What do you need to know about puberty blockers, which are the subject of debate in Alberta?

(Vancouver) Puberty blockers have been in the spotlight since Alberta Premier Danielle Smith announced plans last week to ban them for children aged 15 and under unless they have already started treatment.

The positions of Mme Smith on gender-affirming care earned him heavy criticism from Prime Minister Justin Trudeau, but won him support from federal Conservative Leader Pierre Poilievre, who believes puberty blockers should not be administered in the children.

The Canadian Press consulted several experts to find out more about these drugs.

What are puberty blockers and how long have they been used?

Puberty blockers are given by injection to young people who have gender dysphoria, meaning their gender identity does not match the sex they were assigned at birth.

These medications stop physical changes that occur during adolescence, such as breast development due to estrogen or a deeper voice due to testosterone.

According to the Dr Daniel Metzger, who is a pediatric endocrinologist at BC Children’s Hospital, inhibitors were first used in the 1990s to delay puberty in some children who were beginning to develop certain sexual characteristics as young as three years.

Doctors in the Netherlands began administering these drugs to young people questioning their gender identity in the 1990s. Vancouver Hospital was the first to use them in Canada, about 26 years ago, mentioned the Dr Metzger.

The effects of puberty blockers are reversible if the person stops taking them, giving young people time to decide whether they want to continue with gender affirmation surgeries, some of which are irreversible.

Around what age are puberty blockers usually given?

The average age at which young people identified as girls at birth begin puberty is 10, while those assigned as boys typically begin at 11, said Dr.r Metzger.

“That’s where we would consider using inhibitors in children if their bodies were starting to change and they had gone through the assessment process that we use to decide who needs the inhibitors,” he explained.

Girls at birth can become “very anxious” about having curves and menstruating, while boys at birth are often afraid of seeing hair appear on their bodies.

“The care that is administered concerns the family, the medical system and the mental health system. Politicians have nothing to do with it,” argued the Dr Metzger.

Authorizing puberty blockers only from the age of 18, as Pierre Poilievre suggested, would be “cruel” and would cause “missing the boat”, in the opinion of the Dr Metzger, to the point where there would no longer be any point in using it.

“If you prevent a young person from using inhibitors before the age of 18, you are making an irreversible decision that will force them to go through puberty and the physical and emotional changes that come with it. »

What are the criteria for starting puberty blockers and how often are they given?

Before a young person can begin using puberty blockers, a mental health provider must make sure they understand what it means to consent to treatment, including regular injections in the leg.

“The person has made a social transition, but all of a sudden they start to have breasts or a penis that starts to grow. This is where the frustration comes in and we evaluate the possibility of using inhibitors,” mentioned Dr.r Metzger.

The medications are injected either once a month or every three months.

How does lack of access to gender-affirming care affect trans youth or those experiencing gender dysphoria?

Elizabeth Saewyc, who is a professor in the School of Nursing at the University of British Columbia, conducted a national survey of trans youth in 2019.

This study allowed him to discover that 71% of the more than 1,500 respondents aged 14 to 25 admitted to having needed mental health services in the previous year, but not having received them.

This survey also highlighted the fact that 30% of young people attempted suicide during the previous year, underlined Mme Saewyc.

For young people who have limited access to a family doctor or wait a long time to see a mental health provider, gender-affirming care, including puberty blockers, should not be delayed too long , because the emotional toll would be too high, she analyzed.

“None of this is fast. From a medical point of view, there is no reason to wait until age 18,” she said.

Politicizing access to this medical care could push some trans adolescents not to talk to experts about what they are going through, in a context where they already receive no support at home or at school, warned Mme Saewyc.

“The misinformation out there is truly staggering,” she said of puberty blockers.

“It becomes worrying when our politicians repeat certain ideas without really checking the accuracy of what they are saying. »

The Canadian Press’ health content receives funding through a partnership with the Canadian Medical Association. The Canadian Press is solely responsible for editorial choices.

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