ArticlePloS one2021
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.
Article in PloS one, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 48 papers, 4 of them syntheses that pooled it.
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Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
48 citing papers in PubMed, 4 syntheses or guidelines pooled it, 139 citations in OpenAlex.
- Endocrine Management of Transgender and Gender-Diverse Adolescents: Expert Opinion of the ESPE Working Group on Gender Incongruence and the Endo-ERN Main Thematic Group on Sexual Development and Maturation.Hormone research in paediatrics · 2026Guideline
- Puberty blockers for gender dysphoria in youth: A systematic review and meta-analysis.Archives of disease in childhood · 2025Pooled it
- Systematic Review of Interventions to Reduce Suicide Risk in Transgender and Gender Diverse Youth.Child psychiatry and human development · 2025Pooled it
- Use of gonadotropin-releasing hormone agonists in transgender and gender diverse youth: a systematic review.Frontiers in endocrinology · 2025Pooled it
- History of and evidence for puberty suppression as intervention for children experiencing gender dysphoria.The Medico-legal journal · 2026Article
- Rapid review of gender-affirming healthcare for children and adolescents: Evidence synthesis (2021-2025) and recommendations for South Africa.Southern African journal of HIV medicine · 2026Review
- The evolution of pediatric transgender healthcare in Flanders: Trends in referrals, intakes and gender-affirming interventions over the last 15 years.International journal of transgender health · 2026Article
- Rapid Review of Gender-Affirming Healthcare for Children and Adolescents: Evidence Synthesis (2021-2025) and Recommendations for South Africa.Research square · 2025Article
- A Critique of the Cass Review and the Implications of "Gender Restrictive Care".Archives of sexual behavior · 2025Review
- The Cass Review and Gender-Related Care for Young People in Canada: A Commentary on the Canadian Paediatric Society Position Statement on Transgender and Gender-Diverse Youth.Archives of sexual behavior · 2025Article
- Cass Review does not guide care for trans young people.The Medical journal of Australia · 2025Article
- GnRH analogs as a monotherapy in transgender and gender-diverse adolescents: clinical insights from a single-center study.Endocrine connections · 2025Article
- Psychological and Physical Health Outcomes Associated with Gender-Affirming Medical Care for Transgender and Gender-Diverse Youth: A Critical Review.Healthcare (Basel, Switzerland) · 2025Review
- Individualized and innovative gender healthcare for transgender and nonbinary youth.Nature reviews. Endocrinology · 2025Review
- Mental and Emotional Health of Youth after 24 months of Gender-Affirming Medical Care Initiated with Pubertal Suppression.medRxiv : the preprint server for health sciences · 2025Article
- Treatment trajectories among children and adolescents referred to the Norwegian National Center for Gender Incongruence.Acta paediatrica (Oslo, Norway : 1992) · 2025Article
- Onset Age and Internalizing Problems in Adolescents with Gender Dysphoria: Is There an Association?Archives of sexual behavior · 2025Article
- Population-adjusted numbers, demographics and mental health among children and adolescents referred to the Norwegian National Center for Gender Incongruence over two decades.European child & adolescent psychiatry · 2025Article
- Exploring the practice principles and beliefs of trans-care providers working with trans and detrans youth: A survey-based analysis.International journal of transgender health · 2025Article
- Supporting autonomy in young people with gender dysphoria: psychotherapy is not conversion therapy.Journal of medical ethics · 2024Article
Corrections and comments
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Authors and funding
9 authors at 3 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIn adolescents with severe and persistent gender dysphoria (GD), gonadotropin releasing hormone analogues (GnRHa) are used from early/middle puberty with the aim of delaying irreversible and unwanted pubertal body changes. Evidence of outcomes of pubertal suppression in GD is limited.
methodsWe undertook an uncontrolled prospective observational study of GnRHa as monotherapy in 44 12-15 year olds with persistent and severe GD. Prespecified analyses were limited to key outcomes: bone mineral content (BMC) and bone mineral density (BMD); Child Behaviour CheckList (CBCL) total t-score; Youth Self-Report (YSR) total t-score; CBCL and YSR self-harm indices; at 12, 24 and 36 months. Semistructured interviews were conducted on GnRHa.
results44 patients had data at 12 months follow-up, 24 at 24 months and 14 at 36 months. All had normal karyotype and endocrinology consistent with birth-registered sex. All achieved suppression of gonadotropins by 6 months. At the end of the study one ceased GnRHa and 43 (98%) elected to start cross-sex hormones. There was no change from baseline in spine BMD at 12 months nor in hip BMD at 24 and 36 months, but at 24 months lumbar spine BMC and BMD were higher than at baseline (BMC +6.0 (95% CI: 4.0, 7.9); BMD +0.05 (0.03, 0.07)). There were no changes from baseline to 12 or 24 months in CBCL or YSR total t-scores or for CBCL or YSR self-harm indices, nor for CBCL total t-score or self-harm index at 36 months. Most participants reported positive or a mixture of positive and negative life changes on GnRHa. Anticipated adverse events were common.
conclusionsOverall patient experience of changes on GnRHa treatment was positive. We identified no changes in psychological function. Changes in BMD were consistent with suppression of growth. Larger and longer-term prospective studies using a range of designs are needed to more fully quantify the benefits and harms of pubertal suppression in GD.
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