Intended for healthcare professionals

Letters Gender dysphoria

Gender dysphoria: puberty blockers and loss of bone mineral density

BMJ 2019; 367 doi: (Published 04 December 2019) Cite this as: BMJ 2019;367:l6471
  1. Grant Ferguson, adolescent medicine fellow1,
  2. Peter Simm, consultant endocrinologist1,
  3. Michele O’Connell, consultant endocrinologist1,
  4. Ken C Pang, associate professor2
  1. 1Royal Children’s Hospital, Parkville, VIC 3052, Australia
  2. 2Murdoch Children’s Research Institute, Parkville, VIC 3052, Australia
  1. ken.pang{at}

Cohen and Barnes clearly articulate the ongoing debate on the effects of puberty blockers (gonadotrophin releasing hormone (GnRH) agonists) on bone mineral density in trans and gender diverse young people.1 Contention remains as to whether use of GnRH agonists in adolescents causes slow bone accrual, static accrual, or bone loss. Contributing to the confusion is that previous studies have focused on mean changes in …

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