range: 73–116) for CPP girls and 102 (range 81–125) for control girls; the difference was not significant. The estimated IQ scores were consistent with the school situation; 26/30 girls were attending an appropriate grade for their age. Two girls from the control group and two girls from the CPP group were delayed by 1 year at school. No associations were found between IQ scores and duration of GnRHa therapy. The statistical comparison of parental educational level (Fisher's exact test) showed no significant difference between groups (Table 1)."

With regards to the other study:

"However, a longitudinal study among 25 adopted girls treated with GnRHa for early puberty reported a decrease in IQ from 100.2 ± 12.7 to 93.1 ± 10.5 with a significant decline of performance score during treatment, but it was concluded that the decrease in IQ was not clinically relevant (Mul et al., 2001). A limitation of the study was the lack of a control group."

"...not clinically relevant..."

That’s for precocious puberty, where puberty resumes after treatment is withdrawn.

Do you have anything they shows children who never go through puberty don’t have a lower IQ compared to peers as adults?

@NotBadConsidering

That’s for precocious puberty, where puberty resumes after treatment is withdrawn.

Do you have anything they shows children who never go through puberty don’t have a lower IQ compared to peers as adults?

Trans children do go through puberty. That's how trans girls get boobs and full bottoms.

Taking cross sex hormones is not going through puberty. Puberty is the process by which mammals reach sexual maturity. Nobody who has their natal puberty blocked and goes onto cross sex hormones is reaching sexual maturity. They may develop some secondary sex characteristics like breasts or beard growth, but the clues in the title- secondary

You do know it’s about more than “boobs and bottoms”, right?

Trans children do go through puberty. That's how trans girls get boobs and full bottoms.

Just when you think things can’t more inaccurate, dangerous and offensive...

Trans children do go through puberty. That's how trans girls get boobs and full bottoms.

I understand you want to discuss "boobs and full bottoms", but it would really help if you would read the studies you cite, and perhaps try to understand the concepts under discussion..?