Puberty blockers are sometimes used to medically 'treat' precocious puberty in cis people, this is however very questionable.
It was only when puberty blockers started to be used to delay puberty in trans people (for no good reason) that they finally came under scrutiny and results are bad.
Gonadotropin releasing hormone agonists (GnRHas) have been found to impair memory in adults, so the study by Wojniusz et al. (2016) on the possible cognitive effects of these drugs on children treated for idiopathic central precocious puberty (CPP) represents an important contribution to research in this area. Recent findings that GnRHas increase depression symptoms (Macoveanu et al., 2016) and slow reaction time (Stenbæk et al., 2016) in healthy women, and reduce long-term spatial memory in sheep (Hough et al., 2017) underline the importance of the research that Wojniusz et al. (2016) have undertaken. However, their reassuring statement in the abstract that girls undergoing GnRHa treatment for CPP and controls “showed very similar scores with regard to cognitive performance” and their conclusion that “GnRHa treated girls do not differ in their cognitive functioning … from the same age peers” (Wojniusz et al., 2016) may be overly optimistic. These statements minimize the fairly substantial difference found in IQ scores and may also overemphasize its lack of statistical significance, as given the small number of participants in the study statistical significance has a high threshold. The statements should be qualified to indicate that the research has, in fact, reinforced concerns over the impact of GnRHas on cognitive performance in children.
Girls treated for CPP with triptorelin acetate were tested with the short form Wechsler Intelligence Scale for Children III. It was found that the girls had a mean IQ of 94, as against a mean IQ of 102 for the matched control group (Wojniusz et al., 2016). These IQ estimations are presented as standardized IQ scores, which places a girl scoring 102 at the 55th percentile, and a girl scoring of 94 at the 34th percentile. It is questionable whether scores that indicate a percentile gap of this size can be described as “very similar.” The 8 point gap is not statistically significant (p = 0.09) but, as the authors point out, this may be a function of the small number of participants (15 treated girls, 15 controls).
The authors contend that despite the small number of participants the results can—probably—be relied on to indicate that if GnRHas do cause a decline in IQ, this decline will be under 1 standard deviation (SD), which “represents a boundary of what is a clinically interesting difference” (Wojniusz et al., 2016). The contention that a decline only becomes clinically interesting if it is of at least 1 standard deviation is unconvincing. Any findings which indicate that GnRHas cause a decline, even a modest decline, in IQ are likely to be of considerable interest to patients and their parents. It is a factor that they may well want to consider in deciding whether or not to take the drug. They may, for example, wish to consider the possible effect of GnRHas on a child's school and exam performance. In this respect it can be noted that 2 of the treated girls had been held back a year at school. Given their advanced physical maturity, children with precocious puberty may find it particularly uncomfortable to be put in a class where they are a year older than their class mates. If GnRHa treatment does cause a reduction in IQ, this may contribute to the decision to place a child in a lower age year group. Certainly, treatment that has a deleterious effect on IQ will do nothing to help children who are academically behind to catch up.
The question of whether a drop in IQ of around 8 points has clinical significance must also be considered in the context of the uncertain benefits of GnRHa treatment for CPP. The ability of GnRHas to increase final height has not been confirmed by randomized controlled trials (Bouvattier et al., 1999; Cassio et al., 1999). Where girls with CPP experience psychosocial difficulties, providing support rather than drugs may be the most appropriate response (Hayes, 2016).
The findings of Wojniusz et al. (2016) can be compared with those of a 2001 study in which 25 children treated for early puberty with triptorelin acetate were tested with the short form Wechsler Intelligence Scale for Children (Mul et al., 2001). In this longitudinal study, children took the IQ test before treatment and again after 2 years of treatment. It was found that their IQ dropped 7 points from 100 to 93. With 25 treated participants, this 7 point drop was significant (p = 0.002). In both studies the difference in the performance element of the test was greater than in the verbal element. The similarities between the findings of these two studies strengthens their reliability and increases the possibility that GnRHa treatment may have an adverse impact on cognitive functioning in children. This makes it yet more important for further research to be carried out into the effects GnRHas may have on cognitive performance in children.
