The Olsen-Kennedy study is released - Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression

[Helleofabore]

The long awaited Johanna Olson-Kennedy study

https://www.medrxiv.org/content/10.1101/2025.05.14.25327614v1

Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression

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

May 16, 2025

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.

I will read through it later today.

Pure evil

You have to question the medical abilities of someone who says this.

Yes, they can get fake things that look like breasts superficially. They can't get actual breasts that have the capacity to produce milk or in any way physiologically resemble real breasts. They're 100% fake.

The study seems to have more holes than swiss cheese and their illogical conclusion that it's worthwhile sacrificing normal healthy development to prevent mental health worsening has to surely be medical malpractice? This is not the standard of evidence on risk and benefit required for any other medical intervention.

illogical conclusion that it's worthwhile sacrificing normal healthy development to prevent mental health worsening

The strongest statement this study should be giving is that there was no evidence that the mental health of the children surveyed worsened when taking puberty blockers for 2 years. (This is assuming that the statistical analysis they have conducted is robust - I'm not familiar with LCGM to comment on that).

They provide no evidence that the mental health of the children would worsen if they didn't take puberty blockers.

I commented earlier that they hadn't reported the drop out rate. From looking again, they report recruiting 94 children. The only place I can find the numbers followed up for the full 24 months is fairly hidden in Table 4 where they have 59 children answering the depression & suicidality questionnaire at 24 months.

This suggests they lost 35 children to follow up over the 2 years (or 37%). I would want to know why they have lost such a high proportion of their cohort over two years (and you should be suspicious that they are trying to cover it up). What happened to those kids? What was their mental health like?

Reading bits of the abstract/discussion, I'm shocked that even the authors can't spin it in a more positive (for their thesis) way. It will be interesting to see if the analyses that were pre-registered with the trial were all carried out. A 30% loss to follow up, if confirmed, is really high!

So this is what they have come up with after what, a year of it being supressed and looked at by every activist researcher that could possibly re-interpret the findings?

They appear to have made a huge tower of assumptions, in the hope that nobody will notice that the conclusion perched on top is: 'A cohort that did not significantly differ from the general population remained much the same over a short period.'

The hugh dropout rate and playing up the importance of non-findings looks very much like the previous high-profile study of mental health in trans identified children. Which also found that: 'A cohort that did not significantly differ from the general population remained much the same over a short period.'

What a heartbreaking result.

My soul aches for all those defrauded by the gender identity industry whose pain deserves actual treatment.

They should all feel a deep anger at being lied to by those who were supposed to care for them.

On social media the answer you might get is that the mental health doesn’t improve because of the way society treats them - transphobia/ discrimination, (and family and friends not supporting - not sure if the research covered that part).

I am just reading through the full version now. I am struck by the lack of acknowledgement that 2 years is a very short time to be tracking this. And they have had this data since 2019! In that time they could have continued to track the group at least another 4 or so years and had 6 years of data.

There really is a lack of curiosity about even medium term outcomes, isn't there?

Considering that the average time to regret was found, a couple of years ago, to be around 7 year iirc, 2 years seems to be very short sighted.

Maybe it's because so many had dropped out after 2 years, they were concerned there'd be none left if they carried on...🤷

It does seem to be an issue with these longitudinal studies.

Also suggests there isn’t much clarity about what is being affirmed or why it is linked to puberty.

8 YEARS OLD!!!!

FFS. How long did that child take puberty blockers? And at what stage did they start cross sex hormones? That is really concerning.

8 years old!!

Do you mean the table in figure 5?

Doesn't this mean that only 59 reported depression and reported in those categories?

If so what does average mean? Averagely depressed? 😕

Sorry - my bad for assuming people are used to reading tables like this.

To translate the top row
BL n(%) n=88 means BL at baseline (i.e. the start of the study) and then n(%) is telling the reader that each on row of the table the numbers represent the number of participants and percentage in brackets. n = 88 means number of participants = 88.

24m n(%) n=59 means at 24 months number of participants = 59

So, for example the average row was 63 (of 88 kids) aka 72% at baseline and 42 of 59 kids at 24 months i.e. 71%

This means they surveyed 88 kids at the start and 59 at 24 months, so in those 2 years, they "lost" 29 kids somewhere. Which is not unusual - people decline to continue to take part in longitudinal studies but you should always report this and the reasons for participants dropping out.

Participants who drop out may be different to the group who remain. I suspect now from reading the comment from Sarah Jorgenson (on the preprint page) that they mostly went on to cross sex hormones and the authors excluded them from follow up but they should state their reasons for doing this.

Thanks, really helpful.

Well that is very significant. A third of the participants who were mostly in the younger range and the oldest of whom was 16 went onto cross sex hormones within 2 years (did I read median time 18 month?). Am I understanding correctly?

They are getting the depression scores from something called the Beck Depression Inventory.

From the full text:
Beck Depression Inventory (BDI-Y)
Participants completed the BDI-Y, a 20-item self-report screener of depression symptoms over the previous two weeks. BDI-Y has good internal consistency, convergent validity, and intra-scale correlations; reliability coefficients range from α = .90 to α = .95.Calculated T-scores reflect average (≤ 54), mildly elevated (55-59), moderately elevated (60-69), and extremely elevated (≥70) depressive symptoms.

Also worth pointing out that all the tools they are using are self-reported. How many kids or parents of trans kids who keep getting told that going onto puberty blockers will stop them from killing themselves are going to be honest about worsening mental health from them?

Ah. Ok, well that makes more sense than my version!

Ok. Thanks.

I was rushing to work didn’t tie it to a particular data collection question to check, but to me that table merely reads that only 59 answered that particular question with the values that they reported. Not that they lost people.

I assumed there would be a ‘not depressed ‘ nuetral option that people who felt no depression could choose. Not a forced ‘depressed’ set of options.

This is all they say about cross sex hormones (or GAHT as they call it)

eleven participants started gender-affirming hormone treatment (GAHT), estradiol or testosterone within the first 12 months after GnRHa initiation, and an additional 20 participants started GAHT between 12- and 24-months. For those starting GAHT, average time to GAHT start was 1.18 years (range 0.17-1.92 y)

It's impossible to know from what they have reported which kids from their cohort were going onto cross sex hormones, this just tells us that on average it's 1.18 years after they start puberty blockers.

Assuming the absolute best case scenario and it was the oldest third of the cohort (mean 11.2y standard deviation 1.456) they had 14 year olds starting cross sex hormones.

There really is a lack of curiosity about even medium term outcomes, isn't there?

I don't think it's a lack of curiosity, I think they know there are lots of really negative side effects of this 'treatment' the further out you get from starting puberty blockers and they don't want to 'officially' know this. Call me cynical.

I've read previously that JOK has said she doesn't like to keep patients on puberty blockers for longer than 2 years, I think because of the side effects? Which would fit that drop out rate with patients moving to cross-sex hormones at that stage.

Though it may have been the actual effects she meant, ie halting the physical development of children during their path to maturity to accommodate a highly fluid and culturally bound syndrome that shows a very new change in how the sexes experience it.

I still can't quite believe that this treatment path has ever actually happened.

I've just skimmed the abstract but does their reports suggest that the mental health findings in youth with gender dysphoria before and after treatment were NOT in the abnormal range? In which case, why on earth do they need treatment?

I assumed there would be a ‘not depressed ‘ nuetral option that people who felt no depression could choose. Not a forced ‘depressed’ set of options.

I'd have to check the details of that specific test to be certain, but I think 'average' is the 'not depressed' group. So 70-odd percent of the cohort have no depression at baseline or after treatment.