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The entanglement of sexed bodies and pharmaceuticals: A feminist analysis of early onset puberty and puberty-blocking medications

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Abstract

International epidemiological evidence demonstrates that more children than ever before now enter puberty before the age of 8. Early onset puberty can be an alarming experience for parents and is thought to entail short- and long-term physical and psychosocial risks, particularly for girls. ‘Puberty blocking’ hormonal medications are sometimes used to halt the progress of puberty in order to avoid these dangers. This article analyses medical and pharmaceutical discourses describing these medications, exploring how they articulate sex/gender, sexuality, age and health. Engaging with sociological literatures on pharmaceuticalisation and queer and feminist work on atypical sexual development and trans, I argue that prescribing puberty blockers should not be seen as a straightforward ‘solution’ to early sexual development. Learning from Elizabeth A. Wilson’s (2011) engagement with Karen Barad’s reconceptualising of bodies, I suggest how we might take account of the psychological and physical worldliness of early developing children when evaluating puberty blockers.

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Notes

  1. This claim is based on a database compiling results of systematic searches of scientific and medical literatures (1960–2012) using PubMed and Web of Science undertaken by my research assistant, Perng Sung-Yueh. My use of this literature follows Kelty and Landecker’s (2009, p. 177) suggestion to employ an ethnographic approach to studying scientific texts, using ‘the Literature as informant’.

  2. This research was funded by the European Research Council under the European Union’s Seventh Framework Programme (FP7/2007–2013) / ERC grant agreement No. 263657, PPPHS. As I suggest in this article, the pathologisation associated with medical assessment and treatment of early puberty is potentially harmful to young people. Not wanting to add to this risk, I did not observe or interview children (6–9 year olds) taking puberty blockers. I discussed this research with clinicians and visited a leading UK clinic.

  3. Similar stories of difficulties accessing timely medical treatment are reported by journalists. In an article in the Daily Mail, for example, Rogers (2007) writes: ‘Debbie Smith, 41, a GP dispenser, from Nottingham, tells a similar story. Her daughter, who is now 12, was just eight when she reached full sexual maturity. “We felt very alone. We weren’t even told drugs to stop puberty were an option”’, says Debbie. Interestingly, however, this story frames medical treatments as undesirable: ‘But neither Miranda nor Debbie would have wanted their daughters to have taken hormone-blocking drugs. “What we really need is for someone to recognise this is a horrible thing for the affected families”’ , says Debbie. ‘We need more support.’

  4. See Kaplowitz et al (1999).

  5. See www.ca1.uscourts.gov/pdf.opinions/10-2494P-01A.pdf. In 2013, Takeda Abbott Pharmaceuticals were ordered to pay US$150 in compensation to Lupron consumers (see www.communitycatalyst.org/initiatives-and-issues/initiatives/prescription-access-litigation/past-lawsuits/press-releases/tap-pharmaceuticals-to-pay-150-million-to-settle-with-victims-of-lupron-scheme).

  6. This is only a small part of its work, which concentrates in the main on children with specific medical conditions that affect growth, such as Turner Sydrome, Prader-Willi Syndrome and Growth Hormone Deficiency (www.childgrowthfoundation.org). The Magic Foundation is an American equivalent (www.magicfoundation.org).

  7. The diagnosis of Gender Identity Disorder (GID) was based on the American Psychiatric Association’s Diagnostic and Statistical Manual of Mental Disorders (DSM IV). This manual was revised in May 2013 and GID replaced by ‘gender dysphoria’, a potentially less stigmatising term. DSMV also removed this category from the group of sexual disorders. Here I use the term ‘trans’ in an attempt to sidestep these medical classifications.

  8. McHugh famously argued in 1977 that sex reassignment surgery was also abusive and closed down the Johns Hopkins Gender Identity clinic in 1979.

  9. Off-label use of pharmaceuticals – taking them for indications, age groups, dosages or delivery methods other than those for which they were approved – is a widespread, legal and integral part of US biomedicine (see Dumit, 2012). It is also legal in the United Kingdom.

  10. Debate about the use of vblogs as research materials is somewhat fraught. For a vblog about the use of trans vblogs in research and an interesting string of comments, see www.youtube.com/watch?v=pMOidZb2dpo.

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  1. Department of Sociology, Bowland North, Lancaster University, Lancashire, LA1 4YD, UK

    Celia Roberts

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Roberts, C. The entanglement of sexed bodies and pharmaceuticals: A feminist analysis of early onset puberty and puberty-blocking medications. Subjectivity 7, 321–341 (2014). https://doi.org/10.1057/sub.2014.17

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