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An 11-year-old transgender girl named Flower and her mother, Jenny Lynn, are traveling from Indiana to the University of Chicago to continue Flower's puberty blocker treatment. Flower sees this medication as a crucial step in her transition. It's difficult for Jenny Lynn to explain to her daughter why they have to travel out of state for the treatment. Without the medication, Flower would go through the wrong puberty, resulting in permanent changes she doesn't want.

- "Puberty blockers are a group of medications or hormones that we use in the transgender population to stop puberty from progressing." - "We call them in endocrinology gonadotropin releasing hormone analogs or agonists." - "Their job is to really interfere with the signaling from the brain to either the ovaries or the testicles that produce the hormones." - "When somebody starts puberty, we can use them to stop the puberty from progressing, thereby allowing somebody to really explore their gender without the pressure of having secondary sex characteristics that are often permanent." - "And the really nice thing about puberty blockers is that they are reversible, so it's a really nice way for an adolescent to be able to explore their gender." - "We like to use them in birth assigned males who have already even gone through a full male puberty because they are able to then use a lower dose of estrogen."

A clinician explains that a chart could show a 15 year old female with a testosterone deficiency, but 'it's a boy that has a testosterone deficiency' and that 'testosterone ... doesn't raise any red flags.' An insurance claim showing 'a boy who has a testosterone deficiency on paper' can obscure fraud. The speaker calls the pattern the 'unholy trinity'—'The hospital system, the pharmaceutical industry, and health insurance companies.' Regarding drugs, puberty blockers 'was Lupron is the most common one,' plus testosterone and estrogen. Some of these drugs are used to chemically castrate sex offenders, and there are children with health issues who need them. There are lack of safeguards: Medicaid and similar insurers 'don't have a system in place where they verify to make sure this is correct before they reimburse.' There should be oversight. 'They actually put the sex they want to be, not the sex they are.'

Max, who identifies as a boy, is visiting the doctor to discuss hormone blockers to prevent puberty. He has started experiencing some breast growth and feels uncomfortable. His parent expresses concern about medical interventions and their effects on bone health and psychosocial development. The doctor explains that hormone blockers can halt puberty progression and reassures that if Max changes his mind, he can still go through female puberty later. The procedure involves inserting a small implant in Max's arm, which will last about 14 to 18 months. The entire process is quick, taking only about 10 to 15 minutes.

Puberty blockers are drugs given to children who wish to transition genders, halting their natural development. This practice can lead to lifelong dependency on hormones and sterilization, raising concerns about child welfare. The conversation touches on whether children can truly understand the implications of such decisions at a young age. One perspective argues that gender identity is a personal choice, while the opposing view emphasizes the importance of biological reality. The discussion highlights the risks of affirming a child's desire to transition without addressing underlying mental health issues. Ultimately, it questions the morality of medical interventions on minors, advocating for a more cautious approach that respects the complexities of gender identity and the well-being of children.

The speaker explains how their child's case ended up in court after a meeting with BC Children's Hospital. The hospital planned to administer cross-sex hormones to the child, but the speaker objected and halted the process. The hospital then sent a letter stating that they would proceed with the hormone injections unless the speaker took legal action within two weeks. The speaker ended up in court because they did not respond with legal action. The speaker also mentions that using the wrong pronouns for their child is considered criminal violence, and they were jailed for it. The speaker confirms that their child is now on hormone pills, as ordered by the court.

Clementine began puberty blockers at 12, testosterone at 13, and had a double mastectomy at 14. At 20, she is detransitioned and seeking reconstructive surgery, which her insurance denied. She may pursue legal action with the help of Campbell, Miller, Payne. Clementine says childhood sexual abuse was ignored, but counselors encouraged her to transition due to negative feelings about her body. She rejected womanhood, associating it with pain from the abuse. Therapy addressing the abuse helped her realize she didn't want to transition, and the loss of fertility and changes to her body began to sink in. Before starting puberty blockers, no one asked about the abuse. At her first appointment with Dr. Johanna Olson-Kennedy at Los Angeles Children's Hospital, she was prescribed puberty blockers 30 minutes in, after being out for 4 months. Dr. Olson-Kennedy told Clementine's parents that she was deeply suicidal and that she would be at high risk for suicide if they didn't let her transition.

