Puberty Blockers for Children: Can They Consent?

New Bioeth. 2022 Sep;28(3):268-291. doi: 10.1080/20502877.2022.2088048. Epub 2022 Jun 27.

Abstract

Gender dysphoria is a persistent distress about one's assigned gender. Referrals regarding gender dysphoria have recently greatly increased, often of a form that is rapid in onset. The sex ratio has changed, most now being natal females. Mental health issues pre-date the dysphoria in most. Puberty blockers are offered in clinics to help the child avoid puberty. Puberty blockers have known serious side effects, with uncertainty about their long-term use. They do not improve mental health. Without medication, most will desist from the dysphoria in time. Yet over 90% of those treated with puberty blockers progress to cross-sex hormones and often surgery, with irreversible consequences. The brain is biologically and socially immature in childhood and unlikely to understand the long-term consequences of treatment. The prevailing culture to affirm the dysphoria is critically reviewed. It is concluded that children are unable to consent to the use of puberty blockers.

Keywords: consent in children; gender dysphoria; puberty blockers; ‌gender identity.

Publication types

  • Review

MeSH terms

  • Child
  • Female
  • Gender Dysphoria* / drug therapy
  • Gender Identity
  • Gonadal Steroid Hormones / therapeutic use
  • Humans
  • Informed Consent
  • Puberty* / psychology

Substances

  • Gonadal Steroid Hormones