Pubertal Suppression for Transgender Youth and Risk of Suicidal Ideation
Open accessAbstract
BACKGROUND AND OBJECTIVES: Gonadotropin-releasing hormone analogues are commonly prescribed to suppress endogenous puberty for transgender adolescents. There are limited data regarding the mental health benefits of this treatment. Our objective for this study was to examine associations between access to pubertal suppression during adolescence and adult mental health outcomes. METHODS: Using a cross-sectional survey of 20 619 transgender adults aged 18 to 36 years, we examined self-reported history of pubertal suppression during adolescence. Using multivariable logistic regression, we examined associations between access to pubertal suppression and adult mental health outcomes, including multiple measures of suicidality. RESULTS: Of the sample, 16.9% reported that they ever wanted pubertal suppression as part of their gender-related care. Their mean age was 23.4 years, and 45.2% were assigned male sex at birth. Of them, 2.5% received pubertal suppression. After adjustment for demographic variables and level of family support for gender identity, those who received treatment with pubertal suppression, when compared with those who wanted pubertal suppression but did not receive it, had lower odds of lifetime suicidal ideation (adjusted odds ratio = 0.3; 95% confidence interval = 0.2–0.6). CONCLUSIONS: This is the first study in which associations between access to pubertal suppression and suicidality are examined. There is a significant inverse association between treatment with pubertal suppression during adolescence and lifetime suicidal ideation among transgender adults who ever wanted this treatment. These results align with past literature, suggesting that pubertal suppression for transgender adolescents who want this treatment is associated with favorable mental health outcomes.
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Studies have proven that anti-LGBTQ+ policies such as the denial of gender-affirming care are linked to higher rates of depression, suicidal ideation, and delayed healthcare.
“Studies have proven that anti-LGBTQ+ policies such as the denial of gender-affirming care are linked to higher rates of depression, suicidal ideation, and delayed healthcare [51].”
From Then, Now, Next: Unpacking the Shifting Trajectory of Social Determinants of Health (2025) · cites this paper as [51]
The Results and Discussion report that, among transgender adults who wanted pubertal suppression, those who received it had lower odds of lifetime suicidal ideation than those who did not. The paper does not establish that anti-LGBTQ+ policies caused denial of care, nor does it link such policies or denial to higher depression rates or delayed healthcare. Its finding is an association, not proof of a causal effect. (LLM, conf=0.86)
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Considerations for transgender population health research based on US national surveys
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Then, Now, Next: Unpacking the Shifting Trajectory of Social Determinants of Health
Wallington, S. F., & Feger, C. (2025) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph22101541 · Cited by 6 · see citing works
- Authors
- Turban, J. L., King, D., Carswell, J. M., & Keuroghlian, A. S.
- Affiliations
- Massachusetts General Hospital (US)
- bThe Fenway Institute, Boston, Massachusetts; and
- Boston Children's Hospital (US)
- Corresponding author
- Turban, Jack L.
- Venue
- Pediatrics
- Publisher
- American Academy of Pediatrics (AAP)
- Published
- 2020-02-01
- Volume
- 145
- Issue
- 2
- ISSN
- 0031-4005 (ISSN-L)
- 1098-4275
- PMC
- PMC7073269
- OpenAlex
- W3001825536
- Cited by
- 405
- References
- 3
- Citations by year
- 2026: 33 · 2025: 73 · 2024: 71 · 2023: 75 · 2022: 71 · 2021: 67 · 2020: 15
- FWCI
- 62.31
- Type
- journal article
- Language
- en
- Open access
- green
- www.ncbi.nlm.nih.gov
- Locations
- PEDIATRICS (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- Funders
- National Institute of Allergy and Infectious Diseases (UG3AI133669)
- Topics
- Social Sciences › Psychology › Social Psychology › LGBTQ Health, Identity, and Policy
- Health Sciences › Health Professions › Speech and Hearing › Adolescent and Pediatric Healthcare
- Social Sciences › Gender Studies › Gender, Sexuality, and Education
- Keywords
- puberty suppression, transgender youth, GnRH analogues, suicidal ideation, transgender adults, adolescent mental health, gender-affirming care
- MeSH terms
- Adolescent, Adult, Age Factors, Analysis of Variance, Cross-Sectional Studies, Female, Gender Identity, Health Services Accessibility, Humans, Gonadotropin-Releasing Hormone, Male, Mental Health, Puberty, Surveys and Questionnaires, Confidence Intervals, Odds Ratio, Young Adult, Suicidal Ideation, Transgender Persons
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