Fact Check: New York Times Publishes Misleading Story On Puberty Blocker Study

The New York Times claimed that a prominent gender researcher claimed that a US Study went unpublished because of politics. This is despite the researcher publishing several studies off of the data.

In recent weeks, several studies have emerged focusing on transgender individuals. One study in the prestigious journal Nature Human Behavior, for example, reported up to a 72% increase in suicide attempts in states passing anti-trans legislation, including healthcare bans. Another study, with minimal loss to follow-up, found extremely low detransition rates among transgender youth over 6 to 10 years, along with high levels of satisfaction regarding their care. Yet, you won’t find these stories on The New York Times' website. Instead, as has become routine at the paper, there’s yet another hit piece on transgender care—one that, upon closer inspection, offers a distorted and unfounded portrayal of the current research and one researcher who has helped push that research forward.

The latest piece, which went viral in anti-trans circles on Wednesday, was written by Azeen Ghorayshi, who has a track record of publishing anti-trans articles, including a glowing profile of Jamie Reed, an anti-trans clinician who shared private information about patients at her clinic—some of which was later proven false. This new article makes explosive claims that Dr. Johanna Olson-Kennedy, a prominent gender researcher, is withholding potentially negative research on the risks and benefits of puberty blockers for transgender youth.

A further analysis of the article finds the central premise to be highly misleading.

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Claim: Joana Olson-Kennedy is withholding research from the Trans Youth Care because of a charged American political environment over transgender people.

Fact: Twenty-eight studies have been published from the Trans Youth Care (TYC) Network study, including from patients on puberty blockers.

“An influential doctor and advocate of adolescent gender treatments said she had not published a long-awaited study of puberty-blocking drugs because of the charged American political environment.”

Ghorayshi opens with a claim that Olson-Kennedy is withholding research on puberty blockers because of a “charged American political environment.” The research in question comes from the Transgender Youth Care (TYC) Network study, funded by the National Institutes of Health to evaluate the effectiveness of gender-affirming care for transgender youth. In her interview with Olson-Kennedy, Ghorayshi cites a quote from what was described as a “wide-ranging interview” on the researcher’s work. Olson-Kennedy explains that she is being meticulous with one of the registered studies on puberty blockers because she doesn’t want her findings “to be weaponized,” adding that the work “has to be exactly on point, clear and concise.” Ghorayshi then uses this quote to imply that Olson-Kennedy is withholding research for political reasons.

A closer look at the NIH-funded project’s research record shows that the team’s output has been extraordinarily prolific; if Olson-Kennedy is withholding research, her extensive publication history doesn’t reflect it. The project has resulted in 28 peer-reviewed papers, many with Olson-Kennedy as a co-author. These studies include those who are on puberty blockers, such as one on the height growth rate of transgender youth on puberty blockers, another comparing the effectiveness of puberty blocker implants, and a third showing that patients who presented for puberty blockers had better mental health than those who either waited, or were forced to wait, for hormone therapy. This is in addition to numerous influential studies the team has published on the positive effects of hormone therapy and other key characteristics of transgender youth.

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Claim: Puberty blockers do not lead to mental health improvements, and this is being hidden.

Fact: Earlier initiation of puberty blockers were found in Olson’s research to be linked to better mental health than youth who waited to start hormone therapy. This finding has been confirmed by later studies. The purpose of puberty blockers is not to “improve” mental health but to prevent deleterious effects of puberty.

But the American trial did not find a similar trend, Dr. Olson-Kennedy said in a wide-ranging interview. Puberty blockers did not lead to mental health improvements, she said, most likely because the children were already doing well when the study began.

While Ghorayshi’s piece portrays puberty blockers as ineffectual and suggests that research is being hidden, Olson-Kennedy’s publications tell a different story. For instance, in one of her studies on youth presenting for hormone therapy and puberty blockers, she found that those starting puberty blockers “appear to be functioning better from a psychosocial standpoint than [Gender Affirming Hormone Therapy] cohort youth," highlighting the potential benefits of accessing gender-affirming treatment earlier in life.

While Ghorayshi acknowledges the study, she omits critical context by not comparing those who received puberty blockers with those who didn’t. Instead, she highlights depression and suicidality numbers in isolation. “Dr. Olson-Kennedy and her colleagues noted that one-quarter of the adolescents were depressed or suicidal before treatment,” Ghorayshi writes, seemingly to contradict Olson-Kennedy’s claim that those seeking blockers were generally doing well. What Ghorayshi fails to mention is that among those who didn’t receive blockers, suicidal ideation was much higher—66%, more than twice as high. These figures, notably, come from the same TYC project Ghorayshi accuses Olson-Kennedy of withholding data from.

