Little is known about the effects of puberty blockers

GENDER DYSPHORIAGIDSGNRH—the miserable feeling of being at odds with one’s sex—is one of the fastest-rising medical complaints among children. America had one paediatric gender clinic in 2007. It now has at least 50. The sole paediatric gender clinic for England and Wales, known by its acronym, , has seen referrals rise 30-fold in a decade. A similar pattern is evident across the rich world.Many attending such clinics are given gonadotropin-releasing hormone () agonists, or “puberty blockers”. These drugs, licensed to treat cancers of the breast and prostate, endometriosis and “central precocious puberty”—a rare condition in which puberty starts far earlier than normal—are prescribed off-label to stop the signals that stimulate the testicles or ovaries to ramp up sex-hormone production. The idea is to delay puberty, buying time for patients to decide whether to proceed to cross-sex hormones and surgery with the aim of “passing” as adult members of the opposite sex.