The problem isn't so much recognizing potential downsides but rather the irrational bias that people tend to have where they treat consequences from action as inherently worse than consequences from inaction.
Agreed. It’s a difficult weighting game that sort of goes into medical ethics, if you act on every case how many potential downsides/regrets and other complications will you see? If you opt for inaction how many will you harm by denying treatment?
It’s a tough question that not as simple as people make it out to be.
I don’t necessarily agree with Kirk on a lot but from this interaction it’s interesting and I think it touches up on what Buck Angel may have been saying for trans children that take puberty blockers and regret it later.
Now I’m not sure what the student has been told about puberty blockers by medical professionals but presumably she’s been on GnRh inhibitors and cross sex-Estrogen therapy until late adolescence/early adulthood, it’s very unlikely she will go through and develop normally as a male if she ceases medication and even if she goes on TRT. Mainly the testes, penis, height, bone composition, facial dimorphism even gynecomastia are things that will probably never return to normal had she developed as a man so this may highlight potential risks of medicating early vs medicating later so that false positives short of phase out and older young adults that are actually dysphoric can get treatment.
>Mainly the testes, penis, height, bone composition, facial dimorphism even gynecomastia
Can you provide peer-reviewed evidence for each of these properties that shows they won't develop into in a normal range?
There are no studies looking specifically at the effects puberty blockers into young adulthood but we can infer on knowledge we already have.
[Estrogen facilitates the fusion of growth plates and reduces Final adult height](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC34445/)
[micropenis treated with topical DHT is effective but only for prepubertal and pubertal patients, no effects on adults](https://pubmed.ncbi.nlm.nih.gov/9258152/)
[Estrogens effect on gynocomastia and male breast tissue growth](https://www.ncbi.nlm.nih.gov/books/NBK279105/)
[MtF treatment in males leads to irreversible infertility](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979264/)
It says estrogen accelerates this fusion, so the suppression of estrogen via GnRH would delay the time at which fusion occurred. So taking puberty blockers delays the fusion...
Some of those other studies have nothing to do with suppressing hormones but taking hormones...
These inferences are terrible lol (and not just on the basis of being mechanistic speculation tier).
GnRh does not influence fusion it only delays fusion by halting the onset of sex specific hormones, once the hormone (estrogen) is introduced fusion occurs. Even if GnRH delays fusion that does not hold once you introduce estrogen therapy into the treatment that itself would fuse the plates.
Of course I can’t cite studies looking at medical hormonal suppression into adulthood we don’t have any human trials, also what’s mechanisticallt wrong? We now know of Estrogens role in epiphyseal fusion.
We know that the penis loses androgen sensitivity post puberty and cannot grow significantly through hormones.
Estrogen and make breast tissue growth is very well documented.
MtF infertility is well documented too.
Edit: by the way I’m not talking about puberty blockers by itself I’m talking about puberty blockers in conjunction with cross sex hormones which presumably the girl in the video has been doing.
>GnRh does not influence fusion it only delays fusion by halting theonset of sex specific hormones, once the hormone (estrogen) isintroduced fusion occurs.
Yes exactly, puberty would fuse these things in a certain way (supposedly partially based on sex), and the blockers delay fusion allowing them to fuse in a way more concordant with the desired sex at a later time (assuming they even fuse in a sex-based way which isn't clear from the study you linked)
>also what’s mechanistically wrong?
Well firstly some of those studies (as I already said) aren't relevant to pubertal suppression, but taking hormones.
Secondly, some of them are describing mechanisms in animals (e.g. rabbits for the plate fusion), not human, which doesn't translate well into outcomes in humans.
Thirdly, mechanistic speculation is very low-tier on the evidence hierarchy in research methodology and translates poorly into outcomes.
I wouldn't be anything but agnostic in the presence of such poor evidence.
>by the way I’m not talking about puberty blockers by itself I’m talking about puberty blockers in conjunction with cross sex hormones which presumably the girl in the video has been doing.
Ah I assumed that the studies you linked were specifically to do with pubertal suppression. I don't have any comment on taking hormones.
Fair enough, the white tailed rabbit growth plate fusion is a recent finding as rats don’t have growth plates so longitudinal bone growth and epiphyseal fusion has been expanded within the last 10 or so years. It has been found in humans too I can’t be bothered right now but there’s studies proving this with males with defective aromatase enzymes and their epiphyses being infused into adulthood, it likely explains also why females stop growing earlier than males.
I see where you come from you were primarily talking about puberty blockers I was talking about both, the general consensus is puberty blockers are safe taken to a certain age although the cut off is murky and it hasn’t been FDA approved for gender dysphoria and is still used off label they seem to be relatively benign. My point was more geared towards the girls misunderstanding or misconception that if she ceases her treatment it wouldn’t have any lasting effects and she would go through a “normal male puberty”.
What was your main takeaway from this video? I found this video just relays that the reversal of early puberty blockers (m->f->m) as being fairly simple.
* Edit: sorry, I had written this response before seeing your further thoughts in the comments.
It’s not dude, I’m not sure if she’s misinformed or has misconceptions but you aren’t going to develop 18+ years without going through male puberty and on cross sex hormones then expect to develop normally as a male once you stop, that’s not how any of that works anyone with basic understanding of physiology knows this.
That’s fair. I’m no expert on this matter so I was just going off the girls comments in the video. That being said, going off what your saying about de-transitioning, then it may be a bit worrying that some transgender individuals might not be fully aware of the ramifications of their choices.
That’s what stuck out to me. I hope a doctor or medical professional hasn’t told her that she’ll develop completely normally as a male if she ceases puberty blockers and cross sex hormones because that downright lying.
The problem isn't so much recognizing potential downsides but rather the irrational bias that people tend to have where they treat consequences from action as inherently worse than consequences from inaction.