Case study of global IQ drop: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694455/
If trans children could get on HRT earlier there wouldn't be any need to use puberty blockers at all. Instead we would have the following 3 option
A: start full HRT before puberty. This has the advantage of allowing the individual to pass better as a female but the price is very high, the child will become sterilized for life and SRS will be significantly more difficult since there isn't enough tissue to work with.
B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.
C: have the child undergo puberty and delay HRT.
That's what a lot of people needlessly go through thanks to policies with hardly anyone actually trying to stop that insanity.
We need to help trans people get access to treatments that actually help them. Stop playing political games with healthcare and support what is actually makes medical sense. Pushing for puberty blockers as a compromise didn't even work out politically but now the left is too invested into that bad idea to easily turn around and admit how they harmed trans people without even gaining anything from it politically speaking.
The following study does seem to show puberty blockers to be better than C but even then it can be strongly argued A or B would have been a far better option.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/
That does not mean the 83.1% (the vast majority) who didn't want puberty blockers in the first place would have benefitted. The current dogma is to push puberty blockers on all early transitioners denying them access to full HRT (which is safer and more effective). The study also only looked at self-reported suicidal ideation which is not the only important factor to consider, there is also other issues with the study
https://link.springer.com/article/10.1007/s10508-020-01743-6
It is worth noting that its very rare for children that started on puberty blockers to desist, almost without exception they will proceed with cross-sex hormones meaning they will be infertile for life unless some medical advancement is made allowing them to somehow have biological children.
theguardian.com/society/2016/nov/13/transgender-children-the-parents-and-doctors-on-the-frontline
pinktherapy.com/Portals/0/CourseResources/de_Vries_Puberty_Suppression_in_Adolescents_with_GD.pdf
What was the point in delaying puberty if they all ended up on cross-sex hormones anyway?
Puberty blockers does not even do much for the bones in terms of feminization, many people put on blockers still end up needing surgery
It is worth noting that often FFS doesn't even help much if anything since the issue is bonestructure which is difficult to adjust via surgery.
It was only when puberty blockers started to be used to delay puberty in trans people (for no good reason) that they finally came under scrutiny and results are bad.
Gonadotropin releasing hormone agonists (GnRHas) have been found to impair memory in adults, so the study by Wojniusz et al. (2016) on the possible cognitive effects of these drugs on children treated for idiopathic central precocious puberty (CPP) represents an important contribution to research in this area. Recent findings that GnRHas increase depression symptoms (Macoveanu et al., 2016) and slow reaction time (Stenbæk et al., 2016) in healthy women, and reduce long-term spatial memory in sheep (Hough et al., 2017) underline the importance of the research that Wojniusz et al. (2016) have undertaken. However, their reassuring statement in the abstract that girls undergoing GnRHa treatment for CPP and controls “showed very similar scores with regard to cognitive performance” and their conclusion that “GnRHa treated girls do not differ in their cognitive functioning … from the same age peers” (Wojniusz et al., 2016) may be overly optimistic. These statements minimize the fairly substantial difference found in IQ scores and may also overemphasize its lack of statistical significance, as given the small number of participants in the study statistical significance has a high threshold. The statements should be qualified to indicate that the research has, in fact, reinforced concerns over the impact of GnRHas on cognitive performance in children.
Girls treated for CPP with triptorelin acetate were tested with the short form Wechsler Intelligence Scale for Children III. It was found that the girls had a mean IQ of 94, as against a mean IQ of 102 for the matched control group (Wojniusz et al., 2016). These IQ estimations are presented as standardized IQ scores, which places a girl scoring 102 at the 55th percentile, and a girl scoring of 94 at the 34th percentile. It is questionable whether scores that indicate a percentile gap of this size can be described as “very similar.” The 8 point gap is not statistically significant (p = 0.09) but, as the authors point out, this may be a function of the small number of participants (15 treated girls, 15 controls).
