Analogous Analogs: Considerations Regarding Off-Label Use of Gonadotropin-Releasing Hormone Analogs Among Transgender Adolescents.

Abstract

Although gonadotropin-releasing hormone (GnRH) analogs have been the gold-standard treatment for adolescents with gender dysphoria for more than 3 decades, they continue to be categorized as an off-label use of the same drugs often prescribed to cisgender adolescents. Off-label provision of these medications is one of the many arguments deployed to frame legislative restrictions on pediatric gender-affirming care as an effort to "protect" adolescents from experimental drugs. Here I not only problematize such politicization but use these claims as an entry point to further consider how prospective and historically rooted public health policies could support approval of supplemental indications for certain GnRH analog products for gender dysphoria among adolescents. (<i>Am J Public Health</i>. 2025;115(10):1662-1670. https://doi.org/10.2105/AJPH.2025.308130).