Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
Comment
. 2022 Sep;27(3):259-262.
doi: 10.1111/camh.12533. Epub 2021 Dec 22.

Commentary: The Signal and the Noise-questioning the benefits of puberty blockers for youth with gender dysphoria-a commentary on Rew et al. (2021)

Alison Clayton  1 , William J Malone  2 , Patrick Clarke  3 , Julia Mason  4 , Roberto D'Angelo  5
Affiliations
Comment

Commentary: The Signal and the Noise-questioning the benefits of puberty blockers for youth with gender dysphoria-a commentary on Rew et al. (2021)

Alison Clayton et al. Child Adolesc Ment Health. 2022 Sep.

Abstract

This commentary is a critique of a recent systematic review of the evidence for the use of puberty blockers for youth with gender dysphoria (GD) by Rew et al. (2021). In our view, the review suffers from several methodological oversights including the omission of relevant studies and suboptimal analysis of the quality of the included studies. This has resulted in an incomplete and incorrect assessment of the evidence base for the use of puberty blockers. We find that Rew et al.'s conclusions and clinician recommendations are problematic, especially when discussing suicidality. A key message of the review's abstract appears to be that puberty blockers administered in childhood reduce adult suicidality. However, the study used for the basis of this conclusion (Turban et al., 2020) did not make a causal claim between puberty blockers and decreased adult suicidality. Rather, it reported a negative association between using puberty blockers and lifetime suicidal ideation. The study design did not allow for determination of causation. Our commentary concludes by demonstrating how the GD medical literature, as it moves from one publication to the next, can overstate the evidence underpinning clinical practice recommendations for youth with GD.

Keywords: Gender dysphoria; adolescent; puberty blockers; suicidality; transgender.

PubMed Disclaimer

Comment in

Comment on

References

    1. Andrews, J.C., Schünemann, H.J., Oxman, A.D., Pottie, K., Meerpohl, J.J., Coello, P.A., … & Guyatt, G. (2013). GRADE guidelines: 15. Going from evidence to recommendation-Determinants of a recommendation’s direction and strength. Journal of Clinical Epidemiology, 66, 726-735.
    1. Baams, L. (2021). Equity in paediatric care for sexual and gender minority adolescents. The Lancet Child & Adolescent Health, 5, 389-391.
    1. Biggs, M. (2019). A letter to the editor regarding the original article by Costa et al: Psychological support, puberty suppression, and psychosocial functioning in adolescents with gender dysphoria. Journal of Sexual Medicine, 16, 2043.
    1. Biggs, M. (2020). Puberty blockers and suicidality in adolescents suffering from gender dysphoria. Archives of Sexual Behavior, 49, 2227-2229.
    1. Carmichael, P., Butler, G., Masic, U., Cole, T.J., De Stavola, B.L., Davidson, S., … & Viner, R.M. (2021). Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK. PLoS One, 16, e0243894.

Publication types

LinkOut - more resources