How many trans/nonbinary youth use puberty blockers or hormone therapy?
In a five-year database of over 5 million youth ages 8-17 years
How many trans/nonbinary youth use puberty blockers or hormone therapy?
Quick reminder:
Puberty blockers pause puberty and are reversible. They may be prescribed to youth who reach Tanner Stage 2 of puberty, around ages 8 to 13, with parents’, clinicians’, and therapists’ involvement.
At least six peer-reviewed studies show that withholding puberty blockers is harmful and result in worse mental health, including suicidality.
Hormone therapies (i.e., testosterone, estrogen) may be prescribed to youth ages 16 and older, with parents’, clinicians’, and therapists’ involvement. Exceptions at younger ages happen, but are rare.
At least 11 systematic reviews (which combine results from several studies) show that blockers and/or hormones improve trans adolsecents’ mental health and have very low risks.
A recent study (Hughes et al., 2025) published in a prestigious journal (JAMA Pediatrics) examined a database that tracked private insurance claims for five years (2018 to 2022).
The study tracked over 5 million cis and trans youth ages 8 to 17.
The follow-up time for each youth in the study was over 2 years on average.
That is, the study reported 11,879,766 person-years of data.
Less than 1% of the over 5 million youth had a diagnosis of gender dysphoria.
This amounts to around 0.01 x 5,155,282 = about 51,5531 youth diagnosed in the US over 5 years.
Of those 51k, only 5% were prescribed blockers in those five years.
Around 0.05 x 51,553 = about 2,577 youth with gender dysphoria were prescribed puberty blockers.
That means 51,553 - 2,577 = 48,946 youth with dysphoria were NOT prescribed puberty blockers.
Of those same 51k, only 11% were prescribed hormone therapy.
0.11 x 51,553= about 5,671 youth with dysphoria were prescribed hormones for transition.
Most of them were 16 and 17 years old.
That means 51,553 - 5671 = 45,882 youth with dysphoria were NOT prescribed hormones for transition.
Zero transgender youth under the age of 12 were prescribed hormone therapy.
Age at start of puberty blockers peaked at 13 for trans boys/masc youth and 14 to 16 for trans girls/femme youth.
Citation for figure and all data: Hughes, L. D., Charlton, B. M., Berzansky, I., & Corman, J. D. (2025). Gender-Affirming Medications Among Transgender Adolescents in the US, 2018–2022. JAMA Pediatr.
These are rough estimates and not exact numbers from the Hughes study.
Why does the number for E and T go up dramatically with age but not for blockers? Aren't they usually given in conjunction with a blocker or is this showing HRT vs. "blockers only".