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If a girl begins puberty before age 8, or a boy before age 9, they are considered to have precocious (early) puberty (Klein, Emerick, Sylvester, & Vogt, 2017). Children with early puberty may face psychological and social problems. They feel different from their peers (Klein et al., 2017). Boys who develop earlier are less likely to experience negative consequences like bullying. Early developers are often perceived as more mature and older than they are. Thus, girls may face greater levels of sexualisation earlier. Boys may experience reduced levels of bullying due to their size and increased body mass.

Delayed puberty is a lack of breast growth by age 13 in girls or the absence of a period (menarche) by age 16 (Tang et al., 2020). For boys, it is when testicular enlargement has not occurred by age 14 (Tang et al., 2020). Girls and boys with delayed puberty may face bullying from peers. They appear smaller and more child-like. Boys, in particular, may face heightened levels of bullying and negative self-esteem consequences. Beyond the standard timelines of puberty, specific considerations arise for transgender individuals, particularly in the context of hormone blockers and their role in puberty.

Hormone Blockers for Transgender Individuals

The use of hormone blockers in transgender youth is a topic of debate. Some argue that they should be allowed to take hormone blockers prior to and during puberty, with the goal of preventing unwanted changes in order to align puberty with their gender identity. Physical features are heavily correlated with gender in our society. For example, testosterone deepens the voice and redistributes body mass. This can distress some transgender girls. Hormone blockers would prevent these changes. However, some believe children cannot make such serious decisions. Legally, parents or guardians consent to medical care for minors. This often means waiting until they can consent for themselves before receiving hormone therapy. By then, puberty has already made lasting changes to the body, which require greater medical intervention to alter.

Studies by Turban et al. (2020) and Achille et al. (2020) show important findings. Transgender youth who received pubertal suppression hormones saw a decrease in suicidal ideation, depression and anxiety. They reported improved overall mental health. The Endocrine Society guidelines and the World Professional Association for Transgender Health (WPATH) Standards of Care recommend puberty blockers for transgender adolescents. These blockers are formally known as gonadotropin-releasing hormone analogues (GnRHas).