One reason Olson-Kennedy may be cautious about her data on puberty blockers alone being misused is the small sample size—just 95 youth. The study had a much larger sample of those beginning hormone therapy, and indeed, more studies have been published on that cohort, including one showing improvements in life and body satisfaction, along with reductions in depression and anxiety. Ghorayshi acknowledges this study but follows with the claim that two patients died by suicide, seemingly to undermine the findings. However, the study wasn’t designed to measure such rare events or statistically powered to do so. Publishing a study on puberty blockers alone with a small sample size today might lead to similarly misleading claims from journalists like Ghorayshi, and so it is reasonable that researchers like Olson-Kennedy are cautious to do so.

Ultimately, the purpose of puberty blockers is not to "improve" a trans youth’s mental health. Gender dysphoria arises from a mismatch between a person’s physical development and their internal sense of gender identity. Puberty blockers pause physical changes, ensuring that when a transgender youth is ready to begin hormone therapy, as determined by their medical team, they won’t have undergone unwanted pubertal changes. This role of puberty blockers has become increasingly understood in recent years, with multiple studies—including one from Olson-Kennedy’s dataset—showing that puberty blockers positively impact mental health compared to delaying treatment.

More recent studies have further confirmed these findings. The most significant of these was published in December 2023 in the Journal of Adolescent Health, showing that “TGD youth who received pubertal blockade at Tanner 2 or 3 were found to have less anxiety, depression, stress, total problems, internalizing difficulties, and suicidal ideation than TGD peers who had been through more of a nonaffirming puberty.”

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Claim: Puberty blockers cause bone density problems in transgender youth, and this is being hidden by Olson-Kennedy.

Fact: Olson-Kennedy published a study on bone density of transgender youth presenting for puberty blockers and found that transgender youth actually have more bone density issues prior to treatment due to a lack of exercise and vitamin D. Bone density loss is typically minuscule, and can be treated and prevented with vitamin D and calcium supplementation.

“It’s really important we get results out there so we understand whether it’s helpful or not, and for whom,” Dr. Cass said.

Her report found weak evidence for puberty blockers and noted some risks, including lags in bone growth and fertility loss in some patients. It prompted the National Health Service in England to stop prescribing the drugs outside of a new clinical trial, following similar pullbacks in several other European countries.

One of the most common and misleading critiques of puberty blockers focuses on bone density. In her latest article, Ghorayshi echoes these critiques, referencing the Cass Review’s conclusion that puberty blockers may be associated with lags in bone growth for some patients. She also points out that Olson-Kennedy has yet to publish research specifically on how puberty blockers affect bone density, despite her prolific output from the TYC dataset at large.

In fact, Olson-Kennedy has published a study looking at transgender youth before starting puberty blockers, finding that such youth actually experienced bone density problems before any medication at all was taken. This aligns well with a review by researchers at Yale, which states, “The most recent studies show that puberty-blocking drug therapy either has no effect on bone mineral density (BMD), a proxy measure of bone strength, or is associated with a very small decrease. Calcium supplementation has been shown to protect patients from bone loss.”

The Yale review also found that “puberty-blocking medication has negligible or small effects on bone development in adolescents, and any negative effects are temporary and reversible” and “any reduction in BMD is recovered when adolescents cease taking puberty-blocking medication, whether or not they continue to gender-affirming hormone therapy.”

It is for this reason that when bone density loss is a concern, it is prevented and treated through calcium supplementation and exercise. As such, pediatricians routinely advise calcium supplementation for transgender youth receiving gender-affirming care. The informed consent form explicitly addresses this potential risk and its mitigation, stating, “It is important that patients on Lupron Depot® take other measures to protect their bones: keeping active and ensuring good calcium and Vitamin D intake.”

Contrary to insinuations by Ghorayshi, Olson-Kennedy’s research has actually helped understand bone density issues around young transgender youth.

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Olson-Kennedy stands as a leading researcher in pediatric gender medicine, with a wide array of studies on the effectiveness of gender-affirming care, the mental health of transgender youth, and differences in treatment protocols. Her expertise gives her a unique perspective on the complexities of studying transgender youth and the risks of poorly analyzed data being weaponized—something Ghorayshi's article exemplifies.

Contrary to the article’s framing, Olson-Kennedy has not held back on publishing important articles from the TYC grant. In fact, she has consistently published research on transgender youth, including studies on puberty blockers, from the grant. What she has done is exercise caution, understanding the limitations of her data and recognizing how, in today’s charged climate, misinterpretation and underpowered studies can be used to harm transgender people. By doing so, she has protected both the integrity of her research and the community it serves.