Talk:Puberty blocker

This article is or was the subject of a Wiki Education Foundation-supported course assignment. Further details are available on the course page. Student editor(s): Nor'bro 123 (article contribs).

Other uses?

Are there other uses besides trying to perform a "gender change"? I would assume there would be, and that the article is giving undue weight to a controversial elective procedure which is not the treatment's primary use. — Preceding unsigned comment added by 24.207.136.200 (talk) 03:49, 9 November 2014 (UTC)

• Puberty blockers are primarily used in the case of precocious puberty; that is their main function re. the article topic. That's clearly mentioned in the lede, while the next paragraph involves their clinical usage in dealing with children with GID. I'm not exactly seeing the undue weight here. Since the article is specifically about blocking puberty, it doesn't go into details on where medicines like Leuprorelin and Nafarelin are primarily used in treating cancers that are exacerbated by sex hormones, like ovarian or prostate cancer. - Alison ^❤ 02:14, 12 November 2014 (UTC)

Proposed Edit/Addition

I would like to weigh in on a proposed edit that can enhance the information about puberty blockers. A lot of past and recent research with puberty blockers have been done with patients diagnosed with Gender Dysphoria or that identify as being Transgender. I have several research studies, news articles, and literature reviews that support this piece of information. I think identifying the target population of Puberty Blockers is vital in understanding this medical method. I also think it is pertinent in the world we live in today to accurately represent all specific patients in the medical field. Nor'bro 123 (talk) 00:15, 10 April 2017 (UTC)

The article states that the effects of puberty-blocking drugs are reversible, with a specious footnote that indicates no such thing. 5 minutes of internet research will tell you that the point is controversial. This is way beneath the standards of Wikipedia. — Preceding unsigned comment added by 158.228.48.1 (talk) 03:16, 30 June 2017 (UTC)

It is basic knowledge among professionals that the effects of puberty blockers are completely reversible; only the lay public does not know this. The controversy is artificial and stirred by dishonest bigots who hate transgender people and wilfully spread disinformation and hateful propaganda (manufactured controversy, concern trolling). "5 minutes of internet research" that consist of watching YouTube videos and reading blog posts by known bigots and fake "concerned citizens" are what is really "specious" and "way beneath the standards of Wikipedia". I have replaced the ref with a suitable one (though it is behind a paywall). --Florian Blaschke (talk) 16:19, 9 August 2017 (UTC)

This is incorrect. GnRH antagonists do NOT pause puberty, what they do is prevent the hormone spike from having an effect. The issue is that this hormone spike is limited in duration and tied to many other biological effects that run in parallel. If a person on GnRH antagonists misses that hormone spike, they miss it. if they miss part of it, then that part is missed. As such keeping an adolescent on GnRH blockers though their development will result in either a missed portion of puberty, or missing all of it. It is however TRUE that stopping the GnRH will result in the remaining hormonal spike having effects, but the result is a partially missed puberty. Taking hormones after the fact will not address this, as the parallel processes especially the ones related to bone development have all ready happened. The result is likely to be decreased bone density. This means that while a patient could still "go through puberty" it would be a partial puberty set out of phase. I don't have any credentials to discuss potential mental effects. — Preceding unsigned comment added by 50.204.42.253 (talk) 00:23, 23 October 2019 (UTC)

calling editors derogatory names and making accusation is an effort to stifle the pillars of this project. This article would NEVER pass MEDERS standards and I really have to wonder why this kind of crap is left untouched by editors who regularly jump on every edit by a "medical lay person" who attempts to edit a medical article. OH-and I guess this dr has some kind of "agenda? or would that be OR-(rhetorical, yes it would) http://www.spiked-online.com/newsite/article/its-not-transphobic-to-question-transgenderism/19353#.WIk4j4VFxjo Call me a "concern troll" because I am very concerned TeeVeeed (talk) 23:09, 23 August 2017 (UTC)

Everyone who thinks/knows otherwise is just "laypeople".......very telling — Preceding unsigned comment added by 70.68.165.139 (talk • contribs)

Interesting analysis of Tavistock gender clinic's use of puberty blockers. It raises serious concerns about the reversibility of puberty blockers, and their long term effects on a person's sexual development. This wiki page seems contrived to downplay any perception of risk. http://users.ox.ac.uk/~sfos0060/Biggs_ExperimentPubertyBlockers.pdf

noteworthy this is not balanced and critique is gone

The critique was valid and puberty blockers were referred as chemical sterialisation of children within journals. — Preceding unsigned comment added by 146.200.183.53 (talk) 18:42, 18 September 2018 (UTC)

