Social transitioning is when someone takes non-medical and fully reversible steps to begin living and presenting publicly as their gender. This can include changes such as:
For those who begin transitioning prior to puberty, transition is entirely social. But for many transgender and non-binary people, social transition is the first step in their gender transition journey, regardless of the age they begin transitioning. This is because it offers the opportunity to easily and quickly take small steps to begin living authentically, before involving medical interventions.
For transgender and non-binary youth who are aware of their gender at a young age, going through puberty can cause intense distress and dysphoria, as it leads their body to develop into a gender that is not theirs -including in ways that are irreversible, or only reversible with surgery. For example, teenage transgender boys who do not have access to blockers will have to go through a puberty that includes growing breasts and later in life will require surgery.
In these instances, puberty blockers may be prescribed by doctors early in puberty, in consultation with the child, their parents and therapists, in order to temporarily stop the body from going through the unwanted physical and developmental changes of puberty. They are used to give youth time to continue exploring their gender identity before potentially moving on to more permanent transition-related care when they are older.
Puberty blockers are safe. They were approved by the FDA to treat precocious puberty in cisgender youth in 1993, citing minimal side effects and high efficacy; 30 years later, puberty blockers remain the postorder brudar och lagliga gold standard treatment for precocious puberty in cisgender youth. All youth who are taking puberty blockers – cisgender or transgender – are monitored by their care team for any side effects or complications.
Puberty blockers are fully reversible. While there may be some loss of bone mineral density, this can be easily addressed with calcium and vitamin D supplements. Previous research has also shown that cisgender youth who take puberty blockers for precocious puberty have normal fertility and reproductive function.
If a person stops taking puberty blockers, normal puberty will resume, with minimal long-term effects, if any
Puberty blockers can also be life-saving: Previous studies have found that transgender and non-binary youth who are able to receive puberty blockers report positive psychosocial impacts, including increased well-being and decreased depression. Other recent studies have found that receipt of puberty blockers can dramatically reduce risk of suicidality – in some cases by over 70% – among transgender youth, compared to those who were unable to access desired treatment.
What are cross-sex hormones or gender-affirming hormones? Why are they used? Are they safe?
Gender-affirming hormones are a type of prescription medicine transgender and non-binary people can take to cause their body to begin physically developing into the gender they identify as. These medications allow transgender and non-binary people to live more fully as their identified gender, significantly reducing negative psychological outcomes such as gender dysphoria, depression, anxiety and suicidality.
Gender-affirming hormone medications are synthetic versions of testosterone or estrogen, the same hormones that naturally develop at various levels in both cisgender men and cisgender women. These same medications are used safely every day by millions of cisgender men and women worldwide.
Gender affirming hormones are typically not prescribed until a person is at least 18 years old. Though adolescents may receive gender-affirming hormones starting in their late teens, this is only done with physician approval, parental consent and informed consent from the adolescent in question, and is typically reserved for those adolescents who have been on puberty blockers and/or socially transitioned for some time.
