As someone who has gone through a phase of questioning my ... inner state of the matter on this topic, now in retrospect, I am so so so so soooooo glad that such options were not readily available to me. If I was that age in the current world, I simply would've done it.
Given the permanent nature of a transition on a body, I really wish the advocates of pushing this at young ages would not push back against discussions of people who decide to detransition. Such stories break my heart way more than someone being unable to transition before a certain age.
100%, completely agree with this. I was a raised in an small town in the US where men were expected to football-loving brutes with hair-trigger tempers and went deer-hunting on the weekend. Given I was never like this, I also went through a phase of questioning - until I realized there are many ways of being a man. But I didn't come to that realization until I was in college.
Okay. Is there any evidence that kids who go to a gender care specialist with the idea that they don't fit into typical gender norms just get signed up for transition care right away? Why are we assuming that "hey I don't like sports" gets you puberty blockers?
I mean, I questioned for years myself - longer than I was in that environment. And if some overzealous psychiatrist had diagnosed me as trans I would’ve absolutely taken whatever. Now that I’m older and settled and secure in my gender I’m EXTREMELY glad I didn’t do anything at the time
I think this is a failure of empathy. "Being unable to transition before a certain age" in this context entails a child having their body modified against their will, which they can only partially correct through expensive and avoidable surgeries in adulthood. It seems much worse than merely detransitioning to me.
Kids rarely get to decide unilaterally. They are evaluated by professionals. They don't just show up and say "give me permanent treatments."
There are people who detransition. It is rare. It is wild to me that each of these people matter more to you than each genuinely trans person who is unable to transition because of the law. Both of these sets of people are stuck in bodies they don't want. Why is one worthy of so much more empathy than the other?
Not really understanding you. Are you softly still saying, as someone who isn't them, that you want to gatekeep this from people who don't feel comfortable in their own bodies?
I'm not sure what you're trying to say by - "isn't them"
If I did undergo that path when I wanted to, at which point would you consider me "becoming them"? At the inception of the thought? After some rumination? After making the decision? After first time taking meds? After undergoing surgery?
I don't consider it gatekeeping, rather prevention of making an irreversible choice while the frontal lobe is still far from knowing even what path it wants for itself for the rest of its life. I know that might be seen as unfair to a lot of people, but given the persistence with which gender affirmation is being pushed, I feel that cases like me are simply considered collateral damage. Really glad I didn't end up as such.
> I don't consider it gatekeeping, rather prevention of making an irreversible choice while the frontal lobe is still far from knowing even what path it wants for itself for the rest of its life.
To control access is gate keeping.
Puberty blockers' effects are reversible generally. Puberty's effects are not.
Gender affirming care regret rates are very low.
> I know that might be seen as unfair to a lot of people, but given the persistence with which gender affirmation is being pushed, I feel that cases like me are simply considered collateral damage.
Access to gender affirming care is pushed persistently because denial of gender affirming care was and is pushed persistently. And the benefits are significant. And regret rates are very low.
Do you understand that no regretted treatment would require no treatment? What ratio of regretted treatment and regretted non treatment would you consider fair?
I guess things like these are one of the pillars of the division on the topic.
You're trying to figure out a decent ratio, and I'd like the total number of regretted treatments to become a permanent flat zero.
A child brought into this world learns from those who have walked on it for much much longer. It puts TRUST into them. The moment you have a single regretted treatment, that moment you have a human life who got failed by everyone around them. The social system, the government system, the family system. Systematically encouraging things where a regretted treatment can very well mean a life destroyed is not something I can ever support.
One's perception that life dealt them inadequate set of cards should never result in a borderline-militant push for a systemic change that reduces regretted treatments to a ratio number.
Studies about this show that regret among teens who've received puberty blockers is around 1%. The other 99% are extremely happy with it in the very long term.
Suicide attempts and successful suicides among teens denied puberty blockers when diagnosed as needing them are three times higher than among the general teen population. This was measured after the UK prohibited them.
