England’s National Health Service (NHS) announced this week that doctors can no longer prescribe puberty blockers to children seeking a gender transition because “there is not enough evidence of safety and clinical effectiveness.” Meanwhile, trans activists in the United States are too busy making the “moral case” for sterilizing kids to consider the clear and present danger that puberty blockers pose to children.
Puberty Blockers Cause Lasting Damage
Puberty blockers, also known as gonadotrophin-releasing hormone analogues, artificially halt the changes in sexual development that occur during puberty. Proponents paint puberty blockers as a way for kids to buy “extra time” that can be reversed at any time. But because puberty blockers interrupt natural hormonal development, they do more than simply prevent the emergence of secondary sex characteristics.
Puberty blockers promise to prolong childhood but, by doing so, actually destroy it.
Dr. Hilary Cass, the consultant pediatrician who led the independent review on puberty blockers for the NHS, expressed concerns that “brain maturation may be temporarily or permanently disrupted by puberty blockers,” which would suppress the natural hormone surges that assist with the development of “neural circuits underlying executive function.”
Puberty blockers have been promoted by activists as a temporary remedy that gives children more time to figure out their gender identity. But if that were true — if the hormones were really just a neutral “pause” button — then you’d expect some children to choose to present as their biological sex after temporarily using the blockers. Instead, nearly every child who uses puberty blockers goes on to use cross-sex hormones. Far from simply staving off puberty, blockers are simply the first step in a medical transition, even if that’s not how it’s sold to parents.
Reconsidering Care for Dysphoric Children
The NHS is realizing the risks of going all-in on hormone therapy without evidence of safety and effectiveness. In lieu of puberty blockers, the NHS will now focus on psychological, not medical, remedies for trans-identifying youth. “This is because in many cases gender variant behaviour or feelings disappear as children reach puberty,” the NHS website states. Instead of hormones, trans-identifying children will have recourse to family therapy, individual child psychotherapy, parental support or counseling, regular reviews to monitor gender identity development, and referral to local mental health services for more serious emotional issues.
Children in England and Wales will now only be able to obtain puberty blockers if they participate in a clinical trial. In a way, it’s a darkly honest admission: artificially preventing the normal development of healthy children has been experimental from the start.
England isn’t alone in its reconsideration. National health agencies in several other European nations have opened investigations into so-called “gender-affirming” treatments due to lack of evidence. Fifty years after Sweden became the first country to permit legal gender reassignment in 1972, the Swedish National Board of Health and Welfare ended hormone therapy and warned that “the evidence for ‘hormonal interventions’ for minors is ‘of low quality’ and that treatments may present risks.”
Meanwhile, American medical institutions promote puberty blockers as a “medically accepted treatment for transgender and nonbinary youth,” with little to no acknowledgement of the massive risks involved with halting puberty.
Fortunately, an increasing number of states have passed legislation that prevents minors from taking puberty blockers or starting cross-sex hormones. There has been much wailing and gnashing of teeth from trans activists about these laws — most recently from transgender writer Andrea Long Chu in the pages of New York magazine.
Sterilizing Children in the Name of Freedom
Published the day before the NHS announced the end of puberty blockers for English youth, Chu’s longform essay, titled “Freedom of Sex,” attempted to articulate the moral case for “letting trans kids change their bodies,” or why doctors should be able to mutilate children barely past the age of reason. But unfortunately for Chu, mentioning “justice” a few times doesn’t make something a “moral case” anymore than cross-sex hormones make a man into a woman.
Chu fears that the Left has constrained its ability to argue convincingly for the right to genital mutilation and proposes a new paradigm for progressive trans activists:
We will never be able to defend the rights of transgender kids until we understand them purely on their own terms: as full members of society who would like to change their sex. It does not matter where this desire comes from.
Later in the essay, Chu frames this attitude as a “universal birthright” to the “freedom of sex,” which entails the total separation of biological sex from gender identity. Accordingly, trans-identifying children don’t even need to experience dysphoria to warrant a medical intervention like puberty blockers or genital surgeries — they just need to ask for it. “Freedom of sex” isn’t about medicine; it’s about will. If a kid wants something, that’s sufficient reason to consider saying “No” a human rights violation, according to Chu.
“Parents must learn to treat their kids as what they are: human beings capable of freedom,” Chu writes. “If we are to recognize the rights of trans kids, we will also have to accept that, like us, they have a right to the hazards of their own free will.”
You don’t have to be a parent to see the flaws in Chu’s argument. In fact, it’s hard to see where parents come in at all in this vision. Parents are simply vehicles for endless affirmation. After all, children know best — especially trans children, and especially when the stakes are incredibly high.
If you point out that children can’t truly consent, then you’d be wrong again. “If children are too young to consent to puberty blockers, then they are definitely too young to consent to puberty,” Chu writes. “Yet we let this happen every day — and not without casualties.”
If a child wills a thing, it is good; if not, it is bad. But if a child can consent to sterilization at age 11, as Chu would have it, what can’t she consent to? Chu wouldn’t just do away with age-related boundaries and taboos but with childhood itself.
That’s the irony of puberty blockers — an irony that England and other nations are starting to realize. Puberty blockers promise to prolong childhood but, by doing so, actually destroy it.
Mary Frances Myler is a writer from Northern Michigan living in Washington, D.C. She graduated from the University of Notre Dame in 2022.
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