Puberty Blockers May Help Reduce Mental Health Disparities in Transgender Youth: JAMA
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USA: A nationwide study of transgender youth aged 10–17 years found substantially higher rates of diagnosed mood disorders and suicidal thoughts and behaviors compared with cisgender peers. Prescription of puberty blockers was associated with partial attenuation of these mental health disparities, suggesting potential mental health benefits of gender-affirming treatment. The findings also highlight the need for population-specific mental health support and interventions for transgender adolescents.
The study, published in JAMA Network Open, was led by Clair Kronk from the Institute for Health Equity Research, Department of Population Health Science and Policy, Icahn School of Medicine at Mount Sinai, New York, and colleagues. The researchers sought to examine whether puberty blocker use was associated with lower rates of mood disorders and suicidality among transgender youth compared with cisgender peers and transgender adolescents who did not receive these medications.
Puberty blockers are reversible medications used to treat central precocious puberty and gender dysphoria. Given ongoing debate surrounding their use, researchers evaluated their association with mental health outcomes in transgender youth.
The retrospective cohort study analyzed nationwide US multipayer claims data from 2016 to 2025, including 231,783 youths aged 10–17 years. Participants were categorized by gender identity and puberty blocker use. The primary outcomes were ICD-10 diagnoses of mood disorders and suicidal thoughts or behaviors, with analyses adjusted for demographic, socioeconomic, insurance, geographic, and policy-related factors.
Key findings include:
- The study included 41,472 transgender youths and 190,311 cisgender youths.
- Transgender youths had significantly higher odds of diagnosed mood disorders than cisgender peers (adjusted odds ratio [aOR] 4.42).
- They also had more than 12-fold higher odds of diagnosed suicidal thoughts and behaviors (aOR 12.21).
- Among transgender youths, prescription of puberty blockers was associated with a 48% lower likelihood of mood disorder diagnoses (aOR 0.52).
- Puberty blocker use was also associated with an 80% lower likelihood of suicidal thoughts and behaviors among transgender youths (aOR 0.20).
- Despite these improvements, mental health disparities were reduced but not completely eliminated compared with cisgender youths.
- Puberty blocker use among transgender adolescents was uncommon, occurring in approximately 3.04% of transgender participants.
The authors noted that the study was observational and demonstrates association rather than causation. Because it relied on insurance claims data, it could not account for factors such as family support, access to mental health care, support groups, or other psychosocial influences, and the findings may not be fully generalizable to the broader US population.
Overall, the findings suggest that while puberty blockers may help reduce disparities in mood disorders and suicidality among transgender youth, they do not eliminate them. The researchers emphasize the need for continued mental health support, individualized care, and prospective studies to better understand the long-term mental health effects of gender-affirming treatment.
Reference:
Kronk C, Jain R, Dai Y, et al. Mental Health of Youths Who Use Puberty Blockers. JAMA Netw Open. 2026;9(7):e2623302. doi:10.1001/jamanetworkopen.2026.23302
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