Puberty blockers' effects are not permanent. Stopping to take them reverses their effects and allows normal puberty to proceed, a bit delayed compared to other teens. Had you been actually diagnosed with gender dysphoria at that age (were you an exceptionally skilled actor at 12? were you able to keep acting for six months before a team of professionals without ever breaking the act?), and had you changed your mind at 15, you'd have by now reached normal adulthood at your birth gender normally.
So, please tell us: how many children suiciding are a price worth paying for the non-permanent, temporary, reversible regrets of those 0.01% (1% of regret from the 1% of transgender individuals) of the teen population?
Which is also wrong. People living with BIID are (usually) not irrational. The small percentage that do seek amputation have usually exhausted all treatment options, and find that amputation improves their quality of life.
I agree that you should almost never offer amputations for BIID in minors, since delaying until adulthood would only risk a couple of years of distress and would not cause additional permanent harm.
Puberty blockers aren't amputations; they're reversible medication-based treatments. Amputation can only be opted for after the transgender individual reaches adulthood.
The right-wing sociopathic influencers and politicians you opted to listen to know this perfectly well. They actively chose to lie about it and to stoke rage and fear, lest they lose followers, influence, money, and power.
>The number of members with GH claims per 10,000 beneficiaries under age 18 rose steadily from 5.1 in 2001 to 14.6 in 2016, without a dramatic change around 2003, the ISS approval date.
Just as a reminder for everyone here, 0.14% of US children (+3x in a decade) are given Human Growth Hormone because they are short. Our government says that being in the bottom 2 percentiles is a medically valid condition to be treated with hormones.
Differentially focusing your emotional response on sex-expression hormone therapy vs. hormone therapy generally is reflective of bias.
This thread will likely have extensive hate on a very small portion of the population.
A reminder that actual people have been turned into a cultural wedge issue, their lives put in danger due to the vitriol the culture war issue has stirred.
If you have known a person who has transitioned, you'd likely see someone happier after being able to transition.
Laws targeting trans people won't stop an actual criminal from entering the wrong bathroom.
Children and teens can absolutely know these things about themselves. Imagine telling a child who has a hetero crush on a classmate that they're too young to know they're straight. Children are little people. It won't be the correct choice for every child, but for every child it is the correct choice for, it will lead to a happier life and a more effective transition.
last but not least, you didn't care about competitive women's swimming before, you're not fooling me that you care about it now.
You have to be an adult to get a tattoo. Because by then, you're expected to be able to make a well-informed descision and be able to think of possible coonsequences.
Why on earth would a child be allowed to decide on life-changing or even life-shattering bodily harm?
The entire purpose of puberty blockers is to enable deferring the decision until you are an adult and can make a well-informed decision. The make an irrevocable decision right now options are to go through natural puberty or immediately go on HRT.
We also let children decide on inflicting life-shattering bodily harm to themselves all the time. The classic examples are things like contact sports (children playing tackle football is pretty fucked up) and ballet. In the latter case they're like four when they commit to having deformed feet.
Puberty blockers are not meant to be prescribed from onset of puberty to adulthood. (I don't think anyone wants to be just starting puberty at 18.) They're meant to buy time for the patient to make a decision and get counseling if they need it if they're not sure they want a natal puberty or HRT at the onset of puberty. They will have to decide as a minor.
No, that is not the purpose of "puberty blockers." Those drugs were developed for four different reasons:
1. To delay extremely early-onset puberty in children as young as seven or eight who had a pituitary disorder.
2. To treat advanced prostate cancer.
3. To treat endometriosis and uterine fibroids in women.
4. As part of a treatment for breast cancers, part of fertility protocols, or treatments for endocrine disorders.
This notion of using these drugs to disrupt healthy and physiologically normal puberty, was not even a little part of their purpose. It's how they're being used now in some cases.
The fact is that administering hormone disruptors or synthetic hormones are the opposite of what should be done, as gender dysphoria often resolves itself as the process of puberty and natural maturation unfolds. Interventionism, in these cases, is extremely harmful.
Adults making these choices are a completely different case.
