Several studies have proven the effectiveness of early medical interventions and the safety of these interventions with regard to physical and psychological harm. Overall, research has shown improved psychological functioning during suppression, no change of mind in terms of gender identity and the reduction or disappearance of distress related to GD; in addition, several studies have reported an increase in GD and harmful behaviour when blockers are not used.34, 36
In their longitudinal study on the first 70 adolescents to receive puberty blockers, de Vries and colleagues37 reported an improvement in general functioning after two years, along with a decrease in depression and behavioural and emotional difficulties. Fifty-five of these 70 individuals were assessed later in early adulthood, after cross-sex hormones had been administered and gender reassignment surgery had been performed. Depressive symptoms had decreased, general mental health functioning had improved and no regret about transitioning was found. Many (about 70 per cent) reported that their social transition had been ‘easy’. Cohen-Kettenis and colleagues,38 in a 22-year follow-up of the first described adolescent treated with GnRH analogues and cross-sex hormones, reported overall improved psychological well-being and no clinical signs of adverse effects on the brain. An improvement in global functioning following puberty suppression was also found in the UK study of Costa and colleagues39 in their follow-up of adolescents at the GIDS centre in London.
Consistent with the Dutch and British studies was Spack and colleagues’ report40 about their sample of 97 patients at a clinic in Boston, MA, in which no adolescents showed regrets regarding puberty-blocking or subsequent cross-sex hormone use.