Calling puberty blockers "chemical sterilization" is absurd nonsense. Putting aside the fact that cited source didn't even come close to a WP:MEDRS, the statement wasn't an accurate reflection of the source. The article states: puberty blockers followed by (or used concurrently with) cross-sex hormones to prevent the “wrong puberty” in prepubertal kids results in irreversible sterilization. It is true that people who take puberty blockers followed by cross sex hormones do see reduced fertility, but puberty blockers alone are reversible, and doctors don't prescribe cross-sex hormones unless they believe a person has a firm desire to transition and is old enough to be capable of making informed decisions about their bodies. [[User:Nblund |<span style="background-color:

This is incorrect. as a professional in the medical industry i could provide the medwatch reports that cite the massive endocrine issues caused by these drugs in EVERYONE including children. (and many (not all) of the drugs cause massive problems of osteoporosis.) All of this can been seen and is even explained in the risk assessment/mitigation paperwork submitted to the FDA. I cannot link to the data as it requires a login to the FDA site. However copies can be obtained via FOIA requests. This paperwork also contains the RBAs (risk benefit analysis) for each adverse effect known for approved uses. In the RBAs these effects are discussed openly and without concealment. That said there are ZERO drugs that are currently approved use as puberty blockers, there were a few intended for dealing with dangerous early puberty (think a 4 year old kid) but they were all reassessed as too dangerous for use and rejected as the RBAs were not sufficient. I dont know how to cite a hard FOIA request or a medical professional only link as a source. If someone does, please know they can find all of that information very easily with the FDA. These are ALL very dangerous drugs, and the promotion of off label uses is irresponsible. — Preceding unsigned comment added by 50.204.42.253 (talk) 00:10, 23 October 2019 (UTC) As a side note, the reason puberty in a 4 year old kid is dangerous is the hormone spike is out of phase with the parallel processes i mentioned earlier. This is similar though not identical to the risk encountered when blocking hormones during "puberty". The processes are set out of phase. — Preceding unsigned comment added by 50.204.42.253 (talk) 00:28, 23 October 2019 (UTC)

1. CC79A7; color:white;">Nblund]] ^talk 19:18, 18 September 2018 (UTC)

The source from American Association of Pediatrics is authoritative, but doesn't provide evidence. We should provide a study or other evidence indicating that blockers are safe, which is known at least for children with early-onset puberty 2601:602:9400:3C70:9C19:32D7:93BC:5AA9 (talk) 09:33, 13 January 2019 (UTC)

There is criticism of puberty blockers, but it often concerns what is currently found in the "Effects" section. With regard to WP:MEDRS, the guideline strongly discourages primary sources and prefers secondary and tertiary sources instead. As for including information that is not WP:MEDRS-compliant, that is allowed when it comes to a WP:MEDMOS "Society and culture" and/or "History" section. See what WP:MEDDATE states about history sections, for example. If material is fringe, it's probably best avoided, but WP:Fringe does allow some leeway for fringe views. Flyer22 Reborn (talk) 20:10, 18 September 2018 (UTC)

References

Sorry - I don't know how to do this but - seems not objective ref: Puberty Blockers. Below is from BBC Newsnight. Why have they been controversial?

Legal action being launched against the Tavistock and Portman NHS Trust, which runs the gender identity clinic, focuses on whether children can give informed consent to treatment with puberty blockers.

Puberty hormones are linked to changes not just in the body but also in the brain.

Gids says that it is not yet known whether puberty blocker treatment "alters the course of adolescent brain development".

It also says that the full psychological effects of the blocker are not yet known.

Some early data from one study showed some taking the drugs reported an increase in thoughts of suicide and self-harm but it was unable to say whether it was the drugs or something else causing the increase.

Experts on clinical trials criticised the design of the study but said the data warranted further investigation.