Could you link to recent peer-reviewed meta-studies of medical literature showing "gender dysphoria often resolves itself as the process of puberty and natural maturation unfolds"?
> No, that is not the purpose of "puberty blockers."
The context was gender dysphoria treatment. Please respond to the strongest plausible interpretation of what someone says, not a weaker one that's easier to criticize.[1]
> This notion of using these drugs to disrupt healthy and physiologically normal puberty, was not even a little part of their purpose.
Gender dysphoric puberty has unhealthy effects.
> gender dysphoria often resolves itself as the process of puberty and natural maturation unfolds
I never saw this claim supported by studies which did not include children who did not meet gender dysphoria criteria. And those studies found persistence predictors when they looked. Meeting gender dysphoria criteria for example.
The context was medical intervention for a minor. You trying to narrow it to be only that of treating gender dysphoria has the convenient effect of having to only consider whether the suffering is related to the dysphoria, and not the broader consequences such as whether a minor is able to understand those consequences.
The suffering in the moment is "I want" and the damage the treatment has in satisfying the want creates "I can't ever..."
Discussing that requires the broader context, so your redefinition doesn't work.
Puberty doesn't have unhealthy effects, the dysphoria does. There is also evidence that treatment doesn't resolve the worst "effects" namely depression, anxiety, and suicidal ideation or tendencies. Those often return after the initial euphoria of getting what's desired wears off. It's why there's a fair percentage of kids that later regret having done that to themselves, and it's why the suicide rate for those who receive transition treatment doesn't actually go down, and in some cohorts the rate actually went up.
If we really cared about people suffering from dysphoria we'd look at these facts and be forced to reconsider how quickly we reach for these treatments.
I disagree with this, puberty blockers should be used sparingly and certainly should not be taken until adulthood. Can you imagine starting puberty at 18?
Trans children deserve to mature at the same time as their peers.
Who are you to decide this for them, beyond and above the professional psychiatrists and psychologists who evaluate them based on actual science, and their own parents' informed decision?
If you are 11 and wait 7 years to get a tattoo, your tattoo will look just as good or better.
If you are 11 and wait 7 years to transition, you will suffer irreversible physical and psychological damage. You will have missed formative social experiences. You will have to get expensive, painful surgeries to partially correct what was done to you.
IMO the issue is that we're still seeing the world in black and white. A trans person can't transform into the opposite sex, that's biologically impossible. They exist up in a middle ground, and they should be recognized and accepted as they are so they don't feel the need to transition and detransition to fulfill the binary standard.
Trying to make-believe that people can convert to the opposite sex, and even go back, is doing more psychological damage than accepting our differences, not to speak of the invasive/destructive treatments on an otherwise healthy body.
If you think that a modal person who transitions does so because they don't understand what biological changes can be achieved* and/or because society doesn't accept them "as they are" enough, you are hopelessly confused about this entire topic.
*Note that a disagreement about whether currently available medical procedures constitute a "sex change" is almost always a dispute of semantics and not of fact. A trans woman who describes herself as having "changed her sex" is almost never claiming she can give birth.
You're not getting my point. I've seen that trans people don't want others to think of them as their former sex, they don't want to be reminded that they're still men that look look like women, or viceversa. Mentioning that they can't actually get pregnant, or impregnate someone, is taboo. IMO, this shows a strong psychological, rather than medical, motive. That sets their personal expectations to an impossible ideal, since that needs forcing others to participate in the illusion of a complete sex change.
Disclaimer: I don't know any trans person IRL, so my perception is likely skewed by their loud online interactions.
See this article about muxes, the third gender of the prehispanic Zapotec civilization that still survives today, for an example of accepting gender choice differences healthily, without creating culture wars, and without aggresive treatments on an otherwise healthy individual:
> Mentioning that they can't actually get pregnant, or impregnate someone, is taboo.
Don't know the context, but I don't think this is a "trans" thing. It is usually considered taboo to bring up someone's fertility or sexual issues, even if said issues are common knowledge.
> Disclaimer: I don't know any trans person IRL, so my perception is likely skewed by their loud online interactions.
