Systematic Review: Puberty suppression with GnRH analogues in adolescents with gender incongruity

J Endocrinol Invest. 2021 Jun;44(6):1151-1158. doi: 10.1007/s40618-020-01449-5. Epub 2020 Oct 28.

Abstract

Context: Gender incongruence is defined as disharmony between assigned gender and gender identity. Several interventions are liable in this case including genital affirming surgery among other surgical interventions such as harmonization, and also the use of gonadotropin-releasing hormone agonists (GnRHa) for gonadal shielding. This aids in preventing the development of secondary sexual characteristics related to the genetic sex.

Objective: Systematically review the treatment of gender incongruity with GnRHa analogues.

Data sources: The data source of this research is from Pubmed-Medline and Embase.

Study selection: Articles published between 2009 and 2019 which studied transgender adolescents treated with GnRHa were carefully selected.

Data extraction: Were extracted: design, sample size, study context, targeted subjects of intervention, outcome measures, and results.

Results: Eleven studies were included. The use of GnRHa seems to be well tolerated by the studied population. When started in pubertal transition, it was associated with a more distinct resemblance to body shape than to the affirmed sex. In addition to preventing the irreversible phenotypic changes that occur in cross-hormonal therapy, the use of GnRHa can equally contribute to the mental health of these adolescents.

Limitation: There are few consistent studies on the use of GnRHa for gender incongruence.

Conclusion: As the population of transgender children and adolescents grows, they acquire knowledge and greater access to the various forms and stages of treatment for sex reassignment. The medical community needs to be adequately prepared to better serve this population and offer the safest resources available.

Keywords: Disorders of sex development; Gender disorders; Gonadotropin-releasing hormone.

Publication types

  • Systematic Review

MeSH terms

  • Adolescent
  • Endocrine Disruptors / pharmacology
  • Gender Dysphoria* / metabolism
  • Gender Dysphoria* / physiopathology
  • Gender Dysphoria* / prevention & control
  • Gonadotropin-Releasing Hormone / agonists*
  • Humans
  • Puberty* / drug effects
  • Puberty* / physiology
  • Sexual Development / drug effects
  • Sexual Development / physiology
  • Transgender Persons

Substances

  • Endocrine Disruptors
  • Gonadotropin-Releasing Hormone