The research also finds that casual cannabis use puts teens at risk for problem behaviors, including poor grades, truancy, and trouble with the law, which can have long-term negative consequences that may keep youth from developing their full potential in adulthood.

Co-author Mark Olfson, MD, MPH, professor of epidemiology at Columbia Mailman School of Public Health, and Elizabeth K. Dollard Professor of Psychiatry, Medicine and Law at Columbia University Irving Medical Center, said, “The new findings suggest that the roughly 2.5 million young people in the United States who casually use cannabis are at increased risk for a range of adverse events from depression to poor school performance.  This group is almost four times larger than those who meet formal criteria for cannabis use disorder. Contrary to the growing public acceptance of moderate cannabis use, these new results suggest that clinicians should screen, evaluate, and, when appropriate, treat adolescents who casually use cannabis.”  

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Imagine for a moment, the unthinkable: a supersized asteroid is on a collision course with Earth, and NASA has no idea how to stop it. Nukes, gravitational slingshots, Bruce Willis? All of them might work, but they only have one shot—if only they had more time to figure out a solution.

This is what puberty can feel like to teenagers questioning their gender identity. Many young teenagers start feeling profound distress between the gender assigned to them at birth and their own experienced gender, just as irreversible developments of secondary sex characteristics start appearing on the horizon, such as a changing voice, redistribution of fat deposits, height, body hair, and more. Gender distress, or dysphoria, is only worsened by watching the body change in ways that feel fundamentally wrong. But puberty is always hard, and with such quick-approaching doom it can be difficult to figure out whether this distress indicates a need for gender transition or rather reflects puberty’s trials. However, unlike the erstwhile NASA scientists in apocalypse sci-fi, these young teenagers can stop time—with puberty blockers.

Puberty blockers are a clever bit of endocrinology: most commonly gonadotropin-releasing hormone (GnRH) agonists, they “pause” the release of sex hormones like testosterone and estrogen that drive puberty. Critically, it is a pause, and if a teenager stops taking GnRH agonists, then puberty will resume just like normal. GnRH agonists in concert with counseling and family support can be crucial to improving the mental well-being of a teenager experiencing gender dysphoria, and additionally ease future gender transition by preventing irreversible dysphoric changes from ever occurring.

Crucially for teenagers—who are generally considered unable to fully consent to life-altering medical procedures—it allows them to mature in gender identity and confidence without the time limit of an impending puberty and development of secondary sex characteristics. For these reasons, puberty blockers are considered part of the standards of care for gender-questioning teenagers by the World Professional Association of Transgender Health.

Unfortunately, access to puberty blockers is spotty across the U.S. Twenty states have introduced legislation banning the use of puberty blockers among teenagers entirely, and Arkansas passed a bill to this effect last April. Just this February, Texas Governor Greg Abbot directed all state employees to report parents of trans children receiving any gender-affirming care for criminal prosecution of child abuse. This isn’t even getting into the vast financial barriers to receiving care, including high prices and poor insurance coverage. These barriers enact cruelty against young teenagers and have serious consequences for their mental and emotional health. The federal government must act by requiring that Medicaid and private insurance plans cover gender-affirming care, and specifically puberty blockers for teenagers, as well as make giving gender-affirming care to teenagers legal.

In Texas, Governor Abbot and other officials have argued that gender-affirming care, including puberty blockers, amount to child abuse. Nothing could be further from the truth—and taking vulnerable trans teenagers away from supportive families will be devasting to their health. Again, GnRH agonists are unique among gender-affirming care because they are fully reversible, and allow teenagers to choose their future. As it is now, hundreds of Texas teens stand to lose their choice entirely. If the teenage reconfirms their desire to transition after reaching an appropriate age, they will stop taking the GnRH agonists and to start rounds of Hormone Replacement Therapy (HRT), which begins the development of desired secondary sex characteristics without having to deal with the relics of a dysphoric puberty.

Alternatively, the teenager can realize that they don’t want to transition and stop taking the puberty blockers to begin an unassisted puberty (about 10 percent of teenagers choose this option). Either way, the teenager is supported by psychologists, social workers, and their family throughout the whole process, and is allowed to make the decision without the negative stress that development of dysphoric sex characteristics can engender, leading to better mental health as a teenager and as an adult.

To be fair, there are concerns about the side effects of GnRH agonists on bone health and height. Prolonged use can weaken bones and affect height, and which is why doctors don’t tend to prescribe puberty blockers for longer than two years. However, most teenagers on GnRH agonists stop taking the puberty blockers after one year, and switch to either HRT or stop seeking transition-related care, and current standards of care involve quarterly doctor visits for assessing growth and bone health.

Puberty is hard for everyone, especially gender-questioning teens who see the dropping of the voice or development of breasts as the end of the world. Adults everywhere need to stand up to ensure that our teenagers get the support they need: federally legal and insurance-covered puberty blockers that will give more teenagers more time.

Anthony Lanzillo is an MPH student in the Department of Sociomedical Sciences.

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MESA VERDE — Four juveniles were involved in a fatal UTV crash, including two teenage San Jacinto boys who were crushed to death, Sunday morning, Sept 15. Two girls, including one from San Jacinto and another from Blythe were also injured in the deadly accident, according to CHP and Cal Fire officials.

The deadly crash happened in a dirt area on the 13800 block of Mesa Dr. near Green St., west of Blythe in the unincorporated community of Mesa Verde.

CHP and other emergency personnel were dispatched to the crash shortly before noon, after receiving reports of four juveniles involved in a rollover accident, CHP reported on September 16.

Based on the severity of at least one of the victim’s injuries, an air ambulance was summoned to the scene and eventually life-flighted one or more of the critically injured victims to Desert Regional Medical Center in Palm Springs.

Two of the victims, described only as 14 and 13-year-old boys – who had not been wearing safety belts when the accident happened – died from their injuries as a result of the crash. Two girls, ages 13 and 9 – who had been seat belted into the side-by-side UTV – suffered minor injuries. Both girls were hospitalized after the crash.

During their subsequent investigation, CHP determined a 13-year old girl had been driving a 2015 Polaris RZR with three passengers on board the UTV just before the deadly accident.

As she was operating the vehicle, the teenage girl attempted to make a sharp left turn, causing the Polaris to overturn onto its right side.

As the vehicle rolled onto its side the two teenage boys, who were not wearing seat belts and had been sitting on top of the right rear door panel of the vehicle, were ejected and then crushed to death by the overturning UTV, according to CHP.

The 13-year-old female driver and 9-year-old female passenger suffered minor to moderate injuries, CHP and CAL Fire later reported.

Although officials have not released the victims’ names, CHP has said all of the teens were from San Jacinto, while the 9-year-old girl is from Blythe.

Officials investigating the fatal crash have said they do not believe drug or alcohol intoxication were contributing factor in the crash, but their investigation is ongoing.

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