In a study (pdf) reexamining data on 44 children ages 12 to 15, researchers found that up to 34 percent of trans teens with gender dysphoria taking the puberty blocker triptorelin self-reported declined mental health. At the same time, up to 29 percent reported improvement, while 37 percent reported no change in mental health status.

Researchers elected to reevaluate the data by examining individual-level changes rather than testing differences between group averages to get a clearer picture of the benefits and risks of triptorelin. “Rather than saying ‘on average’ there was a statistically significant difference before and after treatment; we can say ‘of the whole sample, 50% improved but 50% deteriorated’ and so on,” the authors wrote.

What Is Triptorelin and How Does It Work?

Triptorelin falls under a class of medications known as gonadotropin-releasing hormones (GnRH), designed to cause the synthesis and release of two sex hormones: luteinizing hormone and follicle-stimulating hormone. In men, these two hormones prompt the testes to stimulate testosterone production, and in women, induce the ovaries to synthesize estrogen chemically.

The injectable puberty-blocking drug was first approved in the United States in 2000 to relieve symptoms of advanced prostate cancer by lowering testosterone levels and is said to be as effective as surgical castration. Like other GnRHs, triptorelin has been used off-label in girls under age 8 and boys under 9 to offset early puberty, as well as act as a key component of “gender-affirming care” by ceasing menstruation and erections. It also affects secondary sex characteristics such as breast and genitalia development, fat deposition, body hair growth, and changes in the larynx.

Common side effects of triptorelin include:

• Hot flashes.
• Loss of libido.
• Erectile dysfunction.
• Depression.
• Nausea.
• Diarrhea.
• Fluid retention.

The shot also comes with several rare but potentially severe complications, such as:

• Pituitary apoplexy, or bleeding of benign tumors in the pituitary gland.
• Metabolic changes.
• Diabetes.
• Weight gain.
• Osteoporosis.

Mental Health Epidemic in Youth

The results of the current study could potentially add to the epidemic of deteriorating mental health.

Nearly 15 percent of young people aged 10 to 19 have a mental health disorder globally, according to the 2022 National Healthcare Quality and Disparities Report.

Findings from a comprehensive 2022 paper published by UK researchers found that 18 percent of children between 7 and 16 had a suspected mental health disorder. Probable disorder rates also rose from 1 in 9 in 2017 to 1 in 6 in 2020. The rates then leveled off between 2020 and 2022.

Another 2022 study showed similar results. Close to 22 percent of children in the United States experience at least one mental, emotional, or behavioral health condition.