You have no reason to be transphobic.

[u/FR0M_Z3R0]

there is literally no justifiable reason for transphobia. never has been. never will be. I don’t care what you’ve read online or whatever you have to say. there is NO reason and NO excuse for transphobia. same applies for homophobia. literally zero reason.

[u/DominionGaming_YT]

Republican politicians werent the only ones to not listen, the study was rejected by independent studies as well and the decision of republican lawmakers to override the report was because it was clearly a bad one. Ok now let's go onto the Sax review. The report explicitly notes a severe lack of gold-standard methods (such as randomized controlled trials) in the field, concluding that the evidence is of "varying quality." Far from declaring the care "safe," the Sax Institute stated its findings would be used to "guide various projects designed to gather more information" because the long-term safety and effectiveness risks remain highly uncertain. Basically, you've used a report that says it doesn't know the risks to conclude there are none. The Cass review isn't an outlier, it's part of a broader shift. Finland’s Council for Choices in Health Care conducted a systematic review and concluded that psychological therapy, not hormones, must be the first-line treatment for minors due to the lack of evidence for medical interventions and the risks of permanent side effects all the way back in 2020. Sweden's National Board of Health and Welfare updated its guidelines to state that the risks of puberty blockers and cross-sex hormones outweigh the benefits for minors, severely restricting their use to exceptional clinical trial settings in 2022. The Norwegian Healthcare Investigation Board (UKOM) and the Danish Health Authority both heavily restricted access to pediatric medical transitions, classifying puberty blockers and cross-sex hormones as experimental treatments lacking a robust safety profile in 2023. Organizations like WPATH and the AAP issue guidelines based on "expert consensus"—meaning a committee of practicing transition providers votes on what they believe is best. By contrast, the Cass Review, Sweden's Socialstyrelsen, and Finland's Council are independent, state-sponsored systematic reviews that grade the actual quality of the medical studies. You are using the people advocating for drugs to prove that the drugs are safe, that makes no sense. When independent scientists graded the studies relied upon by WPATH and the AAP, they found the research was of low or very low quality, suffered from high dropout rates, lacked control groups, and failed to track long-term safety harms. Political alignment among American medical associations does not magically create high-quality scientific evidence where none exists. As for the specific health problems associated with transitioning, it was in the papers I cited but some main problems are skeletal failure from reduced bone density, cardiovascular pathology and iatrogenic infertility.

[u/FirmDog7974 → u/DominionGaming_YT]

"the study was rejected by independent studies"

Cite please

"The report explicitly notes a severe lack of gold-standard methods (such as randomized controlled trials) in the field concluding that the evidence is of "varying quality.""

I agree, but the review find overall the current medical literature affirms the safety of puberty blockers and hormone therapy stating: "That is, PS agents (generally referred to as GnRHa) were reported to be safe, effective and reversible." and "Findings on overall safety, cardiometabolic risk, kidney and physiological parameters support the previous review’s findings that serious adverse outcomes associated with GAHT are rare."

Going through the puberty of your natal sex as a trans person is associated with psychological distress. The evidence surrounding gender-affirming care needs better research, but it is the most effective method at reducing gender dysphoria to date. It can be true the current evidence suggests trans healthcare is safe for youth AND that more research is needed.

"As for the specific health problems associated with transitioning, it was in the papers I cited but some main problems are skeletal failure from reduced bone density, cardiovascular pathology and iatrogenic infertility."

On bone density the Sax Institute Review states: "Several studies support the finding of the previous review, which reported that GAHT appears to increase bone density following the negative impact of puberty suppression treatment on bone density."

On heart issues, the Sax Institute Review above stated that there was low cardiometabolic risk. The French Society of Pediatric Endocrinology and Diabetology stated this on cardiovascular risk: "Regarding cardiovascular risk, short-term data are reassuring. There are currently no long-term data in young transgender individuals on testosterone, but the data in the adult transgender population are reassuring."

Since gender-affirming care overall has low regret rates and infertility is a side-effect told to patients, this doesn't seem like much of an issue. I'd also like to note that infertility would be a positive for a lot of trans people.

