Transgender and gender-questioning adolescents who have not yet reached the later stages of puberty may undergo pubertal suppression therapy before they begin hormone therapy. Pubertal suppression therapy is also referred to as “puberty blocking.” Pubertal suppression therapy is a non-invasive, reversible process achieved by using compounds that mimic the actions of gonadotropin-releasing hormone (GnRH) – a puberty-stimulating hormone released in the brain. One such compound, Leuprorelin (brand names: Lupron or Eligard) acts on the pituitary gland by making it less sensitive to GnRH. By desensitizing the pituitary gland to GnRH, fewer pubery-stimulating hormones are released, such as follicle stimulating hormone (FSH) and luteinizing hormone (LH). A reduction in FSH and LH results in a reversible “pause” of pubertal development while a patient is actively taking Leuprorelin.
Before initiating pubertal suppression therapy, patients undergo a physical examination to assess pubertal development. Our medical providers approach physical exams in a sensitive manner, recognizing that physical exams can be distressing for some gender diverse youth. Baseline hormone levels and bone health are also examined at this time. The duration of pubertal suppression therapy varies by patient. Leuprorelin is most commonly administered through an intramuscular injection, which the patient and caregiver may be taught to inject at home.