Researchers’ fears over ‘rigged’ data reignite 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 leading a major federally funded study was quoted by The New York Times as saying he delayed publishing some of his results because of fears that “armed”. ” in a heated political climate.

Some advocates of gender-affirming care for youth say the report mischaracterizes the normal precaution researchers take to carefully present and interpret scientific data.

“It’s a lot of ado about nothing and sensational that way,” said Dr. Alex Keuroghlian, director of the Division 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 storywhich was published Wednesday, cites Dr. Johanna Olson-Kennedy, medical director of the Center for Transyouth Health and Development at Children’s Hospital Los Angeles, one of the largest programs of its kind in the US.

Olson-Kennedy said this in studywhich she helped lead, puberty blockers did not appear to improve the mental health of 95 children aged 8 to 16 who were followed for two years to understand their mental and physical functioning as doctors used the drugs to delay the physical changes associated with puberty, including things such as body hair growth, menstruation. and a deepening voice.

“I’m in really good shape going in and I’m in really good shape after two years,” Olson-Kennedy told the Times.

Her description seems to contradict the initial characteristics of the 95 study participants, who were published in 2022. The paper reports that more than 1 in 4 had clinically significant levels of depression, anxiety and suicidal thoughts. About 8% reported a previous suicide attempt.

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

The research project received almost 10 million dollars in federal funding since 2015. Researchers have published more than two dozen papers on its findings, although an update on the group of children who were followed for two years after being prescribed puberty-blocking drugs appears to be overdue.

Dr. Amy Tishelman, a psychologist and research associate professor at Boston College, said she understood the urge to be cautious, but that it was essential to publish the data.

“I think it’s imperative that research, especially taxpayer-funded research, be published for the integrity of the science,” said Tishelman, who helped write the initial grant for the project, which is called “The Impact of Early Medical Treatment on Transgender People.” Youth.” “We must be honest about our findings.”

Tishelman said that just because study participants didn’t see a change in their mental functioning doesn’t necessarily mean the therapy didn’t have a benefit.

“Puberty blockers may have prevented the decline in mental health,” she said, especially for children who may have had greater body dysphoria — or a sense of being in the wrong body — after puberty.

However, it’s impossible to know without seeing the data, she said.

Numerous studies have documented high rates of suicide and suicidal thoughts in 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 prescribed puberty-blocking drugs to certain transgender children who are psychologically judged to need them as a way to reduce that suffering, a model called the Dutch protocol, based on early research supporting the approach in the from Down.

In 2017, the Endocrine Society—a professional group of scientists and health care providers focused on hormone-related issues—published a clinical practice guideline which cites more than 260 studies supporting the use of hormone therapies to support children and adolescents with gender dysphoria, as well as blocking drugs. puberty.

“Puberty delay medication is a safe, generally reversible and conservative approach that gives transgender and gender-nonconforming adolescents and their families more time to explore their options,” the Endocrine Society said in a statement Friday.

Moreover, the society notes, the therapy is not experimental or unusual. “The same treatment has been used for more than 40 years to treat precocious puberty,” it says.

This year, however, a wide-ranging but controversial review in Britain called the practice into question, saying the rationale for early suppression of puberty was “unclear” and that any mental health benefits were supported by “weak evidence”. The review – known as the Cass Review after Dr Hilary Cass, the pediatrician who carried it out – and its methodology came under sharp criticism from some scholars and practitioners.

It has prompted UK providers to reduce their use of the treatment.

The Cass magazine was published amid a growing backlash against gender-affirming care for children. As of 2021, 26 US states have passed laws that prohibit or restrict minors from accessing gender-affirming care, which can include puberty-suppressing drugs as well as other medical interventions such as hormones to support a gender transition.

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

Another study published Monday in the journal JAMA Pediatrics reported high levels of satisfaction and low levels of regret among more than 220 young people who accessed puberty blockers and hormone therapy in childhood and adolescence.

Participants have been followed since 2013 within the Trans Youth Project. Overall, 97% said they were satisfied and continued with gender-affirming care. Nine children—about 4 percent of the sample—expressed regret about puberty blockers or hormones, and four discontinued their therapy.

Tishelman says he fears a more important point is being lost in the Olson-Kennedy controversy. the study’s findings: that scientists may self-censor out of fear that their work will be used against the people they are trying to help.

“The real meaning of the story is that scientists may not be comfortable publishing data because of the political landscape in the country right now, and that’s very problematic,” she said.

CNN’s Jen Christensen contributed to this report.