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Puberty Blockers: An Overview
What Are Puberty Blockers?
Definition:
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- Medications that delay the onset of puberty in transgender and gender-diverse adolescents.
- They work by blocking the hormones testosterone and oestrogen that lead to halt physical changes associated with puberty.
- Purpose: To pause the physical changes associated with puberty such as growth of breasts, testicles, or penis, which are triggered by hormonal signals from the brain to the gonads (ovaries or testicles).
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There are two kinds of puberty blockers:
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- A flexible rod called histrelin acetate that goes under the skin of the arm and lasts for 1 year.
- A shot called leuprolide acetate, which works for 1, 3, or 4 months at a time.
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Uses:
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- Role in Gender Dysphoria: For adolescents experiencing gender dysphoria (conflict between assigned gender at birth and gender identity), these drugs help by halting the development of secondary sexual characteristics that may exacerbate their distress.
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Sex Hormones Affect:
- Primary Sex Characteristics: Organs present at birth, like the penis, scrotum, uterus, and vagina.
- Secondary Sex Characteristics: Physical changes during puberty, such as breast development and facial hair growth.
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- Precocious Puberty: Also used to treat precocious puberty, where puberty begins too early (before age 8 for girls and 9 for boys).
- Mechanism: They are Gonadotropin-Releasing Hormone (GnRH) analogues that stop the production of sex hormones.
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Effects on Physical Development:
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- Assigned Male at Birth: Slows facial and body hair growth, prevents voice deepening, and limits growth of the penis, scrotum, and testicles.
- Assigned Female at Birth: Limits or stops breast development and menstruation.
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Side Effects:
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- Common: Insomnia, weight gain, muscle aches, fatigue, mood shifts, changes in breast tissue, and irregular periods or spotting.
- Potential Psychological Effects: Depression or self-harm tendencies.
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Prevalence and Regulation in India:
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- Primary Use: More commonly prescribed for precocious puberty rather than for gender dysphoria.
- Gender Reassignment Surgery: Typically not performed before age 18 in India, though puberty blockers may be used as part of the transition process.
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What is Puberty?
- Definition: Puberty is the stage when individuals become sexually mature, typically occurring between ages 10-14 for girls and 12-16 for boys.
- Changes in Girls: Breast Development is the first sign. Hair Growth appears in the pubic area and armpits.
- The Menstruation Cycle generally starts last.
- Changes in Boys:
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- Genital Growth: Testicles and penis enlarge first.
- Hair Growth: Develops in the pubic area and armpits.
- Muscle Growth & Voice Changes: Muscles grow, voice deepens, and facial hair begins to appear.
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