NHS England says, in its clinical guidelines, that research evidence around the long-term impacts of puberty blockers is "limited and still developing". Appologies if I'm breaking protocol here. This is why I've posted on Talk page. — Preceding unsigned comment added by 90.219.212.175 (talk) 14:49, 7 July 2020 (UTC)

Questionable Reference

Reference 11 links to an obviously tendentious Article from Daily Signal. Sources on such a low level of impartiality shouldn't be used to back up scientific statements on a topic that is so highly politicized, no matter if these are factual or not. The Article itself cites an article from The New Atlantis as a source. This isn't even a proper scientific journal which is published by a judeo-christian conservative think tank. Finally, the New Atlantis article is written by authors who themselves are also controversial or biased at best. I would suggest to delete the corresponding sentence in this article until someone provides a proper source for this claim. Luftschiffpirat (talk) 20:02, 28 June 2019 (UTC)

Luftschiffpirat, Thanks for pointing out this recent addition. I have removed the sentence as the source obviously does not meet the requirements of WP:MEDRS. Feel free to edit the article and remove such sentences yourself! Galobtter (pingó mió) 08:56, 29 June 2019 (UTC)

Recent revert

@Kabahaly: I thought you were restoring a different edit here, and so my edit summary probably doesn't make much sense.

Nevertheless, I still would have reverted here because the edit appears to mis-characterize the conclusion of the study:The study authors conclude that "there is no actual change in BMAD or tBMD in young transgender adolescents on long term GnRHa therapy". I don't really know where the editor is getting the 95% figure. Nblund ^talk 16:09, 10 July 2019 (UTC)

Claims of negative effects on the brain

I can find no reference to any unknown brain effects in any of the referenced citations. This claim should be removed unless verifiable documentation of the claim can be provided.

The first referenced study said no effects were found, the second only references adult trans people and not anything to do with puberty blockers. I suspect the claims were added in an attempt to create fear, uncertainty, and doubt for concerned parents of transgender kids and this is harmful and medical misinformation. Bl968 (talk) 00:26, 23 July 2019 (UTC)

The cited study does say that it has "unknown effects on brain development", but then it goes on to say that the one study that has been performed didn't really find anything. That paper is from 2016, and a more recent policy statement from The American Academy of Pediatrics doesn't really mention anything about brain functioning, so it's possible that this is just not really considered to be an "unknown" anymore. I've tried to reword it in a way that makes this sound less ominous, but it might be reasonable to simply remove it all together unless there are other WP:MEDRS sources that still talk about this. Nblund ^talk 15:09, 23 July 2019 (UTC)

Thanks for your work, If there was evidence of effects on the brain they wouldn't be unknown, would they. Bl968 (talk) —Preceding undated comment added 10:15, 24 July 2019 (UTC)

Citation needed tag

@James Cantor: I'm a little confused as to what you're looking for with this this CN tag. It comes from a policy statement from a respected medical organization, and it cites three separate studies to support the claim. I'm confused as to why you're removing a citation in order to add a citation needed tag, since this seems like a straightforward interpretation of a MEDRS. Nblund ^talk 15:18, 2 September 2019 (UTC)

Yes, it indeed came from a policy statement. It did not come from research. FWIW, that policy statement itself is riddled with factual errors and rather blatant misrepresentations of what others have said. I list them here: http://www.sexologytoday.org/2018/10/american-academy-of-pediatrics-policy.html. Rafferty does indeed meet WP standards as an RS, but what that document expressed was that committee's political opinion. The specific claim of the effects of puberty blockers was not based on research, and Rafferty did not cite any (unless I've missing it).— James Cantor (talk) 15:45, 2 September 2019 (UTC)

I'm assuming you're objecting to the psychological wellbeing stuff, right? The reduced need for surgeries thing seems like it is kind of self-evident. The statement includes footnotes, I eliminated them from the quote, but they're available in the article. Here are the four studies cited:

• Spack NP, Edwards-Leeper L, Feldman HA, et al. Children and adolescents with gender identity disorder referred to a pediatric medical center. Pediatrics. 2012;129(3):418–425pmid:22351896
• Olson J, Garofalo R. The peripubertal gender-dysphoric child: puberty suppression and treatment paradigms. Pediatr Ann. 2014;43(6):e132–e137pmid:24972421
• de Vries AL, Steensma TD, Doreleijers TA, Cohen-Kettenis PT. Puberty suppression in adolescents with gender identity disorder: a prospective follow-up study. J Sex Med. 2011;8(8):2276–2283pmid:20646177
• Wallien MS, Cohen-Kettenis PT. Psychosexual outcome of gender-dysphoric children. J Am Acad Child Adolesc Psychiatry. 2008;47(12):1413–1423pmid:18981931

WP:MEDRS notes "guidelines or position statements from national or international expert bodies" are ideal sources for this kind of thing. Nblund ^talk 15:56, 2 September 2019 (UTC)