As an exercise, pick any other minority group, and try to imagine forming an impression of them based solely on reading about the group in culture war arguments and online controversies. I know many trans people due to working in tech, living in California, and hanging out in (bio)hacking circles, and I can promise they are sane and normal people.
Try knowing some in real life. I know dozens, and it's really hard not to think of them as psychologically being of the opposite gender. This tracks with the fact that neuroimaging of trans brains shows that the areas in which male and female brains differ are either of the opposite gender or have in-between values.
> Try knowing some in real life. I know dozens, and it's really hard not to think of them as psychologically being of the opposite gender.
I'm not sure what you mean with "opposite gender" (given that "gender" is now often no longer considered a synonym for "sex"), but I can tell you that all the MtF people I knew from college registered to me simply as men trying to act like women.
This is, frankly, ridiculous. You don't know a single trans person and are making a broad sweeping claim about trans people being unreasonable in conversation about the nature of their transition?
No, it's first a matter of different connectomes. Their brains are physically those of the opposite gender, as shown by several studies using advanced neuroimaging and by autopsies. The mental/psychological effects of those brains being that way are effects of those very physical differences.
To fix that, we'd need microneurosurgery on the level of science fiction. Maybe in a few decades we will, but right now, reshaping the body so it gets as close as possible to what the brain expects is the only option available.
And yes, that neuroimaging could be used as a clinical diagnostic criterion, entirely replacing psychological and psychiatric evaluations. The problem is it costs a fortune, so right now only scientific teams with big budgets use it, and only to publish papers. Over the next several years, with any luck, neuroimaging diagnosis may fall enough in price that it may become the norm, at least in first-world countries.
Oh really? If a psychriatic disorder would warrant changing the environment the brain lives in, rather than any other therapy, why stop at gender disphoria?
Could the MPS people get surgerey so they have more mouths, limbs or even entire bodies except the brain? How about the schizo? Would treatment involve a set of VR goggles with a program that randomly generates perpetually morphing fantasy worlds? How about we make the depressed colorblind so their world is actually gray all the time?
I don't see why a therapy would purposefully not treat the actual symptoms, other than helping a patient understand and cope with them so they can recover their wellbeing.
First and foremost, you're incurring in a slippery slope. Do you want reality, as complex as it may be, or merely to win an argument?
Second, you don't see it because you don't care for their problem, otherwise you'd either learn what the actual hard scientific research on the topic by neurologists and psychiatrists show, as well as the measurable results of the different clinical protocols developed by psychiatrists and psychologists, or defer to their expertize. You yourself "not seeing why" what they do in such cases is what needs done is as meaningless as you "not seeing why" any expert does what they do in fields you're not yourself an expert in. So either become one, or stop getting in their way based on "common sense"-based cognitive errors and biases.
I care about people and my children and grandchildren in particular. Are you really implying common sense isn't what got us here so far? That common sense would get in the way of future geberations? Are you also really using the logical fallacy argument on me while disregarding your hypocrisy?
> Children and teens can absolutely know these things about themselves.
The article quotes a campaigner against the trial who first transitioned and then detransitioned (as far as this was still possible I assume, since a lot is irreversible). So kids can absolutely make the wrong decision. The question is what the relative frequency of these mistakes is.
"In a review of 27 studies involving almost 8,000 teens and adults who had transgender surgeries, mostly in Europe, the U.S and Canada, 1% on average expressed regret. For some, regret was temporary, but a small number went on to have detransitioning or reversal surgeries, the 2021 review said."
Dutch study (Steensma 2013) followed 127 children who were referred to the Gender Identity clinic in Amsterdam under the age of 12. The study looked to see if these children were still gender dysphoric by the time they reached adolescence at age fifteen. 37% of these children had persisted. However 64% of children had either desisted or were no longer traceable. Since there is only one Gender Identity clinic for children in Holland it can be assumed that the latter no longer required support and so had also desisted.
