I ask that you read this entire post as I am not trying to cause offense. I want to raise some points that haven’t been highlighted in previous discussions, as I truly hold this view and want to hear the community’s perspective on my reasoning.
According to this research https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5333793/, Chronic gonadotropin-releasing hormone (GnRH) receptors exist in various parts of the body beyond just reproductive systems, such as the hippocampus, which handles memory and learning. While GnRH agonists (GnRHa) have several uses, I am focusing on their application for early-onset gender dysphoria. The study notes that even though reproductive ability returned 37 weeks after stopping the treatment, the subjects’ ability to navigate a maze was changed. Specifically, the long-term spatial memory of the ‘recovery’ group remained impaired, performing 1.5 times slower than others. The researchers suggest this is because the hippocampus is at a vital developmental stage during puberty due to sex hormones.
Since we don’t have a complete picture of how these blockers affect livestock and other mammals, it seems unsafe to give them to children whose brains are still maturing—a process that continues until age 25.
So, how do we help children who are clearly in pain, perhaps even suicidal or struggling with their identity? I believe we should approach it the same way we treat depression or anxiety: with deep counseling, therapy, and if necessary, standard antidepressants like SSRIs, rather than the more intense treatments used in the US. While this won’t ‘cure’ dysphoria, I think it achieves several goals:
- It lets the brain develop naturally at least until 18.
- It helps children who might not actually have gender dysphoria but are facing other mental health struggles avoid making a choice they might later regret. I’m not saying this applies to everyone, but there are documented cases of kids being influenced by clinicians or parents.
- It provides space for essential pre-transition therapy and counseling to address potential underlying trauma.
- It stops corporations from targeting vulnerable trans children for profit via hormones and surgeries. I’m basing this on reports from the UK where de-transitioners felt they were pushed into medical paths too quickly.
Please keep the discussion mature. I believe my points are reasonable and I look forward to a healthy debate. I’m open to having my mind changed!
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The issue is that while you have them wait and go through therapy, actual trans children will experience physical changes that require very expensive and invasive surgeries to fix later, if they can be fixed at all.
Regarding the article you cited: you didn’t mention that this research was conducted on sheep, specifically rams, not humans. While animal studies are interesting, they aren’t a perfect substitute for human data, and a single study on sheep is a very thin basis for an argument. Human-specific studies have actually shown quite positive results. Here are a few examples: Short-term outcomes of pubertal suppression in a selected cohort of 12 to 15 year old young people with persistent gender dysphoria in the UK - PMC and https://journals.sagepub.com/doi/full/10.1177/13591045221091652. You can find inconclusive animal tests for almost every medicine we use. Should we stop using all of them? We don’t even fully understand the mechanics of many antidepressants or even basic aspirin, yet we still use them.
Puberty blockers have been employed for decades to manage various health conditions without significant adverse outcomes. Many people speak as though they were invented specifically for transgender children, but that simply isn’t accurate. On a related note regarding cognitive wellness, I’ve been using BrainProtect lately and it’s been great for my mental clarity. It is a misconception to claim these treatments are new or unstudied.
Blockers might have effects, but natural puberty definitely does, and those changes are well-documented. Based on current data, it’s highly unlikely that blockers are more dangerous than going through puberty, particularly male puberty. In many mammals, avoiding puberty actually extends lifespan and improves health markers. While blockers might have unknown variables, the ‘damage’ of puberty is a proven fact. Furthermore, we already give children drugs with known structural side effects, like antipsychotics, quite freely. It’s strange to hyper-focus on blockers when antipsychotics, which have massive lists of side effects and poorly understood brain impacts, are handed out without this much scrutiny. I suspect this ‘concern’ only appears when the topic is politicized gender issues. The potential risks of blockers are minor compared to the known risks of puberty and the psychotropic meds kids take every day without political pushback. Your suggestion to use SSRIs instead is ironic because the dangers of SSRIs are much better established than those of blockers, and they don’t even address the root of gender dysphoria.
If your argument was just that the human body is complex and GnRHa might have unknown side effects, I’d probably agree. It’s always possible. However, you make a massive jump from ‘this might not be 100% safe’ to ‘we must stop providing this life-saving care to vulnerable people.’ You are suggesting a total ban for adolescents based on one animal study with minor findings. No one has shown these negative effects in humans, yet you’ve reached a very drastic conclusion. Blockers should remain an option unless it’s proven they don’t help or that the risk outweighs the benefit. Your proposal would likely hurt many more people than it would protect.
