> Puberty blockers alter hormones dramatically during critical growth phases.

Which is generally the goal. It is of course not possible to retroactively have allowed puberty to progress as though the blockers had never been taken, but it is possible to cease the blockers and allow it to resume, again, as is done for cisgender children who take them.

It almost feels like you're arguing definitions.

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.

> 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.

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

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.

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

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

In my 20s this was discovered and I went on testosterone replacement. My hands are still the same size as my mom’s. My feet didn’t get back to the size they were before the accident. I didn’t regain the height I lost. God only knows what it did to my brain.

Maybe if you’re only on them a little bit you’d be fine, but the whole concept is bad. My wife fainted when she got her first period. Why? She didn’t want to be a woman. She was a tomboy. It turns out that the flood of sex hormones during puberty can actually make you feel like a woman/man, which should surprise no one. To block that from happening and potentially effectively treating the dysphoria is madness.

But do you even find your life to be significantly harmed by your smallish stature? There are short people who never had brain injuries, and it's generally not such a concern that we feel the need to make them larger. Lots of them even wish they were taller.

And it's a pretty frequent straw-man to compare tomboys to kids with persistent gender dysphoria. They only seem superficially similar to people who really haven't engaged with the huge breadth of research on trans people over the past century. It also ignores the fact that there are feminine presenting trans masculine people (those born female, who medically transitioned, but still present femininely), or tomboy trans feminine people (born male, medically transitioned, still present masculinely).

The point is that my wife has said she very well might have been confused and thought herself trans (at the time) when she very much is not. She liked to do boy things. She didn't want to be a woman. That's pretty much what the lines are.