The ovary doesn't produce estrogen anymore and the testicle doesn't produce testosterone. Thus, the signs that we see from these hormones are blocked and don't progress in puberty. The main benefit is that they prevent the unwanted permanent effects of puberty, and thus future surgeries can be avoided as an adult. We can prevent the need for any chest reconstruction in affirm trans males or facial feminization surgery in transfemales. They are also reversible, and thus if the patient decides to stop using pubertal blockers, their endogenous puberty will resume as previous. Using pubertal blockers can alleviate the depression or worsening gender dysphoria that is often associated with progressing pubertal changes. And lastly, the use of puberty suppression is recommended by the Pediatric Endocrine Society in their clinical guidelines for the treatment of transgender and gender diverse youth.

Clementine, a detransitioner, shares her experience with another person also named Clementine. She began puberty blockers at 12, testosterone at 13, and had a double mastectomy at 14. Testosterone caused her to experience psychosis, so she stopped taking it around age 17. Now 20, she detransitioned earlier this year and is undergoing reconstructive surgery. She notes that getting approval for reconstructive surgery has been more difficult than getting the initial double mastectomy. She expresses disbelief that people question the experiences of detransitioners.

No one is forced to provide medication to adolescents; doctors choose to treat their patients based on the best available evidence. Many young people have known their identities from a very young age and have suffered for years before finding relief. It's important to note that it is the parents who consent to these treatments, not the children themselves. As parents, witnessing our children's suffering is painful, and they are acting out of love and trust in the advice from the medical community. The situation in Tennessee has complicated this dynamic.

Josie and her mother were convinced that the irreversible treatment, despite making Josie sterile, was the right choice. However, one day, Josie had an unexpected conversation with her mother. Josie revealed that she might feel like a boy on the inside and a girl on the outside. Her mother acknowledged that only Josie knows the answer to that. Josie expressed that if she wanted to grow up as a man, she would tell her mother. Josie admitted feeling unsure about her identity, which surprised her mother. This was the first time Vanessa had heard Josie sound uncertain.

By age 24, after the WPATH files came out, I realized that the doctors who write the guidelines didn’t know what they were doing, and that everything that had happened to me was wrong and had nothing to do with evidence-based medicine. I was experimented on. I was not told they were experimental; I was told it was medicine and that it would help, and it did none of that. It gave me complications the doctors ignored or treated as separate illnesses. It made my already preexisting mental health worse, and my physical health continued to deteriorate because I had a collapsed lung and a large intestine up in my chest that was still ignored by the same medical system fast-tracking me for a disorder I did not have. When I found out what was wrong, I started making appeals. I made claims to the College of Physicians and Surgeons of Ontario. They decided to reject my claim and chose not to take any further action because, according to their investigation, the doctors had done nothing wrong. I appealed that decision with the health committee, and we are still awaiting their decision on that. But those are how I'm getting the answers from the doctors of why they treated me the way they did, because they wouldn’t tell me to my face whenever I asked. So that’s how the regulatory system has approached it. That’s how the doctors have approached it. And even trying to apply the disability because I have recurring hernias from the reparative surgery that was done in 2023 for the physical defect I was born with that was missed, I still have complications from that. I am physically disabled, but disability has rejected me because they don’t deem it a recurring disability. So I’ve also had to appeal that decision. But this is what the medical system has left me with: a body that does not work, that is deteriorating, that was given drugs I was never supposed to have been given. I was approved for top surgery. Unfortunately, I did not go through with it, but there are several who do. There are several who go much, much further, and the complications are not explained. These people do not know what they’re signing up for because they are children. I was a child. I wanted help. That’s all I wanted. I did not need to be medicalized. I did not need to be cut up. I didn’t need to be drugged. I just wanted to be loved the way I was. That was all. Thank you. Excellent.

The speaker discusses the standards applied to children and the potential benefits of going on blockers. They mention that blockers can prevent the development of a deep voice, Adam's apple, and facial hair. The speaker shares their personal experience of spending $5,000 on facial hair removal and $25,000 on facial feminization surgery. They believe that blockers can prevent the need for such procedures and alleviate stress.

Doctor Olsen faced a decision regarding Josie's treatment. She advised starting hormone blockers around age 13, ensuring Josie wouldn't have to wait until 16 to begin. Josie received the blockers as an implant in her arm, showing great bravery as she embraced this new chapter in her life. The doctor reflected on how, just twenty years ago, such treatment wouldn't have been possible, and Josie would have faced male puberty, which was a terrifying thought. The doctor expressed relief that they could provide this support now, emphasizing the importance of the decision for Josie's well-being.

She mentioned that for pleasure, a girl could gently massage the testicles. She also discussed the topic of blocking puberty for individuals, although she did not mention the term "changing sex." Instead, she mentioned that one can block hair growth and facial hair.

