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0 pointsAurornis1mo ago0 comments

> It is absolutely possible, and it has been done in cisgender children with precocious puberty for decades

Precocious puberty is a condition in which puberty happens earlier than it's supposed to.

The goal of puberty blockers in precocious puberty is to delay puberty until the correct age and physiological growth window.

Puberty blocker in precocious puberty are also not used to induce hormonal profiles that are different than the body's eventual genetic set point, just to delay them until typical puberty ages.

Delaying puberty until it aligns with the body's expected pubertal ages is completely different. You cannot extrapolate and claim this as evidence that we can safely delay puberty until adulthood, well beyond pubertal age.

> but it is possible to cease the blockers and allow it to resume, again

I don't understand what you're trying to claim, but ceasing the medications does not reverse the changes they made during critical teenage growth windows.

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space_fountain1mo ago

You're making scientific claims, but with the only evidence that I'm aware of contradicting the claim. The usual approach with puberty blockers is prescribing them around the onset of natural puberty and one way or another stopping them around the age of 16. While there are sadly some cases of people who started hormone therapies and later regretted it, I'm aware of no cases of long term health impacts that are attributed to delaying puberty until 16. If you do know of some reports please let me know.

I asked Claude to see if it could find anything and the only reports it could find was some long term bone density issues, but only in trans women and it seemed potentially related to estrogen dosing

AurornisOP1mo ago

> You're making scientific claims, but with the only evidence that I'm aware of contradicting the claim.

> I asked Claude...

There are no double-blind studies, RCTs, or otherwise on this topic because it's not a situation that lends itself to that type of study. Please don't try to ask AI to summarize the situation because its training set is guaranteed to have far more discussion about it from Reddit and news articles than the limited scientific research

Of the papers out there, many are either case reports or they're studies that look into the case where people go from puberty blocker therapy into gender-affirming care, not the cases where they change their mind and discontinue with hope of returning to their baseline state.

Above I was addressing the implication that puberty blockers are a safe way to press pause on puberty until much later without consequence. That's simply not true.

Those studies you found about bone density also note that they can reduce height, and along with it other growth changes that occur during those ages in conjunction with puberty. Someone who takes puberty blockers until 16-18 will have a different physical anatomy than someone who does not. You cannot resume growth in adulthood after discontinuing the medications.

So the studies you found are consistent with what I'm saying: You cannot delay puberty without also impacting the growth that happens during that phase. That's one of the main reasons why people take the puberty blockers! As someone gets older, the window for that growth does not stay open forever.

space_fountain1mo ago

I'm not asking for a double blind study. I'm asking for examples of someone who took puberty blockers, regretted it and stopped, and then went on to not be able to live the life they wanted to live. I'm not aware of any such stories and I'm pretty familiarly with the population of people who regret taking hormones. When I double checked with Claude it also failed to find anything accept the issue around bone density I mentioned.

There are plenty of studies that point to strong evidence that this protocol results in better mental health outcomes because for whatever potential consequence there is for delaying natural puberty, there are plenty of known irreversible impacts of allowing it to progress.

If you have other evidence, even just observational studies it would be good to share that.

And again the recommendation is to continue until 15 or 16, not until 18

delecti1mo ago

It's unclear what age puberty is "supposed to" happen. The age of onset of puberty has gotten substantially younger, even just over the past couple hundred years. If the "correct" age is what we see today, then there's thousands of generations of humans who had puberty naturally occur "too late" yet we're all still here to talk about it. If the "correct" age instead is when it used to occur, then everyone should go on puberty blockers for a few years to avoid this unnatural surge of precocious puberty.

> I don't understand what you're trying to claim, but ceasing the medications does not reverse the changes they made during critical teenage growth windows.

Puberty blockers do not themselves induce changes. They block hormones whose job is to trigger release of sex hormones which would induce changes. For young trans people, access to blockers can save them from a lifetime of dealing with the consequences of a puberty they did not want. Likewise, blockers can save a cisgender child from unwanted consequences of a puberty happening too early.

That doesn't mean "until adulthood", it could just be a few years. But even then, I think blockers are a compromise to appease people who doubt the ability of trans kids to make their own decisions about their bodily autonomy. I think trans people should be able to go on cross-sex hormones basically at will, but certainly after no more than a cursory chat with a therapist.

AurornisOP1mo ago

> It's unclear what age puberty is "supposed to" happen. The age of onset of puberty has gotten substantially younger, even just over the past couple hundred years.

The change over the past couple hundred years is measured on the order of a couple years at most.

This has nothing at all to do with hormonal intervention until adult ages. Once someone reaches adulthood the window for a lot of changes has closed.

> Puberty blockers do not themselves induce changes. They block hormones whose job is to trigger release of sex hormones which would induce changes.

You're either not understanding, or trying to avoid an inconvenient point: Once blocked during critical periods, many of those changes simply cannot happen at a later date.

Puberty cannot be delayed until adulthood and then resumed as if nothing happened.

crote1mo ago

Puberty only lasts a couple of years. First menstruation usually happens between ages 9 and 18 - that's a spread longer than the duration of puberty! Look at any puberty-age high school class and you'll find one kid who has basically finished puberty, while another has barely started.

In other words: the "window" isn't as crucial as you make it seem.

delecti1mo ago

I feel like you ignored my entire last paragraph. I don't know how to respond to this without just pasting it again.

AurornisOP1mo ago

I read it, but you keep moving the goalposts around so much and introducing irrelevant detours that I can't respond to everything you write, sorry.

I've been consistent about my point, but you've introduced so many other topics including the "maybe it's only for a year or two" point that this is just one big gish gallop

Your point about puberty happening earlier and earlier also contradicts your arguments about how it might only be for a year or two

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space_fountain1mo ago

I asked Claude to see if it could find anything and the only reports it could find was some long term bone density issues, but only in trans women and it seemed potentially related to estrogen dosing

AurornisOP1mo ago

> You're making scientific claims, but with the only evidence that I'm aware of contradicting the claim.

> I asked Claude...

Above I was addressing the implication that puberty blockers are a safe way to press pause on puberty until much later without consequence. That's simply not true.

space_fountain1mo ago

If you have other evidence, even just observational studies it would be good to share that.

And again the recommendation is to continue until 15 or 16, not until 18

delecti1mo ago

> I don't understand what you're trying to claim, but ceasing the medications does not reverse the changes they made during critical teenage growth windows.

AurornisOP1mo ago

> It's unclear what age puberty is "supposed to" happen. The age of onset of puberty has gotten substantially younger, even just over the past couple hundred years.

The change over the past couple hundred years is measured on the order of a couple years at most.

This has nothing at all to do with hormonal intervention until adult ages. Once someone reaches adulthood the window for a lot of changes has closed.

> Puberty blockers do not themselves induce changes. They block hormones whose job is to trigger release of sex hormones which would induce changes.

You're either not understanding, or trying to avoid an inconvenient point: Once blocked during critical periods, many of those changes simply cannot happen at a later date.

Puberty cannot be delayed until adulthood and then resumed as if nothing happened.

crote1mo ago

In other words: the "window" isn't as crucial as you make it seem.

delecti1mo ago

I feel like you ignored my entire last paragraph. I don't know how to respond to this without just pasting it again.

AurornisOP1mo ago

I read it, but you keep moving the goalposts around so much and introducing irrelevant detours that I can't respond to everything you write, sorry.

I've been consistent about my point, but you've introduced so many other topics including the "maybe it's only for a year or two" point that this is just one big gish gallop

Your point about puberty happening earlier and earlier also contradicts your arguments about how it might only be for a year or two

j / k navigate · click thread line to collapse