A Lifeline for Trans Youth: Puberty Blockers, Explained

What are "puberty blockers"? 

Puberty can be a tough time for anyone, but trans youth have specific concerns about how their bodies might change.  

For many trans youth, especially those who have long been consistent in their gender identity, doctors may prescribe puberty-pausing medications. They’re often referred to as “puberty blockers,” but it’s much more accurate to say that they pause puberty – because that’s exactly what they do.  

The use of these medications gives trans youth the opportunity to pause physical changes that can be deeply harmful to their mental health and may be difficult and expensive to reverse later on in life - if it’s possible to reverse them at all. For those young people who experience distress and dysphoria about their bodies, these medications are a crucial lifeline. They give trans youth the time to decide what’s right for them, without feeling the pressure of a puberty process that they can’t control and that might result in changes that they don’t want. 

It's important to know that these medications aren’t new – they have been studied and safely prescribed for decades. In fact, puberty-pausing medicines have been used to treat precocious puberty in cisgender youth since the 1980s (for which they’ve received FDA approval), and trans youth have been treated with these medications since the early 1990s! Today, these medications may be prescribed to trans youth as part of safe and evidence-based healthcare that is supported by all major medical organizations.  

How do puberty pausing medications work? 

Puberty pausing medications temporarily pause the production of sex hormones, to alleviate the distress caused by the onset of puberty. In most people who were assigned male at birth, puberty-pausing medications pause the growth of facial and body hair, the deepening of the voice, masculinizing skeletal changes, and genital growth. In most people assigned female at birth, puberty-pausing medications pause breast development, redistribution of body fat, pubic hair growth, and pause or delay menstruation. In all cases, puberty-pausing medications pause or delay changes to an adolescent’s body during the length of time that an adolescent is on the medication. Like all medications, these medications have potential side effects, which are carefully monitored throughout treatment.  

It’s important to know that the effects of puberty-pausing medications are reversible. Once the medications are stopped, the adolescent will either continue with the pubertal development that they would have experienced anyway – or they will be prescribed gender-affirming hormone therapy.  

Why are puberty pausing medications so important? 

Wonderfully, teens who receive hormone therapy after taking puberty pausing medication can go through the correct puberty for their gender identity the first time! When this care isn’t available, teens are forced to undergo a distressing puberty that isn’t right for them – and then they are often forced to undergo additional procedures and treatments as adults. Everyone’s individual case is different, but preventing these changes at puberty can also mean that any gender-affirming procedures that they pursue as adults will be less invasive and have an easier recovery. There are also enormous mental health benefits, as access to puberty pausing medications reduces the risk of depression and suicidality.  

Emma Curtis, a trans woman in her mid-20s, testified about the need for this care in 2023 as Kentucky trans activists fought against bans on our healthcare. She remembers the “intense, all-encompassing depression [she] felt during puberty, and the fear [she] felt" when she looked in the mirror.  

She went on to write, “I wanted to literally crawl out of my skin. Even now, it’s difficult for me to think or speak about how traumatizing it was to watch my body develop male secondary sex characteristics like body hair, broad shoulders and masculine facial features. I know now that I was experiencing gender dysphoria, a deep sense of distress at the incongruence between my gender identity and the gender I was assigned at birth.” 

Emma is just one of many young trans adults who now say that they wish they could have gotten the care they needed when they needed it.   

“Some of the changes my body went through during puberty are permanent; others I have spent many years and thousands of dollars trying to reverse. It is heartbreaking to know that this damage to my body could have been prevented had my mother, doctors and mental healthcare providers been aware of gender-affirming care.” Despite these challenges, Emma finally got the care she needed - and she became a filmmaker, a local organizer, and a candidate who is currently running for the city council of Lexington, Kentucky! Young people like Emma shouldn't have to struggle and fight for the essential medical care that they need. 

For trans people who received this care when they were teenagers, it enabled them to pursue their dreams more easily. We saw this clearly in our brief for L.W. vs. Skrmetti, where we collected the stories of over 60 trans people. In this Supreme Court case, Samantha and Brian Williams of Nashville, TN and their 16-year-old transgender daughter, plus two other families, are challenging a Tennessee law that bans gender-affirming care for transgender people under 18. Tennessee is home to over 3,000 transgender adolescents, and the health care banned by this law is supported by the entire mainstream of the medical community. 

Beck Witt Major, an Arkansas trans man whose story is included in our brief, went to a youth gender clinic. He noted the care those healthcare providers took in ensuring that their young patients fully understood their options and any risks. Like some other trans men, Beck also had a “lifelong dream of birthing a baby,” which he recently achieved, and which he considers “an incredible blessing.”  

Beck noted that his peers at the gender clinic all took different paths – some took hormones, some didn’t. Some have since chosen to have children, but others had no interest in doing so. Each journey was unique to the individual. He went on to say that one of the reasons puberty pausing medications are a good choice for transgender adolescents is that this treatment “gives you more time to see what feels best for you.” 

Emma and Beck’s stories are two of many showing that trans young people deserve the best possible care to meet their needs and achieve their dreams. These decisions must be made by young people, with the support of their doctors and families – not by anti-trans politicians. 

We can help our young people grow up in a body that feels right for them, and it’s simply wrong for extremist politicians to ban this care. Trans youth know who they are, and they deserve the healthcare they need to thrive.