Pubertal blockers for transgender and gender diverse youth
Transgender and gender diverse children might choose to temporarily suppress puberty through the use of prescription medications called pubertal blockers. But deciding to get this treatment is a big step.
跨性别和性别不同的儿童可能会选择通过使用被称为青春期阻滞剂的处方药来暂时抑制青春期。但是决定是否接受这种治疗是很大的一步。
Here's what you need to know about the pubertal blocker medication known as gonadotropin-releasing hormone (GnRH) analogues, including the benefits, side effects and long-term effects.
以下是关于青春期阻滞剂类似物促性腺激素释放激素类似物的药物治疗，包括益处、副作用和长期影响。
What do pubertal blockers do?
青春期阻滞剂起什么作用？
Puberty's physical changes can cause intense distress for many gender-nonconforming adolescents. When taken regularly, <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues suppress the body's release of sex hormones, including testosterone and estrogen, during puberty. These hormones affect:
青春期的身体变化可能会给许多性别不符的青少年带来极大的痛苦。经常服用 GnRH 类似物会抑制青春期身体释放性激素，包括睾丸激素和雌激素。这些激素影响:
- Primary sex characteristics. 主要性别特征 These are the sexual organs present at birth, including the penis, scrotum and testicles and the uterus, ovaries and vagina. 这些是出生时存在的性器官，包括阴茎、阴囊和睾丸，以及子宫、卵巢和阴道
- Secondary sex characteristics. 第二性征 These are the physical changes in the body that typically appear during puberty. Examples include breast development and growth of facial hair. 这些身体上的变化通常出现在青春期。例如，乳房发育和面部毛发生长
In those identified as male at birth, <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues decrease the growth of facial and body hair, prevent voice deepening, and limit the growth of genitalia.
在那些出生时被确定为男性的人群中，GnRH 类似物会减少面部和体毛的生长，防止声音加深，并限制生殖器的生长。
In those identified as female at birth, treatment limits or stops breast development and delays or stops menstruation.
在那些出生时被确定为女性的人群中，治疗限制或阻止了乳房的发育，推迟或停止了月经。
What are the benefits of use of pubertal blockers?
使用青春期阻滞剂的好处是什么？
Gender dysphoria is the feeling of discomfort or distress that might accompany a difference between experienced or expressed gender and sex assigned at birth.
性别认同障碍是伴随着出生时经历或表达的性别和性别差异而产生的不适或痛苦的感觉。
For children who have gender dysphoria, suppressing puberty might:
对于有性别认同障碍的孩子来说，抑制青春期可能会:
- Improve mental well-being 改善心理健康
- Reduce depression and anxiety 减少抑郁和焦虑
- Improve social interactions and integration with other kids 改善与其他孩子的社交互动和融合
- Eliminate the need for future surgeries 消除未来手术的需要
- Reduce thoughts or actions related to self-harm 减少与自我伤害有关的想法或行动
However, puberty suppression alone might not ease gender dysphoria.
然而，仅仅抑制青春期可能不能缓解性别认同障碍。
What are the criteria for use of pubertal blockers?
使用青春期阻滞剂的标准是什么？
To begin using pubertal blockers, a child must:
要开始使用青春期阻滞剂，孩子必须:
- Show a long-lasting and intense pattern of gender nonconformity or gender dysphoria 表现出持久而强烈的性别不一致或性别认同障碍
- Have gender dysphoria that began or worsened at the start of puberty 青春期开始或恶化的性别认同障碍
- Address any psychological, medical or social problems that could interfere with treatment 解决任何可能影响治疗的心理、医学或社会问题
- Provide informed consent 提供知情同意
Particularly when a child hasn't reached the age of medical consent, parents or other caretakers or guardians must consent to the treatment and support the adolescent through the treatment process.
特别是当儿童未达到医疗同意年龄时，父母或其他看护人或监护人必须同意治疗，并在治疗过程中支持青少年。
Are the changes permanent?
这些变化是永久性的吗？
Use of <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues doesn't cause permanent changes in an adolescent's body. Instead, it pauses puberty, providing time to determine if a child's gender identity is long lasting. It also gives children and their families time to think about or plan for the psychological, medical, developmental, social and legal issues ahead.
促性腺激素释放激素类似物的使用不会引起青少年身体的永久性变化。相反，它会暂停青春期，为判断孩子的性别认同是否持久提供时间。它也给孩子和他们的家庭时间去思考或计划未来的心理、医疗、发展、社会和法律问题。
If an adolescent child stops taking <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues, puberty will resume.
如果一个青少年停止服用 GnRH 类似物，青春期就会恢复。
What is the typical treatment time frame?
