Researchers' fears of “weaponized” data are sparking renewed focus on puberty-blocking drugs for transgender youth

CNN
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The benefits of puberty-blocking drugs for transgender children are drawing new attention after the scientist who led a large, federally funded study was quoted by the New York Times as saying she was afraid of publishing some of her findings “to be used as a weapon,” delayed “in a heated political climate.

Some advocates for gender-equitable youth care say the report misrepresents researchers' normal caution in carefully presenting and interpreting scientific data.

“It is much ado about nothing and is sensationalized in this way,” said Dr. Alex Keuroghlian, director of education and training at the Fenway Institute, a group that advocates for the health needs of sexual and gender minorities and those affected by HIV.

The story, published Wednesday, quotes Dr. Johanna Olson-Kennedy, medical director at the Center for Transyouth Health and Development at Children's Hospital of Los Angeles, one of the largest programs of its kind in the United States.

Olson-Kennedy said that in the study she co-led, Puberty blockers did not appear to improve the mental health of 95 children ages 8 to 16, who were followed for two years to understand their mental and physical functioning, as doctors used the drugs to control the physical changes associated with puberty, including things like hair growth on the body and menstruation, delaying and a deepening voice.

“They're in really good shape when they come in, and they're in really good shape after two years,” Olson-Kennedy told the Times.

Your description appears to contradict the basic characteristics of the 95 study participants published in 2022. This paper reports that more than one in four had clinically significant levels of depression, anxiety and suicidal ideation. About 8% had reported a previous suicide attempt.

Olson-Kennedy did not respond to CNN's request for comment.

The research project has received nearly $10 million in federal funding since 2015. The researchers have published more than two dozen articles on their findings, although an update on the group of children who were followed for two years after being prescribed puberty-blocking drugs seems overdue.

Dr. Amy Tishelman, a psychologist and senior lecturer at Boston College, said she understands the impulse to be cautious but that it is important to publish the data.

“I believe it is essential that research, particularly taxpayer-funded research, be published for the integrity of science,” said Tishelman, who helped write the first grant for the project, titled “The Impact of Early Medical Treatment on Transgender.” Youth helped.” “We have to present our results openly.”

Tishelman said the idea that study participants noticed no change in their mental performance does not necessarily mean the therapy has no benefit.

“Puberty blockers may have prevented worsening mental health,” she said, particularly in children who may have experienced more body dysphoria — or feelings of being in the wrong body — after puberty.

But it's impossible to know without seeing the data, she said.

Numerous studies have documented high rates of suicide and suicidal ideation among transgender children and adolescents, and the physical changes of puberty can greatly increase the stress of feeling trapped in the wrong body.

For years, doctors have been prescribing puberty-blocking drugs to relieve this distress to certain transgender children who are psychologically determined to need these medications. This model is called the Dutch protocol and is based on early research supporting this approach in the Netherlands.

In 2017, the Endocrine Society – a professional group of scientists and medical providers focused on hormonal issues – published a clinical practice guide It cites more than 260 studies that support the use of hormone therapy to support children and adolescents with gender dysphoria, as well as blocking medications Puberty.

“Puberty-delaying medications are a safe, generally reversible, and conservative approach that gives transgender and gender diverse teens and their families more time to explore their options,” the Endocrine Society said in a statement Friday.

Furthermore, the company notes that the therapy is neither experimental nor unusual. “The same treatment has been used to treat precocious puberty for more than 40 years,” it said.

However, this year a comprehensive but controversial research study in the UK questioned the practice, saying that the reasons for early puberty suppression were “unclear” and that any mental health benefits were supported by “weak evidence”. The review – known as the “Cass Review” for Dr. Hilary Cass, the pediatrician who carried it out – and her methodology have been sharply criticized by some scientists and practitioners.

This has led providers in the UK to limit the use of the treatment.

The Cass Review was published amid a growing backlash against gender-affirming care for children. As of 2021, 26 US states have passed laws prohibiting or restricting minors' access to gender-affirming care. These may include medications to suppress puberty as well as other medical interventions such as hormones to support a sexual transition.

A recent study found that these restrictions may have come at a cost, showing that youth suicide rates have increased in states that have enacted anti-transgender laws.

Another study published Monday in the journal JAMA Pediatrics reported high levels of satisfaction and low levels of regret in more than 220 young people who had used puberty blockers and hormone therapy as children and adolescents.

The participants were supported from 2013 onwards as part of the Trans Youth Project. Overall, 97% said they were satisfied and were continuing with gender-inclusive care. Nine children—about 4% of the sample—expressed regret about puberty blockers or hormones, and four discontinued their therapy.

Tishelman says she fears a larger point is being lost in the Olson-Kennedy controversy Study Finds: That scientists may censor themselves because they fear their work will be used against the people they are trying to help.

“The real significance of the story is that scientists may not be interested in publishing data due to the current political landscape in the country, and that is very problematic,” she said.

CNN's Jen Christensen contributed to this report.