U.S. Study on Puberty Blockers Delayed Due to Political Concerns, Doctor Claims

In an increasingly polarized political climate, a U.S. study on the use of puberty blockers in transgender children has yet to be published, with its lead researcher citing concerns over how the findings might be used in political debates. The long-running study, led by Dr. Johanna Olson-Kennedy, was designed to assess the mental health impacts of puberty-blocking medications on children experiencing gender dysphoria. The results, however, did not show the expected mental health improvements, leading Dr. Olson-Kennedy to withhold the data out of concern that it could be “weaponized” by opponents of gender-affirming care.

A Pioneering Study with Unexpected Results

Dr. Olson-Kennedy’s study began in 2015 as part of a larger federally funded initiative aimed at improving care for transgender youth. The research team recruited 95 children from across the United States, providing them with puberty blockers to prevent the irreversible physical changes of puberty that might exacerbate their gender dysphoria. The researchers followed these children for two years, hoping to observe improvements in their mental health, based on earlier research conducted in the Netherlands, which had shown positive outcomes for children treated with puberty blockers.

However, the American study did not replicate those results. Dr. Olson-Kennedy explained in a recent interview that, on average, the children’s mental health was stable both before and after treatment. This, she noted, was likely because the participants were already in “good shape” when they entered the study. Nevertheless, these findings conflicted with earlier descriptions of the group, which suggested that a significant portion of the children had been struggling with depression, anxiety, and even suicidal thoughts before receiving treatment.

Fear of Political Fallout

The study’s findings come at a time when gender-affirming care, including the use of puberty blockers, has become a highly contentious issue in the United States. Over 20 states have enacted or are considering bans on youth gender treatments, and the Supreme Court is expected to weigh in on the issue soon. Dr. Olson-Kennedy, who is one of the country’s leading advocates for adolescent gender treatments, expressed concerns that publishing the data could provide fuel for those seeking to ban such treatments.

“I do not want our work to be weaponized,” Dr. Olson-Kennedy said. She emphasized that the findings needed to be presented in a clear and precise manner to avoid misuse. Delays in the publication of the data, she added, were also due in part to a reduction in funding from the National Institutes of Health (N.I.H.), which she attributed to political pressure—an assertion the N.I.H. has denied.

Divided Opinions Among Researchers

While Dr. Olson-Kennedy stands by her decision to delay the study’s publication, other experts have expressed concern over withholding data that could be critical for families and healthcare providers. Dr. Amy Tishelman, a clinical and research psychologist who was involved in the study, acknowledged the political sensitivities but stressed the importance of transparency in science. “It’s really important to get the science out there,” Dr. Tishelman said, noting that even if the study didn’t show dramatic mental health improvements, the drugs might still have prevented some children from worsening.

Dr. Hilary Cass, a pediatrician who recently conducted an extensive review of youth gender services in England, echoed these concerns. Delays in publishing both the U.S. and U.K. studies, she argued, have contributed to public misunderstandings about the efficacy of puberty blockers. The public, she noted, has been led to believe that these medications improve mental health, even though the scientific evidence is not as robust as commonly assumed.

The Origins of Puberty Blockers for Gender Dysphoria

The use of puberty blockers in transgender youth has its roots in research conducted in the Netherlands in the 1990s and 2000s. Dutch doctors began studying children with persistent gender dysphoria, many of whom saw their distress worsen during puberty. To alleviate this, they began prescribing puberty blockers, reasoning that delaying the physical changes of puberty would help transgender adolescents feel more comfortable in their bodies as adults.

In 2011, the Dutch researchers published results from their study of 70 children, showing that puberty blockers led to psychological improvements, including fewer symptoms of depression and anxiety. These findings helped shape the standard of care for transgender youth worldwide, with clinics in the U.S., U.K., and other countries adopting the so-called “Dutch Protocol.”

Growing Skepticism and Changing Guidelines

Despite the initial enthusiasm for puberty blockers, more recent studies have raised questions about their long-term benefits and risks. The U.K.’s youth gender clinic attempted to replicate the Dutch findings with a study of 44 children, but its results, reported in 2020, showed no significant improvements in well-being. Similarly, Dr. Olson-Kennedy’s U.S. study has not shown the expected mental health benefits.

In response to these findings, several European countries, including England, Sweden, and Finland, have scaled back their use of puberty blockers. England’s National Health Service (NHS) recently announced that it would only prescribe puberty blockers as part of a new clinical trial, citing concerns over bone growth and fertility loss in some patients.

Dr. Cass’s report in England highlighted the weak evidence supporting the use of puberty blockers and called for more rigorous research to determine who might benefit from the treatment. “It’s really important we get results out there so we understand whether it’s helpful or not, and for whom,” she said.

What’s Next for the Study?

While the political landscape remains tense, Dr. Olson-Kennedy has stated her intention to publish the study’s findings. She remains committed to gender-affirming care but acknowledges that the data might not be as straightforward as initially hoped. “They have good mental health on average,” she reiterated, noting that the full data set is still being analyzed.

As the debate over puberty blockers and gender-affirming care continues, the delay in publishing the U.S. study highlights the complex interplay between science and politics. For families, healthcare providers, and policymakers, access to reliable data is crucial for making informed decisions. The eventual publication of Dr. Olson-Kennedy’s study will likely play a key role in shaping the future of transgender healthcare in the United States and beyond.