Researchers’ fear of ‘weaponized’ data reignites attention to 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 who led a major federally funded study was quoted by The New York Times as saying she had delayed publication of some of her results for fear they would be “weaponized.” are. ‘ in a heated political climate.

Some advocates of gender-affirming care for young people say the report mischaracterizes the normal caution researchers exercise in carefully presenting and interpreting scientific data.

“It’s much ado about nothing and sensationalized that way,” said Dr. Alex Keuroghlian, director of the Education and Training Division of the Fenway Institute, a group that advocates for the health needs of sexual and gender minorities and people affected by HIV. .

The storywhich was published Wednesday, quotes 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 that in the 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 slow the physical changes associated with puberty, including things like body hair growth, menstruation, and a deeper voice.

“They’re in really good shape when they come in, and after two years they’re in really good shape,” Olson-Kennedy told the Times.

Her description appears to contradict the baseline characteristics of the 95 study participants published in 2022. That article reports that more than 1 in 4 had clinically significant levels of depression, anxiety and suicidal ideation. About 8% had reported a previous suicide attempt.

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

The research project has received almost $10 million in federal funding since 2015. The researchers has published more than 20 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 professor at Boston College, said she understood the impulse to be cautious, but that it is critical to publish the data.

“I believe it is imperative that research, especially tax-funded research, be published for the integrity of science,” says Tishelman, who helped write the initial grant for the project, which called “The Impact of Early Medical Treatment on Transgender”. Youth.” “We must be candid about our findings.”

Tishelman said the idea that study participants saw no change in their mental functioning doesn’t necessarily mean the therapy had no benefit.

“Puberty blockers may have prevented a decline in mental health,” she said, especially in 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 ideation in transgender children and teens, and the physical changes of puberty can greatly increase the sensation of feeling trapped in the wrong body.

For years, doctors have prescribed puberty-blocking drugs to certain transgender children who are psychologically identified as needing them as a way to reduce this distress, a model called the Dutch Protocol, based on early research supporting this approach in the Netherlands.

In 2017, the Endocrine Society – a professional group of scientists and medical providers focused on hormone-related issues – published a clinical practice guideline which cites more than 260 studies supporting the use of hormonal therapies to support children and teens with gender dysphoria, as well as medications to block it puberty.

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

Additionally, the association notes that the therapy is not experimental or unusual. “The same treatment has been used to treat precocious puberty for more than 40 years,” the report said.

However, this year the practice was called into question by an extensive but controversial study, saying that the rationale for suppressing early puberty was ‘unclear’ and that any mental health benefit was supported by ‘weak evidence’. The review – known as the Cass Review for Dr. Hilary Cass, the pediatrician who conducted it – and its methodology are covered sharp criticism from some scientists and practitioners.

It has prompted providers in Britain to scale back their use of the treatment.

The Cass Review was published amid a growing backlash against gender-affirming care for children. As of 2021, 26 U.S. states have passed laws banning or limiting minors’ access to gender-affirming care, including medications to suppress puberty, as well as other medical interventions, such as hormones to support gender transition.

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

Another one study published Monday in the journal JAMA Pediatrics reported high levels of satisfaction and low regret among more than 220 young people who had used puberty blockers and hormone therapy as children and teens.

The participants were followed from 2013 as part of the Trans Youth Project. Overall, 97% said they were satisfied and continued with gender-affirming care. Nine children – about 4% of the sample – expressed regret about puberty blockers or hormones, and four stopped their therapy.

Tishelman says she worries a more important point is being lost in the controversy over Olson-Kennedy’s case. research findings: that scientists might censor themselves for 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 feel comfortable publishing data because of the political landscape in the country right now, and that is very problematic,” she said.

CNN’s Jen Christensen contributed to this report.