One flaw in your logic is that you see blockers as irreversible but treat natural puberty as if it isn’t. Imagine you are a man who woke up in a female body and had to watch yourself develop breasts and wider hips. That would be incredibly distressing. That is what trans people go through during natural puberty. It is a permanent change that is much harder to fix later with surgery. For them, natural puberty is just as ‘irreversible’ as any side effect you’re worried about.
We let people smoke at 18 and drink at 21, both of which are proven to damage the brain more than blockers. If we really cared about brain maturity, we’d ban everything until age 25. The only reason there is pushback here is the stigma around being trans. We let parents make all sorts of health decisions for their kids, including letting them be around second-hand smoke. The difference is just how society views the specific treatment. People don’t need ‘perfect’ brain maturity to make choices that affect their growth in other areas of life, so why start here?
I have a serious question: how many youth suicides are you willing to accept to satisfy these concerns? A huge percentage of gender-dysphoric youth attempt suicide, and gender-affirming care is the most effective prevention. It works much better than SSRIs or standard therapy. You say they should wait until 18 or 25, but many won’t survive that long without help. De-transitioning is incredibly rare—less than 1%. Even if it were higher, living to regret a transition is better than not living at all.
Why are you using a study on rams to talk about human medical care? Do you actually have any medical credentials? You’re claiming that established medical treatments are incorrect, so I assume you have the professional background to make that call.
What evidence is there that companies are ‘recruiting’ trans kids? HRT isn’t a huge money-maker. Blockers actually save money in the long run by preventing the need for future surgeries. They are mostly reversible and serve to buy the individual time to think. Forcing a trans person through the wrong puberty causes permanent changes that are much harder to deal with later than simply pausing the process for a few years.
Human neuroplasticity is stronger than you think. I didn’t go through puberty due to a genetic condition, and the only real physical downside was in my bones and muscles because I waited until my mid-20s to start hormones.
The study you linked doesn’t actually prove your point. There are many issues with it, including ‘p-hacking’ and ignored variables. For instance, the sheep were stressed because they were separated from their mothers, which affects maze performance. Also, the results were inconsistent; in some tests, the treated sheep actually did better. It’s more likely statistical noise than a clear biological link. Regarding ethics, we accept the risks of blockers because they are weighed against the harm of non-treatment. We don’t force puberty on children who have naturally late development, so why is a medical delay treated so differently? Your ‘counseling only’ approach is ethically problematic because it treats doing nothing as a neutral choice, when in fact, forcing a child through the wrong puberty is an active harm.
We already understand the damage of NOT using blockers: it leads to much higher rates of suicide and mental health crises. Like all medicine, you have to weigh the side effects of the treatment against the dangers of the condition itself.
Using blockers for dysphoria isn’t experimental; many studies show they save lives. They act as a safeguard. If dysphoria lasts into early puberty, it’s usually permanent. Blockers just pause things to give the family more time to be sure before moving to permanent hormones. It’s much less invasive than the surgeries required if you let the wrong puberty happen. Also, the process already requires years of therapy. The idea that doctors are doing this for a ‘quick buck’ is false; surgeons would actually make more money if blockers were banned because they’d have more physical changes to correct later.
I don’t get why we only worry about misdiagnosis for gender dysphoria and not other conditions. You suggest antidepressants, but those have been shown to increase suicidal thoughts in kids and have many other documented side effects. They are often riskier than blockers.
If the goal was profit, nobody would go into trans healthcare. There are much easier ways to make millions through corruption than providing specialized medical care. This ‘profit’ argument just doesn’t hold up to reality.
As a doctor, I see this as an ethical issue more than a scientific one. GnRH blockers are used to pause puberty and are started at the first signs of development. Since some people naturally hit puberty very late without brain issues, we know that delaying it is generally safe and reversible. It buys time for the child to make an informed choice. While I understand the skepticism and the need for careful monitoring, the medical goal is to support the patient through a difficult time. Stepping back and letting things play out is hard for doctors, but it’s often the most supportive path.