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.

Ahhh. That might make sense then. Thank you. I still have only paid scant attention to it. So I appreciate all and any direction.

Thanks. That is so worrying. Those are the kids that really need to be tracked.

Does anyone know what happens if you are, say, a girl at 12 who starts PB and then moves to cross sex hormones at 14? Could you go through female puberty while on the cross sex hormones? Or do you just not go through puberty?

I've read a lot on this but it's really unclear for those who start early . If anyone could point me to further reading I'd be grateful.

I also think the lack of any information on this is horrific.

I thought their argument was that they were giving these children these drugs because they were so mentally distressed that they were likely to kill themselves otherwise.

Now they're telling us that about 70% weren't actually depressed in the first place. So why did they need this treatment?

Rule-breaking behavior demonstrated a statistically significant decline (improvement) over time. Because the mean reported for rule-breaking behavior was not clinically concerning at any time point, the clinical significance of this change is unclear.'

Surely the clinical significance is that they these kids are not maturing. Don't we expect teenagers to be rebellious and start challenging authority whereas these kids just become more compliant.

What blows my mind is that they've been giving these drugs to kids for so long and this is the biggest study of them ever, at less than 100 kids, and for less than 24 months.

That tells the biggest story IMHO.

I think with regard to the sample size, it is genuinely small numbers ever being given these drugs, so a study of 100 kids is big in those terms. It will add up in a big country like the US with the explosion in gender clinics following the funding agreement in 2015. A big multisite study would be the next thing I guess - maybe the British study will be set up as multinational and multisite?

I suppose they will argue that their mental health is OK because they have been promised they're getting the drugs.

Just another reminder that prior to the mass arrival of GLP1s (weight loss drugs), 65% of Americans were on at least one prescription drug and 25% of Brits were. Those proportions may well have changed post GLP1s and I don't know the pattern for under-18s. But it is culturally normal for Americans to have 'their meds' in a way that is not quite the same here. I have enormous respect for the power of culture in people's choices, emotions and perspectives on their own lives.

Does this study comment on the amount of physical side effects? Or just focus on mental health?

Cos if it merely maintains mental health but results in poorer physical health it's really not a great result is it?

So what you're saying here is that children should be put on meds that have no provable benefits and plenty of concerning side effects, because ... people like being on meds.

Seriously?

and the Cass report considers a longer one with more children….

its not going to show any difference

effects of drugs on human brains are often studied in sheep because apparently there are many similarities (!)

in sheep studies there have been sex differences and lack of maturity, especially in the hippocampus. Which is important for all sorts of things but also is often smaller in depressed individuals

Children whose mental health is much like their peers, take serious drugs for two years after which their mental health is … much like their peers!

When I google 'how many kids in the USA are on puberty blockers' and all the returns are 'just x% are on puberty blockers' or 'only a very few children' I get the heebie jeebies about it. I'm sorry, I just don't believe these numbers.

No that isn't what I'm saying FGS. Trying to imagine how this extraordinary treatment looks in different societies. Every society has weird ideas about some drugs - alcohol being the classic British one. I can't imagine sitting in a room with a doctor informing me that they needed to halt my young child's physical development with chemotherapy for anything other than an aggressive cancer, and my reaction not being 'fuck off'. So I'm trying to see how this is considered OK, or more OK than it is over here.

Does anyone remember, years ago, there was an article/report by an American HCP who worked in a clinic or practice that treated trans kids and she said that teenage girls were coming to the clinic for PBs like they were going to get their ears pierced together, like a group social thing, something along those lines? I think she herself was in a relationship with a transman.
Am I completely misremembering this?

Gender medicine started off in the U.S - which is a culture saturated in drugs and pharmaceuticals, and where drugs are advertised on the TV. It has suffered from periodic pharmaceutical crises and opiod epidemics etc, for which big pharma and elected representatives have been held responsible

The U.S is also a culture in which 'the individual' is king ( pursuit of freedom and happiness etc), and which has had a very domineering consumer culture for far longer than here in Europe. Everything is monetised and marketised. Including medicine.

The U.S is the home of "be the best you can be'"and " "your best self", " "whatever you want" and is the home of social media, with all of its imperatives and its influence.

Transgenderism as a social phenomenon is the apotheosis of American consumer culture aligned with the cult of the individual; fed by big Pharma and by post modernistic theories of the self - borne on liberal university campuses.

Have you heard of 'Crazy Like Us'? A book about how the U.S exports its cultural and social maladies around the world, along with ready made solutions to 'curing' them.

That sounds like Jamie Reed

Could be Jamie Reed. She's a whistleblower in the US, married to a trans man.

You’re not misremembering - it’s Jamie Reed:

https://nitter.net/JamieWhistle

She had a good interview on Gender a Wider Lens.

🤣 @spannasaurus and @rebmacesrevda crossposted!

If I remember correctly, Jamie’s partner is in the process of detransitioning.

Grok says:

Key Points to Estimate:
Pediatric Endocrinologists:
There are approximately 2,000–2,500 pediatric endocrinologists in the USA, based on data from the American Board of Pediatrics and the Endocrine Society. Most of these specialists are trained to prescribe puberty blockers for precocious puberty, and a significant portion likely offer gender-affirming care, though not all do. Assuming 50–75% are involved in gender-affirming care (a conservative estimate given the increasing demand), this suggests 1,000–1,875 pediatric endocrinologists may prescribe puberty blockers for transgender youth.
Adolescent Medicine Specialists:
There are about 500–600 adolescent medicine specialists certified in the USA (based on American Academy of Pediatrics data). Many work in gender clinics or transgender health programs and are trained to prescribe puberty blockers. If 80–90% of these specialists provide gender-affirming care, that’s 400–540 doctors.

So taking a ball park figure of both, say 1500 plus 470 so around 2000 people that are regularly prescribing puberty blockers.

So they are what, prescribing to one patient each a year to come up with the numbers that are 'very few'? Come the fuck on.

Yes, Jamie Reed, thanks everyone.

This might be interesting if you want more robust data. It discusses the available data and also what's missing
https://benryan.substack.com/p/1-in-1000-privately-insured-17-year

They actually excluded these kids (you couldn't make it up!) You have to go to their protocol (available here: https://www.researchprotocols.org/2019/7/e14434/) to find the info.

The exclusion criteria were ... presence of serious psychiatric symptoms (eg, active hallucinations and thought disorder), or appearing visibly distraught (eg, suicidal, homicidal, and exhibiting violent behavior) at the time of consent or the baseline study evaluation