There is considerable controversy over the earliest age at which it is clinically, morally, and legally safe to use GnRH analogues, and for how long. The sixth edition of the World Professional Association for Transgender Health 's Standards of Care permit it from Tanner stage 2 but do not allow the addition of hormones until age 16, which could be five or more years later. Sex steroids have important functions in addition to their role in puberty, and some skeletal changes (such as increased height) that may be considered masculine are not hindered by GnRH analogues.
In February 2017, American triathlete Beth Gerdes was given a 2-year suspension for presence of ostarine, and American triathlete Lauren Barnett was given a 6-month suspension for the presence of Ostarine. Both triathletes claimed contamination from salt tablet supplements. Lauren Barnett was able to provide tablets and sealed bottle tablets which both tested positive for contamination, thus only the 6-month suspension. The 2-year suspension still stands for Beth Gerdes who provided tablets for testing, but tests showed only low levels of ostarine not high enough to confirm the finding.