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The Zembla investigation reveals that the scientific evidence for the treatment of transgender youth is insufficient. Concerns also exist regarding the impact of treatment on brain development, with research on this topic being announced seventeen years ago but never conducted. Puberty blockers are used to pause puberty in children with gender dysphoria, allowing time for reflection before irreversible hormone treatments and surgeries. However, the effectiveness of these blockers is questioned, and their potential effects on brain development remain unknown. Limited research suggests that they may influence brain development, but the implications for adolescents are unclear. Further research is needed to provide clarity and inform decision-making for transgender youth.

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- "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."

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In 2016, participants in an early intervention study had been on puberty blockers for a year. Results showed no change in psychological well-being. Despite this, JIDS continued to refer under 15s for blockers without solid data to support it. The findings were not published until 5 years later.

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Dr. Olsen decides to start Josie on blockers and promises to give her estrogen in two years. Josie receives the blockers as an arm implant and holds on tight as she prepares for the next chapter of her life. The speaker reflects on how just 20 years ago, they wouldn't have been able to provide blockers, and Josie would have had to go through male puberty, which terrifies them. They express uncertainty about whether Josie would have survived male puberty.

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Special interest groups influenced Jids to offer physical interventions to children at a young age without strong evidence. Important information about puberty blockers and surgical risks was not shared with families due to fear of backlash. Lack of communication within Jids led to crucial details being overlooked. Written information on surgery implications was only provided in 2019. Families need full information on interventions for informed consent.

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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.

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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.

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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.

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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.

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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.

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Most trans kids know they're trans between ages two and seven, with the speaker's daughter knowing around two and a half. The speaker emphasizes that children know things that adults don't, and these are the things to which adults should listen. The speaker states their child is not mentally ill. To begin gender affirming care, the speaker had to consult with numerous healthcare professionals.

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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.

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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.

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Admiral Rachel Levine, a pediatrician and the assistant secretary for the Department of Health and Human Services, addresses concerns about children transitioning before 18. She emphasizes the challenges of adolescence, particularly for those experiencing gender dysphoria. If a child feels female but is undergoing male puberty, it can be distressing. Critics argue that children are too young to make such decisions. Levine clarifies that for prepubertal children, no medical procedures are performed; instead, they are supported through therapy to explore their feelings.

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"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."

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No doctor is being forced to provide medication to adolescents; they are choosing 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 this treatment, driven by love and concern for their suffering children. Parents are following the advice of medical professionals and doing what they believe is best for their kids. The situation in Tennessee has created challenges for these families.

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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.

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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.

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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.

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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.

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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.

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At the age of 2, she insisted that she was a girl, not a boy, despite being called a cute little boy. She struggled with tantrums, which were initially thought to be due to sensory processing disorder. However, when she was 4 and a half, she visited the gender clinic at Lurie Children's Hospital in Chicago. The doctor asked if she was a girl, and she confirmed it. From that moment, everything changed. She became the easiest kid to navigate the world with, put on clothes, and had no more tantrums.

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The Jits team learned that children's well-being did not improve with puberty blockers, and all who were old enough continued to hormones. This raised concerns about blockers not providing time to think but rather starting a pathway. Only 1% of young people stopped treatment. There are questions about why none stopped once they started, suggesting either not enough young people were being considered or the treatment itself could have an impact. Despite evidence showing blockers weren't effective for many young females, there was no significant change in the service's approach.

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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.

The Megyn Kelly Show

A Deep Dive into Detransitioners, with Experts, Doctors, and Those Who Have Been Through It
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Megyn Kelly hosts a discussion on transitioning and de-transitioning, featuring Walt Heyer and Grace Ladinsky-Smith, both of whom regret their transitions. Walt transitioned to Laura Jensen in his forties but de-transitioned after realizing he needed therapy for childhood trauma rather than surgery. He recounts how adverse childhood experiences, including emotional and sexual abuse, influenced his decision to transition. He emphasizes that many individuals who transition may be dealing with unresolved trauma rather than genuine gender dysphoria. Grace, who began questioning her gender in her twenties, underwent a double mastectomy and hormone therapy but later recognized her mistake. She describes her experience as being influenced by social media and a mental health crisis, leading her to believe that transitioning would resolve her issues. Both Walt and Grace face backlash from trans activists for sharing their stories, highlighting the societal pressure to affirm transitions without exploring underlying psychological issues. The conversation shifts to the medical perspective, with Dr. Julia Mason and Dr. Erica Anderson discussing the implications of puberty blockers and cross-sex hormones. They outline significant risks associated with these treatments, including bone density issues, cognitive effects, and irreversible changes to sexual function. They express concern over the lack of thorough evaluations before medical interventions are prescribed, noting that many young people may be seeking transition as a solution to broader psychological problems. The discussion also touches on the increasing number of young girls identifying as trans and the potential societal factors influencing this trend. Both doctors advocate for a more cautious approach, emphasizing the need for individualized assessments and addressing underlying mental health issues rather than rushing into medical treatments. They call for a systematic review of the scientific evidence surrounding these practices, similar to actions taken in countries like Sweden and Finland, which have begun to reassess their approaches to gender-affirming care for minors.
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