Brignardello-Petersen and Wiercioch, 2022

Introduction

Florida’s Agency for Health Care Administration published this evidence review alongside their recommendations. The review finds that puberty blocking treatment has minor improvements to mental health of low or very low certainty.

Method and Results

The two authors are experts in systematic reviews and clinical guideline creation from McMaster University in Hamilton, Ontario Canada.

The reviewers undertook a comprehensive search for systematic reviews that addressed mental health outcomes, quality of life, suicidal ideation, suicide, and adverse effects from puberty suppression treatment. The review covers cross-sex hormones and surgical interventions as well as puberty blockers.

The reviewers found four systematic reviews that met assessed the effects of puberty blockers and met screening criteria. The reviewers graded these reviews on methodological quality:

The reviews show blockers may have small effects on decreasing depression and anxiety and slightly increase gender dysphoria. The reviewers rate all outcomes as having a low or very low certainty. Suicidal ideation results relied on Turban et al. and was too uncertain to draw conclusions.

The reviewers also searched for studies that were not included in the systematic reviews and found three more studies that addressed puberty blockers, or puberty blockers in combination with other treatments.

The results from these studies were not strong or certain enough to change the reviewers conclusions.

Conclusion

In 2022, a decade after puberty suppression was recommended in NZ guidelines, there is no strong evidence that puberty improve mental health or prevent suicide.

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