They are a reversible treatment, approved decades ago for precocious puberty and later extended to adolescent gender dysphoria. And yet few drugs in modern medicine are so surrounded by political controversy. A large study published in JAMA Network Open now provides one of the largest analyses to date of what happens to the mental health of the transgender youths who receive them: the result, favourable to the treatment, arrives just when a data point of this size was most needed.
More than 230,000 youths in a health insurance registry
The team, led by researchers at Mount Sinai Hospital in New York, analysed a health insurance claims database from the United States with national coverage, between January 2016 and January 2025. The starting point was 231,783 youths aged 10 to 17, divided into four groups according to two criteria: whether they were transgender or cisgender, and whether they had been prescribed a puberty blocker or not. Of them, 41,472 were transgender (17.9%).
To measure the outcome they focused on two specific diagnoses: mood disorders (mainly depression) and suicidal behaviours and ideation. The calculations were adjusted with statistical models that took into account age, region, type of insurance, socioeconomic status and the political environment of each young person.
An unequal starting point
The first thing the study confirms is a reality already known but of a starkness hard to match in such large numbers: being transgender in adolescence entails far greater suffering than that of cisgender peers. Compared with them, transgender youths were 4.4 times more likely to receive a diagnosis of a mood disorder and 12.2 times more likely to record suicidal ideation or behaviour.
That gap is not an artefact: it reflects the weight of social rejection, harassment and the distress of an identity that does not fit the body during especially vulnerable years.
The data point that changes the reading: among transgender youths, the effect is protective
The most relevant result appears when only transgender youths are analysed. For them, the prescription of a puberty blocker was associated with a reduction of almost half the risk of mood disorder (48% less) and with an 80% drop in suicidal ideation and behaviour.
It is the contrast that matters: within the same transgender group, those who received the treatment showed notably better mental health than those who did not.
A statistical trap worth understanding
A quick reading of the overall figures could lead to the opposite conclusion: across all 231,783 youths, taking a blocker was associated with more depression and more suicidal ideation. But that figure has a simple explanation: those who receive the drug usually arrive already with more distress, because the treatment is prescribed precisely to those who suffer most.
That is why the authors insist that the valid comparison is the one internal to the transgender group, where the statistical design neutralises that selection. It is a clear example of why the same number can be misread if one forgets to ask who is behind each prescription.
Why it matters
The study does not prove causality, and its own authors acknowledge it. But it brings an unprecedented scale to a debate that usually moves between anecdote and dogma. That the mental health gap of transgender youths is enormous is a problem that demands specific interventions; that puberty blockers are associated with attenuating it, even partially, is a data point that health policy makers should keep very much in mind.
Source: Kronk C, Jain R, Dai Y, et al. Mental Health of Youths Who Use Puberty Blockers. JAMA Network Open. 2026;9(7):e2623302. doi:10.1001/jamanetworkopen.2026.23302.
Article published on dosier.es. Image generated with artificial intelligence (marta ai → marta.syf.es).