The authors contend that despite the small number of participants the results can—probably—be relied on to indicate that if GnRHas do cause a decline in IQ, this decline will be under 1 standard deviation (SD), which “represents a boundary of what is a clinically interesting difference” (Wojniusz et al., 2016). The contention that a decline only becomes clinically interesting if it is of at least 1 standard deviation is unconvincing. Any findings which indicate that GnRHas cause a decline, even a modest decline, in IQ are likely to be of considerable interest to patients and their parents. It is a factor that they may well want to consider in deciding whether or not to take the drug. They may, for example, wish to consider the possible effect of GnRHas on a child's school and exam performance. In this respect it can be noted that 2 of the treated girls had been held back a year at school. Given their advanced physical maturity, children with precocious puberty may find it particularly uncomfortable to be put in a class where they are a year older than their class mates. If GnRHa treatment does cause a reduction in IQ, this may contribute to the decision to place a child in a lower age year group. Certainly, treatment that has a deleterious effect on IQ will do nothing to help children who are academically behind to catch up.
The question of whether a drop in IQ of around 8 points has clinical significance must also be considered in the context of the uncertain benefits of GnRHa treatment for CPP. The ability of GnRHas to increase final height has not been confirmed by randomized controlled trials (Bouvattier et al., 1999; Cassio et al., 1999). Where girls with CPP experience psychosocial difficulties, providing support rather than drugs may be the most appropriate response (Hayes, 2016).
The findings of Wojniusz et al. (2016) can be compared with those of a 2001 study in which 25 children treated for early puberty with triptorelin acetate were tested with the short form Wechsler Intelligence Scale for Children (Mul et al., 2001). In this longitudinal study, children took the IQ test before treatment and again after 2 years of treatment. It was found that their IQ dropped 7 points from 100 to 93. With 25 treated participants, this 7 point drop was significant (p = 0.002). In both studies the difference in the performance element of the test was greater than in the verbal element. The similarities between the findings of these two studies strengthens their reliability and increases the possibility that GnRHa treatment may have an adverse impact on cognitive functioning in children. This makes it yet more important for further research to be carried out into the effects GnRHas may have on cognitive performance in children.
Case study of global IQ drop: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5694455/
If trans children could get on HRT earlier there wouldn't be any need to use puberty blockers at all. Instead we would have the following 3 option
A: start full HRT before puberty. This has the advantage of allowing the individual to pass better as a female but the price is very high, the child will become sterilized for life and SRS will be significantly more difficult since there isn't enough tissue to work with.
B: have the child undergo enough male puberty such that sperm can be banked, after that full HRT is quickly introduced.
C: have the child undergo puberty and delay HRT.
I would go for B. The puberty blocking route sometimes lead to awkward situations. Like having to use a breast prosthesis to keep up with the other girls in the class. And also change it regularly for correct size for the age. Kinda weird and fake and feel horrible to wear. But you have to do it as it's just too important to not miss out on teen years.
We need to help trans people get access to treatments that actually help them. Stop playing political games with healthcare and support what is actually makes medical sense. Pushing for puberty blockers as a compromise didn't even work out politically but now the left is too invested into that bad idea to easily turn around and admit how they harmed trans people without even gaining anything from it politically speaking.
The following study does seem to show puberty blockers to be better than C but even then it can be strongly argued A or B would have been a far better option.
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7073269/
Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2–0.6).
https://link.springer.com/article/10.1007/s10508-020-01743-6
It is worth noting that its very rare for children that started on puberty blockers to desist, almost without exception they will proceed with cross-sex hormones meaning they will be infertile for life unless some medical advancement is made allowing them to somehow have biological children.
Spack has, he says, put “about 200 children” on to hormone blockers at the onset of puberty. Of these, 100% have gone on to take cross-sex hormones.
No adolescent withdrew from puberty suppression, and all started cross-sex hormone treatment, the first step of actual gender reassignment.” These were out of 70 children put on hormone blockers.
What was the point in delaying puberty if they all ended up on cross-sex hormones anyway?
Puberty blockers does not even do much for the bones in terms of feminization, many people put on blockers still end up needing surgery
It is worth noting that often FFS doesn't even help much if anything since the issue is bonestructure which is difficult to adjust via surgery.