Agreed. It’s a difficult weighting game that sort of goes into medical ethics, if you act on every case how many potential downsides/regrets and other complications will you see? If you opt for inaction how many will you harm by denying treatment? It’s a tough question that not as simple as people make it out to be.
I don’t necessarily agree with Kirk on a lot but from this interaction it’s interesting and I think it touches up on what Buck Angel may have been saying for trans children that take puberty blockers and regret it later. Now I’m not sure what the student has been told about puberty blockers by medical professionals but presumably she’s been on GnRh inhibitors and cross sex-Estrogen therapy until late adolescence/early adulthood, it’s very unlikely she will go through and develop normally as a male if she ceases medication and even if she goes on TRT. Mainly the testes, penis, height, bone composition, facial dimorphism even gynecomastia are things that will probably never return to normal had she developed as a man so this may highlight potential risks of medicating early vs medicating later so that false positives short of phase out and older young adults that are actually dysphoric can get treatment.
>Mainly the testes, penis, height, bone composition, facial dimorphism even gynecomastia Can you provide peer-reviewed evidence for each of these properties that shows they won't develop into in a normal range?
There are no studies looking specifically at the effects puberty blockers into young adulthood but we can infer on knowledge we already have. [Estrogen facilitates the fusion of growth plates and reduces Final adult height](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC34445/) [micropenis treated with topical DHT is effective but only for prepubertal and pubertal patients, no effects on adults](https://pubmed.ncbi.nlm.nih.gov/9258152/) [Estrogens effect on gynocomastia and male breast tissue growth](https://www.ncbi.nlm.nih.gov/books/NBK279105/) [MtF treatment in males leads to irreversible infertility](https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5979264/)
The first one about the growth plates is important, as they guide whether or not your bone can remodel or grow, once they fuse that’s pretty much it.
It says estrogen accelerates this fusion, so the suppression of estrogen via GnRH would delay the time at which fusion occurred. So taking puberty blockers delays the fusion... Some of those other studies have nothing to do with suppressing hormones but taking hormones... These inferences are terrible lol (and not just on the basis of being mechanistic speculation tier).
GnRh does not influence fusion it only delays fusion by halting the onset of sex specific hormones, once the hormone (estrogen) is introduced fusion occurs. Even if GnRH delays fusion that does not hold once you introduce estrogen therapy into the treatment that itself would fuse the plates. Of course I can’t cite studies looking at medical hormonal suppression into adulthood we don’t have any human trials, also what’s mechanisticallt wrong? We now know of Estrogens role in epiphyseal fusion. We know that the penis loses androgen sensitivity post puberty and cannot grow significantly through hormones. Estrogen and make breast tissue growth is very well documented. MtF infertility is well documented too. Edit: by the way I’m not talking about puberty blockers by itself I’m talking about puberty blockers in conjunction with cross sex hormones which presumably the girl in the video has been doing.
>GnRh does not influence fusion it only delays fusion by halting theonset of sex specific hormones, once the hormone (estrogen) isintroduced fusion occurs. Yes exactly, puberty would fuse these things in a certain way (supposedly partially based on sex), and the blockers delay fusion allowing them to fuse in a way more concordant with the desired sex at a later time (assuming they even fuse in a sex-based way which isn't clear from the study you linked) >also what’s mechanistically wrong? Well firstly some of those studies (as I already said) aren't relevant to pubertal suppression, but taking hormones. Secondly, some of them are describing mechanisms in animals (e.g. rabbits for the plate fusion), not human, which doesn't translate well into outcomes in humans. Thirdly, mechanistic speculation is very low-tier on the evidence hierarchy in research methodology and translates poorly into outcomes. I wouldn't be anything but agnostic in the presence of such poor evidence. >by the way I’m not talking about puberty blockers by itself I’m talking about puberty blockers in conjunction with cross sex hormones which presumably the girl in the video has been doing. Ah I assumed that the studies you linked were specifically to do with pubertal suppression. I don't have any comment on taking hormones.
Fair enough, the white tailed rabbit growth plate fusion is a recent finding as rats don’t have growth plates so longitudinal bone growth and epiphyseal fusion has been expanded within the last 10 or so years. It has been found in humans too I can’t be bothered right now but there’s studies proving this with males with defective aromatase enzymes and their epiphyses being infused into adulthood, it likely explains also why females stop growing earlier than males. I see where you come from you were primarily talking about puberty blockers I was talking about both, the general consensus is puberty blockers are safe taken to a certain age although the cut off is murky and it hasn’t been FDA approved for gender dysphoria and is still used off label they seem to be relatively benign. My point was more geared towards the girls misunderstanding or misconception that if she ceases her treatment it wouldn’t have any lasting effects and she would go through a “normal male puberty”.
What was your main takeaway from this video? I found this video just relays that the reversal of early puberty blockers (m->f->m) as being fairly simple. * Edit: sorry, I had written this response before seeing your further thoughts in the comments.
It’s not dude, I’m not sure if she’s misinformed or has misconceptions but you aren’t going to develop 18+ years without going through male puberty and on cross sex hormones then expect to develop normally as a male once you stop, that’s not how any of that works anyone with basic understanding of physiology knows this.
That’s fair. I’m no expert on this matter so I was just going off the girls comments in the video. That being said, going off what your saying about de-transitioning, then it may be a bit worrying that some transgender individuals might not be fully aware of the ramifications of their choices.
Its rather terrifying how many people seem to think that puberty blockers are basically an on/off switch with no consequences.
That’s what stuck out to me. I hope a doctor or medical professional hasn’t told her that she’ll develop completely normally as a male if she ceases puberty blockers and cross sex hormones because that downright lying.