The "desistance" measured in that study is between going to the clinic as a child (before any treatment would be offered) and the time they would go to receive medical treatment from the clinic. Most sources I've seen suggest that change in gender identity is more common in younger children and drops off around the time puberty would start, which is the earliest that medical treatments are offered. The meaning of "desistance" being discussed here is regret after receiving medical treatment - basicly, the Type I error (false positive) rate of the treatment decision. These aren't really comparable.
So this includes both detransitioners and people who just changed their phone number. Not exactly something where we can assume that all of these people were unhappy with their transition.
With how few trans people are, the people among them who have detransitioned is even smaller. I'm not sure why these people should be the only ones that are taken seriously. They're nearly as big of grifters as the "tied-in-fifth-place" swimmer who decided the grift train would pay better than being a mid swimmer.
The thing about Puberty blockers, is they can be mostly reversed. This isn't about children getting things cut off, it's about preventing certain features that surgery cant fix from developing. IMO it's cruel for a teenager who is absolutely sure, to be forced to go through the incorrect puberty and have to undo that later.
I'm 100% with Sarah McBride on this. The blame for this culture war is arguably as much because of how pro-trans folks handled it as it is resistance from conservatives. It did not need to happen this way. There will be progress in the future but it definitely got set back a ways over the last few years. Unfortunately with collateral damage for the rest of the LGBT community.
The culture war started in the US when North Carolina passed a bathroom bill. Prior to this we'd had trans people participating in sports, using the bathroom of their choice, and being allowed to medically transition for years and years. The idea that trans people somehow brought this on themselves for being too pushy is simply false.
> Children and teens can absolutely know these things about themselves.
They can also absolutely be unduly influenced by their parents or other authority figures. The fact that Megan Fox has 3 trans kids points to upbringing as being a major factor.
The pattern I've observed repeated around issues of transgender health care is "ordinary levels of scientific uncertainty used to argue for the most extreme possible restrictions." Puberty blockers have long been used to treat precocious puberty, the main problems of which are social difficulty from going through puberty earlier than one's peers and a shorter adult height.
The opponents of transgender healthcare have used the minor uncertainty of prescribing this medication to a group a few years older to argue not for tighter safeguards, but for a legal ban on prescribing it for that purpose. Not letting doctors evaluate the potential risks and benefits for their patients is one thing, but not even wanting a medical trial to begin to gather more data is outrageous. There is absolutely no concern from these same groups about any risk of the medication to cisgender children, which casts doubt that the concerns are raised in good faith.
> Puberty blockers have long been used to treat precocious puberty
That seems orthogonal, yes? Delaying puberty until the body gets into the usual range of growth is arguably improving something that was otherwise going off the rails. Delaying puberty from normal onset until after the body has otherwise stopped growing is a different use case, different intended goal. It does not seem unreasonable to have different expectations.
Puberty blockers for transgender and potentially transgender teens aren't meant to be taken all the way through to adulthood, if that's what you mean by "otherwise stopped growing." Ideally they're taken just long enough for them to get counseling and come to a decision, a couple years at max.
Apart from that, "different use case, different intended goal" is cause for what I'd call "ordinary levels of scientific uncertainty." A 13-year-old just starting puberty is not so different from an 8-year-old just starting puberty to justify denying a medication to one by law while still prescribing it to the other without concern.
> A high-profile clinical trial of drugs that can delay puberty in children questioning their gender can go ahead after the High Court rejected a legal challenge by campaigners.
The trial protocol said diagnosed with gender incongruence. And explained this.[1] Not questioning their gender.
The root cause problem is that this is based on sexist beliefs about how women and men should present themselves and behave. Children, and adults, are being iatrogenically harmed, and irreversibly so, because of this.
> Campaigners who brought the legal action had argued the safeguards in place were inadequate and raised concerns about the long-term physical and psychological effects on young people.
What exactly are the safeguards for real? It’s literally irreversible damage when you mess up with hormones while on puberty.
I am conflicted myself, but I think I err on the side of caution and think that avoiding messing with your hormones should be no brainer.
> It’s literally irreversible damage when you mess up with hormones while on puberty.