典型的治疗时间框架是什么？
For most children, puberty begins around ages 10 to 11, though some start earlier. The effect of pubertal blockers depends on when a child begins to take the medication. <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogue treatment can begin at the start of puberty to delay secondary sex characteristics. In slightly later stages of puberty, the treatment could be used to stop menstruation or erections or to prevent further development of undesired secondary sex characteristics.
对于大多数孩子来说，青春期开始于10到11岁，虽然有些孩子开始得更早。青春期阻滞剂的效果取决于孩子什么时候开始服药。促性腺激素释放激素类似物治疗可以在青春期开始时开始，以推迟第二性征。在青春期稍晚的阶段，这种治疗可以用来阻止月经或勃起，或者防止不受欢迎的第二性征的进一步发展。
While most children take the medication for a few years, every child is different. After suppressing puberty for a few years, your child might decide to stop hormone therapy or pursue other hormone treatments.
虽然大多数孩子服用这种药物几年，但每个孩子都不一样。在抑制了几年的青春期之后，你的孩子可能会决定停止激素疗法或者寻求其他激素疗法。
How is the medication given?
如何给予药物治疗？
<abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogue treatments for children are prescribed, administered and monitored by a pediatric endocrinologist. The medication is typically given as injections, either monthly or every three months, or through an implant placed under the skin of the upper arm. The implant typically needs to be replaced every 12 months.
儿童 GnRH 类似物治疗是由儿科内分泌专家处方、管理和监测的。这种药物通常以注射的形式给药，每月或每三个月一次，或者通过植入在上臂皮肤下的植入物。植入物通常需要每12个月更换一次。
While taking pubertal blockers, your child will have regular blood tests to monitor the medication's effectiveness. Your child will also be monitored for any side effects.
在服用青春期阻滞剂的同时，你的孩子会定期进行血液检测，以监测药物的有效性。你的孩子也会被监控任何副作用。
What are the possible side effects and complications?
可能的副作用和并发症是什么？
It's important for your child to stay on schedule with all related medical appointments. Contact your child's doctor if any changes cause you or your child concern.
所有相关的医疗预约都要按时完成，这对你的孩子来说很重要。如果有任何变化引起您或您的孩子的关注，请与您孩子的医生联系。
Possible side effects of <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogue treatment include:
促性腺激素释放激素类似物治疗可能的副作用包括:
- Injection site swelling 注射部位肿胀
- Weight gain 体重增加
- Hot flashes 热潮红
- Headaches 头痛
Use of <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues might also have long-term effects on:
使用促性腺激素释放激素(GnRH)类似物还可能对以下方面产生长期影响:
- Bone density 骨密度
- Future fertility 未来的生育率
Children will likely have their height checked every three months. Your child's doctor might recommend yearly bone density and bone age tests.
孩子们可能每三个月检查一次身高。你孩子的医生可能会建议每年做一次骨密度和骨龄测试。
If children with male genitalia begin using <abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues early in puberty, they might not develop enough penile and scrotal skin for certain gender confirmation genital surgical procedures, such as penile inversion vaginoplasty. Alternative techniques, however, are available.
如果有男性生殖器的儿童在青春期早期就开始使用 GnRH 类似物，他们可能不会发育出足够的阴茎和阴囊皮肤来进行某些确认性别的生殖器外科手术，比如阴茎倒置阴道成形术。然而，替代技术是可行的。
In addition, delaying puberty beyond one's peers can be stressful. Your child might experience lower self-esteem.
此外，把青春期推迟到同龄人之后可能会有压力，你的孩子可能会感到自尊心降低。
What other treatments are needed?
还需要什么其他的治疗方法？
Assessment and counseling by a behavioral health provider can help you and your child as you move through the decision-making process and provide support during therapy. Engaging your child's school teachers and officials also might help ease your child's social adjustment during this process.
行为健康提供者的评估和咨询可以帮助你和你的孩子完成决策过程，并在治疗期间提供支持。在这个过程中，让孩子的学校老师和官员参与进来也可能有助于缓解孩子的社会适应。
After a period of adjusting to pubertal blockers, adolescents might work with their care team to add cross-hormone treatment. This is done to develop masculine or feminine secondary sex characteristics, helping the mind and body look and act like the gender with which your child identifies. Keep in mind that some of these changes aren't reversible or will require surgery to reverse the effects.
经过一段时间的适应青春期阻滞剂，青少年可能会与他们的护理小组增加交叉激素治疗。这样做是为了发展男性或女性的第二性别特征，帮助大脑和身体的外观和行为与你的孩子所识别的性别相似。请记住，这些变化中的一些是不可逆的，或者需要通过手术来逆转这些影响。
<abbr title="gonadotropin-releasing hormone">GnRH</abbr> analogues aren't the only medications that can delay puberty. If you're interested in alternative treatments, talk to your child's doctor.
促性腺激素释放激素类似物并不是唯一可以延缓青春期的药物。如果你对替代疗法感兴趣，可以和你孩子的医生谈谈。
