A ban on puberty blockers for children diagnosed with gender dysphoria in the UK has been put in place for an indefinite time - should Ireland follow suit?

The ban has come into effect after experts warned of an unacceptable safety risk associated with the puberty blockers.

On Newstalk Breakfast, National Gender Service consultant psychiatrist Dr Paul Moran said this has been “coming for a while” and “stems from research in Europe and in Britain”.

He said the effects of puberty blockers have not been properly trialled.

“Normally, when a new treatment is developed, it undergoes trials before it's used, widespread in the population - that didn't happen,” he said.

“Years ago, there was an idea that if we could block puberty, it would give the children time to work out their identity and then enable them to choose how they want to live their lives.”

True effects

Dr Moran said there was a “small trial” completed in Holland with “inconclusive” results, but it was “not a randomised control trial”.

“When you want to see if a treatment works or what harms, you have to compare a group of patients who get the treatment with a group who don't - in this case, that didn't happen,” he said.

“So, we don't know yet what their true effect of this treatment is.

“When [gender dysphoria treatment] was widespread throughout the world, what was noticed that the effect of this was not what was hoped for, both in terms of relieving the children of distress about their bodies or improving the mental health.”

Stopping puberty

Dr Moran said “concerns” have arisen around the “effects of stopping puberty”.

“We know that the that the hormones that involved in puberty, such as testosterone and oestrogen aren't just sex hormones,” he said.

“They're sex and bone and brain hormones, and they're essential for the development of the body and the brain.”

“When you stop that happening, there are unknown effects,” Dr Moran said.

“We do know that, for example, in the children who received these blockers for long periods, it stopped the development of their bones - many of them were much, much shorter than they should have been, and many of them developed bone problems and fractures.

“We also know that there's some evidence that the brains did not develop as they should have.”

Is it safe?

Puberty is “really important in the process of growing from being a child and adult” Dr Moran said.

“Across Europe and in Britain, the Governments have said this is an unknown treatment and we have to do some proper research before we can decide if it's safe or not,” he said.

Dr Moran said he believes Ireland should follow the UK’s lead and The Cass Report, created by Dr Hilary Cass.

The Cass report, published in April, looked at gender identity services for under 18-year-olds in the National Health Service (NHS) in England.

The report found “shaky foundations” around evidence for medical treatment like prescribing hormones to pause puberty or to transition to the opposite sex.

“[Dr Cass] also commissioned a huge systematic review by the University of York into all the trials of this treatment worldwide,” Dr Moran said.

“That systematic review showed that the evidence for its benefits and harms was inconclusive, and it recommended that before this is used in treatment for children, it should undergo evaluation.”

Comprehensive assessments

Dr Moran said that if children are having problems with gender, “they need a far more comprehensive assessment than just being put straight on to treatments that stop them developing their bodies”.

“I think that what we need to do is develop a holistic, multi-disciplinary approach to the care of these children,” he said.

“What we know is that the children who are presenting are far more complex than is presented in the media.

“A lot of them have difficulty socialising, functioning mental health problems, and what they need is a proper multi-disciplinary service to look at their whole needs and not just focus in on their gender dysphoria.”

Dr Moran said he has received no response from the Health Service Executive about concerns he communicated in regards to the treatment for children with gender dysphoria in Ireland.

Listen back to the interview in full here:

Medical and puberty blockers symbol. Image: Alamy