The Amsterdam University Clinic UMC, a pioneer in the use of puberty blockers, admitted that children taking these drugs may find themselves locked into increased medicalisation.
The admission comes following the publication earlier this month of a new retrospective study examining 20 years of hormonal interventions known as the 'Dutch protocol', conducted on 1,766 children and adolescents between 1972 and 2018 at the famous Amsterdam clinic and published in The Journal of Sexual Medicine. But even after a reportage had revealed that the study on which the puberty blocker treatment was based had been financed by the manufacturers of these drugs.
In the new study, researchers found that 93% of the patients eligible for puberty blockers then took hormonal drugs to transition to the opposite sex (cross-sex)
Dutch doctors until now claimed that blockers were completely reversible and allowed patients to 'pausing' puberty to clarify the diagnosis, explore gender identity and consider the next step towards opposite-sex hormones. However, the new study confirms the findings of three recent studies that thehe vast majority of those who start with blockers switch to hormones of the opposite sex (see here, here e here).
Medicalising girls and boys with puberty blockers raises many ethical issues: hormone therapies in fact, if started at prepubertal age, lead young patients to infertility. This also implies that 8-9 year old children would be able to give informed consent to a lifelong medical course.
The article by endocrinologist Maria A.T.C. van der Loos and colleagues states that the finding that blockers at the Amsterdam clinic almost always led to opposite-sex hormones 'may imply that the treatment [of puberty blockers] is used as beginning of the transition rather than as an extension of the diagnostic phase'.
The researchers suggest that most of the patients who started treatment with the blockers in the study must have suffered from 'sustained' gender dysphoria, a distressing sense of conflict between birth sex and inner gender identity. "However," the paper states, "one cannot exclude the possibility that the initiation of [taking puberty blockers] in itself renders adolescents more likely to continue the medical transition'.
According to sociologist Michael Biggs of Oxford University, who last September published a detailed critique of the Dutch protocol treatments, it is the 'greatest admission' that puberty blockers are neither reversible nor a diagnostic tool.
"Finally, Dutch doctors admit what many of us have been saying for years, that puberty blockers and social transition (living as the opposite sex) become a self-fulfilling prophecy', Dr Biggs told Gender Clinic News.
Full article here.
Translation by Maria Celeste