{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T01:09:25Z","timestamp":1790644165854,"version":"4.1.0"},"reference-count":47,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2020,12,15]],"date-time":"2020-12-15T00:00:00Z","timestamp":1607990400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["acamh.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Child Adoles Ment Health"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Increasingly, early adolescents who are transgender or gender diverse (TGD) are seeking gender\u2010affirming healthcare services. Pediatric healthcare providers supported by professional guidelines are treating many of these children with gonadotropin\u2010releasing hormone agonists (GnRHa), which reversibly block pubertal development, giving the child and their family more time in which to explore the possibility of medical transition.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a critical review of the literature to answer a series of questions about criteria for using puberty\u2010blocking medications, the specific drugs used, the risks and adverse consequences and\/or the positive outcomes associated with their use. We searched four databases: LGBT Life, PsycINFO, PubMed, and Web of Science. From an initial sample of 211 articles, we systematically reviewed 9 research studies that met inclusion\/exclusion criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Studies reviewed had samples ranging from 1 to 192 (\n                      <jats:italic>N<\/jats:italic>\n                      \u00a0=\u00a0543). The majority (71%) of participants in these studies required a diagnosis of gender dysphoria to qualify for puberty suppression and were administered medication during Tanner stages 2 through 4. Positive outcomes were decreased suicidality in adulthood, improved affect and psychological functioning, and improved social life. Adverse factors associated with use were changes in body composition, slow growth, decreased height velocity, decreased bone turnover, cost of drugs, and lack of insurance coverage. One study met all quality criteria and was judged \u2018excellent\u2019, five studies met the majority of quality criteria resulting in \u2018good\u2019 ratings, whereas three studies were judged fair and had serious risks of bias.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Given the potentially life\u2010saving benefits of these medications for TGD youth, it is critical that rigorous longitudinal and mixed methods research be conducted that includes stakeholders and members of the gender diverse community with representative samples.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/camh.12437","type":"journal-article","created":{"date-parts":[[2020,12,20]],"date-time":"2020-12-20T07:45:35Z","timestamp":1608450335000},"page":"3-14","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":118,"title":["Review: Puberty blockers for transgender and gender diverse youth\u2014a critical review of the literature"],"prefix":"10.1111","volume":"26","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1365-0550","authenticated-orcid":false,"given":"Lynn","family":"Rew","sequence":"first","affiliation":[{"name":"School of Nursing The University of Texas at Austin Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cara C.","family":"Young","sequence":"additional","affiliation":[{"name":"School of Nursing The University of Texas at Austin Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria","family":"Monge","sequence":"additional","affiliation":[{"name":"Dell Medical School The University of Texas at Austin Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roxanne","family":"Bogucka","sequence":"additional","affiliation":[{"name":"Life Science Library The University of Texas at Austin Austin TX USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2020,12,15]]},"reference":[{"key":"e_1_2_9_2_1","article-title":"Longitudinal impact of gender\u2010affirming endocrine intervention on the mental health and well\u2010being of transgender youths: Preliminary results","volume":"8","author":"Achille C.","year":"2020","journal-title":"International Journal of Pediatric Endocrinology"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1176\/appi.books.9780890425596"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1080\/15265161.2018.1557277"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.pcl.2015.04.013"},{"key":"e_1_2_9_6_1","volume-title":"Experimental and quasi\u2010experimental designs for research","author":"Campbell D.T.","year":"1963"},{"key":"e_1_2_9_7_1","first-page":"e2017374","article-title":"Hormonal treatment in young people with gender dysphoria: A systematic review","volume":"14","author":"Chew D.","year":"2018","journal-title":"Pediatrics"},{"key":"e_1_2_9_8_1","unstructured":"Cochrane Consumer Network(n.d.)Levels of evidence. 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