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Comment by bitshiftfaced | Hacker News Reader

Just so I understand, you're making the claim that you can put a child on puberty blockers / hormone treatments from age 10 to 17, and then you can take them off of it and they will resume their sex-at-birth biological development the same as their peers who didn't have hormone treatment, with no permanent effects? Is that right?

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If it's just puberty blockers, as I claim in the previous comment, correct. Which is to say, up to the age of 15, there are no permanent changes. From 15 - the point where they start hormone therapy, that's anywhere between 5-10 years into the overall treatment - there are more permanent changes. The two are distinct phases in their transition.

But nothing really life altering. Will the child end up looking different if they de-transition after taking hormones, yes. More breast tissue if they took E, and more muscle definition if they took T. However, these are also body developments that can also happen without human intervention.

I didn't mean to misrepresent your post. It looks like throughout this thread, my original question became distorted from a larger scope to just puberty blockers taken at an early age.

Anyway, aside from effects on bone density, I did find this:

> One of the disadvantages in adolescent girls who have been treated with GnRH analogues at an early age is the possibility of insufficient skin for penile inversion vaginoplasty. > How Young Is Too Young: Ethical Concerns in Genital Surgery of the Transgender MTF Adolescent

I could be misunderstanding this, but it sounds like there could be lasting effects on penis growth. Wouldn't that make sense, since your body would be getting estrogen during a time where it'd normally be developing in a way where it'd otherwise would be receiving testosterone?

Double check those bone density results, because new research shows they're present before treatment with puberty blockers starts. Some theories are that some children have reduced access to sporting activity.

The penis growth effect has been a solved issue for a long time, dr powers talks about using testosterone gel on the genitals.

Puberty blockers have a long use in children. Unlike a lot of paediatric medications puberty blockers are licensed for use in children, and are used for their licensed use (blocking puberty), albeit for a different population (gender incongruent children with strong trans indicators, instead of children with precocious puberty).

This - being licensed in children, and being used mostly in line with the license - is better than many paediatric meds.

We have a lot of research about use in precocious puberty - they meds are mostly harmless. We don't have a huge amount of research in trans children, but that's for exactly the same reason we don't have research in a bunch of different meds for children.

There's some crazy stat, that 98% of kids put on puberty blockers continue to cross-sex hormones. Which clearly tell you, whatever the puberty blockers are for, its not temporary and its not 'time to think'...

https://www.thelancet.com/journals/lanchi/article/PIIS2352-4...

According to the Cass Review, even social transition isn't a neutral act but should be considered an active intervention, which could lock in what may be a temporary phase of identity development, and make it more difficult for the patient to accept their body as it is.

https://cass.independent-review.uk/wp-content/uploads/2022/0...

The Cass Review has also said that children should have easier access to cross sex hormones - they're considering removing the requirement for children to have spent time on puberty blockers before moving onto CSH.

The Cass review supports transition.

The alternative explanation is that it was almost impossible for trans children to access healthcare in the UK and the only people making their way through the pipeline of GP to GIC to hormone centre were those who were undeniably trans.

Do you not believe that 5-8 years is enough time for a child to think about whether they want their bodies to look like how their minds already feel?

Its also enough time for them to accept their body the way it is. Yet that doesn't appear to be what ever happens, why?

Prior estimates were 90% would desist..

https://www.frontiersin.org/articles/10.3389/fpsyt.2021.6327...

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