Of those studies, only deVries would work. Spack did not give any data on outcomes at all; they merely described their incoming patients. Olson mentions "preliminary data" as a justification for their recommendations, but does not provide that data. Wallien is not about puberty suppression at all; it is about post-pubescent kids (age 16 and up).— James Cantor (talk) 16:12, 2 September 2019 (UTC)

Okay. You should cite other ones then. This is also supported by the the Endocrine Society guidelines: Treating GD/gender-incongruent adolescents entering puberty with GnRH analogs has been shown to improve psychological functioning in several domains (86) A slightly older review in the Lancet is a bit more circumspect, but still concludes that The few studies that have examined the psychological effects of suppressing puberty, as the first stage before possible future commencement of CSH therapy, have shown benefits. Unless you have something more substantive than your website, I don't think there's much here to go on. The standard is WP:V not truth. Nblund ^talk 16:29, 2 September 2019 (UTC)

I think you are missing my point. It is entirely true that various associations have included that policy, but it is not true or verifiable that THE RESEARCH says it. That clinicians and their professional associations are speaking beyond the data is what much debate is about. I think it would be better (both verifiable and true) to change the sentence to indicate that this is professional opinion rather than a research result. (As I said, deVries is the only actual study which suggests a beneficial effect, but it was a pre/post study with no control group. That study says only that kids post- blockers were less distressed than pre- blockers, but because many other things change in these kids lives during transition, we can't know which changes produced which effects.)— James Cantor (talk) 20:05, 2 September 2019 (UTC)

No, we're not just talking about "policies", the three sources quoted all say that the research says this. WP:V says that statements should come from reliable sources, and that standard has been met here. I understand that you believe they are mis-characterizing the existing research, and you could be right, but Wikipedia isn't the place to correct the record. We cant discount high quality sources based solely on your word. Nblund ^talk 20:25, 2 September 2019 (UTC)

Neutrality warning/omitting endometriosis use of these drugs

I had added to the intro that these drugs have been used to treat endometriosis for decades (with of course reference) and it was removed by another user... Why? This use is FDA approved, and it is controversial, nevertheless, because of the side effects on women.

The page is including, in the other hand off-label/non-FDA approved use of this drugs for short height kids in the same intro.

Are we on purpose trying to hide known side effects of these drugs?

I am adding endometriosis use in the intro again... for neutrality... Algalindoo (talk) 23:56, 2 February 2020 (UTC)A

Stick to WP:MEDRS-compliant sourcing. Flyer22 Frozen (talk) 01:25, 4 February 2020 (UTC)

Endometriosis use erased twice by same user/POV

I don't see why a user is obssessed with hiding the most widespread use of these drugs: endometriosis.

I am adding it again, with a different source, if the problem "was the source" then the appropriate thing to do is to flag the source, not to erase endometriosis + my comment here.

The most likely cause is that the user wants to hide the known side effects of the drug. — Preceding unsigned comment added by Algalindoo (talk • contribs) 02:43, 4 February 2020 (UTC)

Algalindoo, and now I see that you added this and this. Read Template:POV. An article does not become POV simply because you don't like it. And I'm not obsessed with anything regarding this topic. Nor am I trying to hide anything. You are a newbie who is not listening. I will alert WP:Med to this. And do stop creating talk page sections at the top; per Wikipedia:Talk page guidelines#Layout, newer sections go at the bottom. There was also no need for you to create another section just to comment again. Flyer22 Frozen (talk) 02:45, 5 February 2020 (UTC)

The lede of the article has strayed off the topic of the article. I suggest that the material on endometriosis and sex offender recidivism (and other topics) is moved to Gonadotropin-releasing hormone agonist#Medical uses, and that the lede also indicate that compounds other than Gonadotropin-releasing hormone agonists can be used for the purpose of blocking puberty. For example, looking at the bottom of the current article: The combination of bicalutamide, an antiandrogen, and anastrozole, an aromatase inhibitor, can be used to suppress male puberty as an alternative to GnRH analogues. Klbrain (talk) 09:36, 5 February 2020 (UTC)

Agree with User:Klbrain. This article is about medications when used to block puberty. Not when the medications are used for other stuff. We have other articles. Doc James (talk · contribs · email) 11:33, 5 February 2020 (UTC)

also agree w/ Klbrain--Ozzie10aaaa (talk) 20:35, 9 February 2020 (UTC)

That was not clear from the article. I've changed the introduction to be clearer. WhatamIdoing (talk) 17:03, 6 February 2020 (UTC)