Hormone Therapy

Increasingly, hormone blockers are prescribed to delay the onset of puberty in children who are believed to suffer from gender dysphoria. By preventing the development of such things as facial bone structure, vocal chords, facial hair, and breasts, the individual is better prepared to make the physical transition from one gender to another, and future surgeries may be minimized. Dr. Annelou de Vries, a child and adolescent psychiatrist at the Center of Expertise on Gender Dysphoria explains that by delaying the onset of puberty, those children who eventually pursue gender reassignment “have the lifelong advantage of a body that matches their gender identities without the irreversible body changes of a low voice or beard growth or breasts …”.[1] Furthermore:

Since puberty suppression is a fully reversible medical intervention, it provides adolescents and their families with time to explore their gender dysphoric feelings, and [to] make a more definite decision regarding the first steps of actual gender reassignment treatment at a later age.[2]

In reality, however, it is unknown whether the effects of hormone blockers is “fully reversible.” The use of hormone blockers is considered an “off label” use of medication, meaning that it is has not been approved by the Food and Drug Administration.[3] The estrogen and testosterone hormones that are blocked by this medication assist in a child’s neurological development and in bone growth. It is unknown what the long-term neurological effects of using hormone blockers may be. Similarly, hormone blockers cause a decrease in bone density, and it is unknown if the patient may be at higher risk for osteoporosis in the future.[4]

Despite its widespread acceptance, the American College of Pediatricians has published the warning:

Puberty is not a disease and puberty-blocking hormones can be dangerous. Reversible or not, puberty-blocking hormones induce a state of disease – the absence of puberty – and inhibit growth and fertility in a previously biologically healthy child. … According to the DSM-V [Diagnostic and Statistical Manual of Mental Disorders, 5th Edition], as many as 98% of gender confused boys and 88% of gender confused girls eventually accept their biological sex after naturally passing through puberty (emphasis removed).[5]

Similarly, the Endocrine Society’s clinical guidelines reports:

In most children with GID [gender identity disorder], the GID does not persist into adolescence. The percentages differ between studies, probably dependent upon which version of the DSM was used in childhood, ages of children, and perhaps culture factors. However, the large majority (75–80%) of prepubertal children with a diagnosis of GID in childhood do not turn out to be transsexual in adolescence … Clinical experience suggests that GID can be reliably assessed only after the first signs of puberty.[6]

For those who do not outgrow their sense of gender dysphoria, the next step in gender reassignment is to begin taking the hormones associated with the desired gender. PBS: Frontline reports:

While the Endocrine Society’s guidelines suggest 16, more and more children are starting hormones at 13 or 14 once their doctors, therapists and families have agreed that they are mentally and emotionally prepared. The shift is because of the concerns over the impact that delaying puberty for too long can have on development, physically, emotionally and socially.[7]

As is to be expected, such treatment comes with a variety of side-effects, such as severe mood swings. However, it should be troubling that treatment which includes serious mood swings is being administered to children who are known to be 25 times more likely to commit suicide than the national average of the general population.[8] As an example, consider the testimony of 17-year-old Brad Cooper when he was in the process of transitioning to Ria Cooper. Cooper told the Sunday Mirror:

“The hormones have made me feel up and down. One minute I feel moody and the next minute I feel really happy. The night I tried to slash my wrists I’d downed a bottle of Jack Daniel’s and just thought about how alone I am, and how my decision has alienated my family and how I will have to become a boy again to resolve it.”[9]

Another serious side effect of hormone therapy is reduced fertility—possibly leading to sterility.[10] Despite the fact that teenagers may not yet comprehend how meaningful the ability to have biological children may one day be to them, children as young as 15 are now able to receive state-funded sex change therapy without parental consent, or even notification.[11] Dr. Jack Drescher, a member of the American Psychiatric Association who worked on the Sexual and Gender Identity Disorders Work Group, told Fox News, “Children age 15 may not fully understand all the consequences of the procedures they are undergoing.”[12]

The use of hormone therapy is a serious medical matter. Nobody truly knows the long-term effects of hormone therapy. Doctors do not know what the effect of taking cross hormones for 50 or 70 years may be.[13] Similarly, although many of the effects of hormone therapy may be reversible, there could be long-term physical consequences for those who use hormone blockers or for those who stop receiving cross-sex hormones. Furthermore, there may be permanent psychological effects involved with hormone therapy.[14] At present, there simply are more questions than answers.