This is equally true when you don't intervene. The children being recruited for this study would otherwise be forced to undergo physical changes that cause them severe psychological distress and would need to be surgically corrected in adulthood.
> Puberty blockers are safe, effective, and generally reversible
Any credible studies to back this up? I find the contrary when I looked last time around, and it does not feel reversible when you disrupt the most important phase of your development (body wise).
Rew, L., Young, C.C., Monge, M. and Bogucka, R. (2021), Review: Puberty blockers for transgender and gender diverse youth—a critical review of the literature. Child Adolesc Ment Health, 26: 3-14. https://doi.org/10.1111/camh.12437
Jamie L Finegan, Maja Marinkovic, Kyle Okamuro, Ron S Newfield, Jennifer T Anger, Experience with gender affirming hormones and puberty blockers (gonadotropin releasing hormone agonist): a qualitative analysis of sexual function, The Journal of Sexual Medicine, Volume 22, Issue 5, May 2025, Pages 945–950, https://doi.org/10.1093/jsxmed/qdaf061
Besides the bait, if the claim is that the evidence for treatment is weak (or well, "evil") a study with appropriate safeguards seems like it should be welcomed not eschewed.
In this case regretting it generally means stopping taking blockers and letting puberty progress as it would without the intervention. Puberty blockers give time to assess if further intervention is needed later (such as hormone replacement therapy)
Interesting that you apparently can’t distinguish between puberty blockers and HRT. When women use puberty blockers, it does not make them develop male traits.
What’s even more interesting is that you value Reddit as a citable source. What other valuable resources have you used to inform your opinion?
> Are you saying you believe if children use puberty blockers they will develop male traits?
They will fail to develop their respective sex-typical traits, which in turn is typical of the opposite sex.
> Are you saying you would cite Reddit as a valid source?
Is there any reason to think the Reddit report is fake? If not, it is fine for me to refer to it. Besides, you were the one asking for a reference. Do you think she should have posted this to the arxiv? You are moving the goal posts.
That’s not how puberty works. Delaying puberty doesn’t make a child develop the “opposite sex’s” puberty. A boy on puberty blockers doesn’t start growing breasts because of the blockers, and a girl doesn’t develop a deeper voice because of the blockers. Puberty blockers pause sex-hormone-driven development. They don’t replace testosterone with estrogen or vice versa. The absence of masculinization is not feminization, and the absence of feminization is not masculinization.
I’m not implying that the single Reddit post you refer to is fake. I’m stating that relying on a single Reddit post as the basis of your entire argument is factually weak.
> The absence of masculinization is not feminization, and the absence of feminization is not masculinization.
It is, to a certain degree. An man/woman who didn't develop several of their respective sex traits will automatically appear more feminine/masculine because these are polar opposites.
> And since gender transition is a lifelong process required to maintain a masculinized or feminized appearance, instances of medical detransition—reported by one study as reaching 30% within just 4 years of initiating treatment—is an alarming warning signal of high numbers of inappropriate transitions.
"The Society for Evidence-Based Gender Medicine (SEGM) is an anti-trans organization that is known for its opposition to gender-affirming care for transgender youth and for engaging in political lobbying. SEGM is known for transgender health care misinformation. It has falsely claimed that the majority of transgender children desist, argued that gender exploratory therapy should be the first line treatment for those under 25, and promoted the scientifically unsupported theory of rapid-onset gender dysphoria. SEGM is often cited in anti-transgender legislation and court cases, sometimes filing court briefs."
Dutch study (Steensma 2013) followed 127 children who were referred to the Gender Identity clinic in Amsterdam under the age of 12. The study looked to see if these children were still gender dysphoric by the time they reached adolescence at age fifteen. 37% of these children had persisted. However 64% of children had either desisted or were no longer traceable. Since there is only one Gender Identity clinic for children in Holland it can be assumed that the latter no longer required support and so had also desisted
Given the permanent nature of a transition on a body, I really wish the advocates of pushing this at young ages would not push back against discussions of people who decide to detransition. Such stories break my heart way more than someone being unable to transition before a certain age.
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