Last month, the American Academy of Pediatrics (and other medical groups) wrote Merrick B. Galrland, Attorney General, asking the Justice Department for an investigation into growing violence against doctors and hospitals providing transgender medical treatment to adolescents. Because more Republicans are calling the treatment child abuse, doctors have been reluctant to talk about their work in fear of being made targets.

More than a dozen doctors declined to be interviewed for this article, and several who spoke to The Times — some who support treatment, others who question it — asked not to be named.

Research could be affected by the changing climate, according to Dr. Natalie Nokoff at the University of Colorado. She was an assistant professor of pediatrics endocrinology and recently published a study. study showing A longer treatment duration for puberty blockers was associated to a lower bone density.

“It’s leading to concerns that people’s well-intentioned scientific research could be misconstrued” She said that they were exploited for political gains.

It is a sad prospect for Emma Basques’, Ms. Chavira’s and the teens in New York. Despite their differences in experiences, they share similar hopes for transgender Medicine: less vitriol and more science.


Methodology

The Times requested an analysis that examined seven observational studies done in Canada, England, and Canada. It found that there was a correlation between puberty blocking drugs and bone density in around 500 adolescents.

Each study measured bone density at the spine and hip using Dual-energy-X-ray absorptiometry (or DEXA scan). Because individual data was not available in every study, the analysis considered group means. Each study’s findings were weighted based on its number of participants.

Blockers were not associated with any decrease in bone density. The analysis also showed that the adolescents’ Z-scores, a measure of bone density that is benchmarked to peers, consistently fell during treatment with blockers.

The following studies were included:

“Bone Mass in Young Adulthood Following Gonadotropin-Releasing Hormone Analog Treatment and Cross-Sex Hormone Treatment in Adolescents With Gender Dysphoria,” Klink et. al, Journal of Clinical Endocrinology & Metabolism, 2015

“Effect of Pubertal Suppression and Cross-Sex Hormone Therapy on Bone Turnover Markers and Bone Mineral Apparent Density (BMAD) in Transgender Adolescents,” Vlot et. al, Bone, 2017 

“The Effect of GnRH Analogue Treatment on Bone Mineral Density in Young Adolescents With Gender Dysphoria: Findings From a Large National Cohort,” Joseph et. al, Journal of Pediatric Endocrinology and Metabolism, 2019

“Physical Changes, Laboratory Parameters and Bone Mineral Density During Testosterone Treatment in Adolescents With Gender Dysphoria,” Stoffers et. al, The Journal of Sexual Medicine, 2019

“Bone Development in Transgender Adolescents Treated With GnRH Analogues and Subsequent Gender-Affirming Hormones,” Schagen et. al, Journal of Clinical Endocrinology & Metabolism, 2020

“Short-Term Outcomes of Pubertal Suppression in a Selected Cohort of 12- to 15-Year-Old Young People With Persistent Gender Dysphoria in the U.K.,” Carmichael et. al, PLOS One, 2021

“Pubertal Suppression, Bone Mass and Body Composition in Youth With Gender Dysphoria,” Navabi et. al, Pediatrics, 2021