"Puberty blockers work at the level of the pituitary gland and they actually suppress the release of the LH and the FSH so that the sex organs are no longer stimulated." "The main benefit is that they prevent the unwanted permanent effects of puberty, and thus future surgeries can be avoided as an adult." "They are also reversible, and thus if the patient decides to stop using pubertal blockers, their endogenous puberty will resume as previous." "Using pubertal blockers can alleviate the depression or worsening gender dysphoria that is often associated with progressing pubertal changes." "Lastly, the use of puberty suppression is recommended by the Pediatric Endocrine Society in their clinical guidelines for the treatment of transgender and gender diverse youth." "The practice of using puberty suppressors in transgender youth is new." "Since the first clinical guidelines were only published in 02/2009."

Abigail's physical changes due to hormone treatments were primarily seen in her voice. However, these treatments caused her to suffer greatly. The chemicals introduced into her body caused pain in her bones, affected her concentration, and disrupted her sleep. To alleviate these issues, she was advised to use CBD oil. Unfortunately, the hormone treatments had a negative impact on Abigail's life, leading her to take her own life. Her mother questions why these changes were allowed if they didn't bring her happiness.

Beauty blockers have been used by doctors for kids experiencing precocious puberty. The conversation then shifts to transgender children, with one speaker arguing that gender affirming care is life-saving and reduces suicide rates. The other speaker questions the lack of studies on suicide rates among transgender children and argues against medical interventions like hormone therapy and surgeries. The conversation becomes heated, with one speaker claiming that transgender children don't exist and that they should be accepted as they are, while the other argues that they need medical interventions. The debate centers around the belief that transgender children are either born in the wrong body or that they should be accepted without medical interventions.

Speaker 0 confirms that the person is currently taking 6 milligrams of estrogen per day. Speaker 1 clarifies that they take it twice a day. Speaker 0 reviews the person's history and asks about the surgery they are seeking. They discuss the irreversible effects of estrogen therapy, such as breast development and shrinkage of the testicles. Speaker 0 mentions that hair growth and redistribution may be affected by estrogen. Speaker 1 mentions that they are not complaining about taking daily pills, but rather wondering if it accelerates the process. The conversation ends.

I often see youth who have already undergone medical interventions due to a backlog in mental health support. Children may not fully understand the impact of these interventions, making it challenging to discuss. It can be especially difficult for young adolescents starting puberty suppression. We aim to make kids happy in the moment, but it's crucial to consider the long-term effects on their development. This is a growing challenge in our field that requires further exploration.

If you're transgender or nonbinary and feel uncomfortable with your puberty experiences, you're not alone. Puberty blockers can temporarily halt the changes caused by hormones like testosterone and estrogen, giving you more time to figure out your gender identity. It's okay to not have all the answers right now, as understanding yourself takes time. Talking to a trusted adult, nurse, or doctor can be helpful. To learn more, visit plannedparenthood.org/teens.

Beauty blockers have been used by doctors for children experiencing precocious puberty. The conversation then shifts to transgender children, with one speaker arguing that gender affirming care is life-saving and reduces suicide rates. The other speaker questions the lack of studies on suicide rates among transgender children and challenges the necessity of medical interventions such as hormone therapy and surgeries. The conversation becomes heated as they discuss the cutting off of body parts and the speaker's belief that there is no such thing as a transgender child. The debate centers around the message being sent to children and the potential harm or benefit of gender affirming care.

Karen Selva, pediatric endocrinologist and medical director of Randall Children's Hospital T Clinic, discusses puberty blockers for transgender and gender expansive youth. Puberty blockers work at the level of the pituitary gland and they actually suppress the release of the LH and the FSH so that the sex organs are no longer stimulated; The signs are blocked and don't progress. The main benefit is that they prevent the unwanted permanent effects of puberty, and thus future surgeries can be avoided as an adult. We can prevent chest reconstruction in affirm trans males or facial feminization surgery in transfemales. They are reversible; if stopped, endogenous puberty resumes. They can alleviate depression or worsening gender dysphoria. The Pediatric Endocrine Society recommends puberty suppression in clinical guidelines for transgender and gender diverse youth. The practice is new; first guidelines were published in 02/2009, and long-term data are not yet available.

Josie and her mother believed that irreversible treatment was the right choice, despite the fact that it would make Josie unable to have children. However, during a conversation, Josie expressed uncertainty about their gender identity. Josie wondered if they were a boy on the inside and a girl on the outside. Their mother acknowledged that only Josie could truly know the answer. Josie was told that if they wanted to grow up as a man, they could. Josie admitted to feeling unsure about their identity, which was a surprise to their mother. This was the first time Vanessa had heard Josie express uncertainty.