One thing, however, is certain. The use of hormone therapy as a treatment for gender dysphoria is an intentional manipulation of the physical body to conform to the individual’s self-perception. This is a rebellion against God and His created design and order. According to the Bible, this is a form of sorcery. Galatians 5:19–21 says:

Now the works of the flesh are evident: sexual immorality, impurity, sensuality, idolatry, sorcery, enmity, strife, jealousy, fits of anger, rivalries, dissensions, divisions, envy, drunkenness, orgies, and things like these. I warn you, as I warned you before, that those who do such things will not inherit the kingdom of God (emphasis added).

The word translated “sorcery” in Galatians 5:20 is pharmakeia which could mean “a medical drug” or “witchcraft.”[15] Both definitions are applicable. God declares rebellion to be equivalent to witchcraft in 1 Samuel 15:23, “For rebellion is as the sin of witchcraft, and stubbornness is as iniquity and idolatry” (KJV). The use of medical drugs to transform the body into something God never intended is pharmakeia, or “sorcery.” As such, God warns that such practices lead only to death and destruction. Those who place their sexual identity above God’s Word and the identity of “child of God” that He offers through repentance and faith in Jesus Christ will not inherit the kingdom of God. Only a child of God can inherit God’s kingdom.

The debate over hormone therapy is far more significant than the potential psychological and physical effects. At the heart of the matter is whether an individual is willing to submit to God and to His commandments. In what does an individual find their true identity—in their sexuality, or in their relationship to God?

  1. Mozes, “Transgender Teens Become Happy, Healthy Young Adults.”

  2. Ibid.

  3. Boghani, “When Transgender Kids Transition, Medical Risks are Both Known and Unknown.”

  4. Ibid.

  5. American College of Pediatricians, “Gender Ideology Harms Children.”

  6. “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline Endocrine Society,” Journal of Clinical Endocrinology and Metabolism 94, no. 9:3131–3154 (September 2009), Source: Endocrine Society, “Endocrine Treatment of Transsexual Persons: An Endocrine Society Clinical Practice Guideline.”

  7. Boghani, “When Transgender Kids Transition, Medical Risks Are Both Known and Unknown.”

  8. Grant, et al., “National Transgender Discrimination Survey Report on Health and Health Care.”

  9. Winter, “‘I Was Born a Boy, Became a Girl, and Now I Want to Be a Boy Again’: Britain’s Youngest Sex Swap Patient to Reverse Her Sex Change Treatment.”

  10. Boghani, “When Transgender Kids Transition, Medical Risks are Both Known and Unknown.”

  11. Huston, “Oregon Medicaid Now Paying for Sex Changes for 15-yr-olds Without Parent’s Consent.”

  12. Ibid.

  13. Boghani, “When Transgender Kids Transition, Medical Risks are Both Known and Unknown.”

  14. Garrett Oppenheim, “Ihlenfeld Cautions on Hormones: Stresses Psychological Dangers,” Transition, no. 8 (January/February 1979), Source: Oppenheim, “Ihlenfeld Cautions on Hormones: Stresses Psychological Dangers.”

  15. Zodhiates, The Complete Word Study Dictionary, G#5331, 1438.

Transitioning by Timothy Zebell is licensed under a Creative Commons Attribution 4.0 International License, except where otherwise noted.


“Timothy Zebell has carefully studied the Scriptures and discerned the culture to provide a foundational understanding of transgenderism and its implications. Although not openly discussed in many Christian circles, if we are not informed on this issue, we will give this generation over to transgenderism, just like the last generation was given over to homosexuality. To help young people embrace how God has created them, this book is a must read!”

Dave Warn

Director, Forerunners of America