Retrospective Study of the Management of Childhood and Adolescent Gender Identity Disorder Using Medroxyprogesterone Acetate

GnRH analogues are the standard therapy but expensive therapy for the suppression of pubertal changes in transsexual individuals. In the 1960s, medroxyprogesterone acetate was found to be efficacious in treating central precocious puberty by inhibiting the secretion of gonadotropins and/or interfering with gonadal steroid synthesis. To avoid the adverse effects and prohibitive cost of gonadotropin releasing hormone analogues, this study utilized medroxyprogesterone as an alternative treatment for puberty sex hormone suppression. The goal of this retrospective chart review is to determine the efficacy and safety of medroxyprogesterone. Sixteen subjects with Gender Identity Disorder less than 19 years were offered medroxyprogesterone to suppress puberty sex steroids. Seven male-to-female individuals were treated with the oral form of medroxyprogesterone. Six female-to-male individuals used depot medroxyprogesterone acetate; one used oral; and two refused. One decided to change back to being female. None of the patients discontinued therapy because of unwanted side-effects. In conclusion, medroxyprogesterone is an effective, safe, and affordable option for the suppression of pubertal hormones in teens desiring gender change. It is also an excellent option for those who have needle phobia. Response to treatment and compliance were favorable.