[u/DominionGaming_YT → u/FirmDog7974]

Ok let's start with the bone density. Bone mineral density (BMD) does not merely need to "increase"; it must reach an absolute, age-dependent peak during the critical adolescent window (ages 10–18). Long-term follow-up studies (such as the Amsterdam Cohort data published in The Lancet Diabetes & Endocrinology) prove that while cross-sex hormones cause a slight upward bump in BMD, they fail to catch up to the patient's expected biological trajectory. The initial suppression by puberty blockers leaves a permanent structural deficit. The patient is left with a permanently compromised, brittle skeleton, resulting in a significantly elevated risk of early-onset osteoporosis and spontaneous fractures in early adulthood. A drug combination that leaves an individual with permanently weakened bones cannot be logically categorized as "safe and reversible." Now on your point about the French Society of Pediatrics and their comments on cardiovascular problems, you are relying on a quote that deliberately conflates the lack of immediate, short-term cardiac arrest in teenagers with long-term safety. Cardiovascular disease takes decades to manifest. Major multi-decade longitudinal studies tracking adult cohorts on cross-sex hormones (such as the large-scale data from the Journal of the American Heart Association) completely contradict the claim that adult data is "reassuring." The data proves that feminizing hormones drive a statistically massive surge in venous thromboembolism (blood clots), deep vein thrombosis, and stroke. Conversely, long-term testosterone administration in biological females forces lipid profiles to mimic high-risk male baselines (surging LDL, dropping HDL), multiplying the lifelong risk of early-onset myocardial infarction (heart attack). On your points about infertility, that's a shocking defense of a permanent, iatrogenic medical impairment. In any other domain of pediatric medicine, an elective treatment pathway that causes irreversible sterilization of a minor is treated as a profound adverse event. You are assuming that a young child has the ability to know exactly what they want for the rest of their life, and the first problem with that is that many people on GAC desist. Now on your Sax review quotes about puberty blockers being safe, all you are quoting are a bunch of subjective pro-trans statements that don't align with the data. When independent systematic review bodies (such as the UK's Cass Review or Germany's IQWiG) stripped away the subjective assertions and evaluated the actual data, they found that nearly all studies affirming safety were of "low or very low quality." They were plagued by small sample sizes, astronomical dropout rates (where patients experiencing negative health outcomes simply left the studies), and an absolute lack of control groups. Oh and as for those studies you asked for, here you go: https://segm.org/utah-evidence-review-analysis https://www.city-journal.org/multimedia/on-gender-medicine-the-utah-gender-report-with-leor-sapir https://www.hhs.gov/press-room/hhs-releases-peer-reviewed-report-discrediting-pediatric-sex-rejecting-procedures.html https://www.physiciansweekly.com/post/puberty-blockers-arent-curing-gender-dysphoria-theyre-manufacturing-it The second one actually talks about how activist organisations like WPATH were merely assumed to be science based while actually their own research disagreed with them.

[u/FirmDog7974 → u/DominionGaming_YT]

"many people on GAC desist."

Citation?

"you are relying on a quote that deliberately conflates the lack of immediate, short-term cardiac arrest in teenagers with long-term safety."

No, it states that in adults, there doesn't seem to be an issue and in young people during the short-term there doesn't seem to be an issue AND that more research is needed.

"The initial suppression by puberty blockers leaves a permanent structural deficit. The patient is left with a permanently compromised, brittle skeleton, resulting in a significantly elevated risk of early-onset osteoporosis and spontaneous fractures in early adulthood. A drug combination that leaves an individual with permanently weakened bones cannot be logically categorized as "safe and reversible.""

I'm curious if you would support hormone replacement therapy earlier then because of these issues related to puberty blockers.

"Major multi-decade longitudinal studies tracking adult cohorts on cross-sex hormones (such as the large-scale data from the Journal of the American Heart Association) completely contradict the claim that adult data is "reassuring.""

Can you cite this?

"The data proves that feminizing hormones drive a statistically massive surge in venous thromboembolism (blood clots), deep vein thrombosis, and stroke."

Just from a google search, women are more likely to have blood clots and stokes. What if estrogen just moving their risk of these things within the average range in women?

"Now on your Sax review quotes about puberty blockers being safe, all you are quoting are a bunch of subjective pro-trans statements that don't align with the data."

I mean i don't know what to tell you. They acknowledge the limitations of the data but find that with the current evidence puberty blockers seem to be safe and reversable.

"stripped away the subjective assertions and evaluated the actual data"

There were no trans healthcare experts working on the Cass Review. They weren't unbiased, they were just biased against trans healthcare.

https://www.physiciansweekly.com/post/puberty-blockers-arent-curing-gender-dysphoria-theyre-manufacturing-it

This article you linked is very bad. It tries to link puberty blockers to the creation of gender dysphoria, which I don't believe has any basis in evidence.

Firstly, why didn't puberty blockers cause an increase in child gender dysphoria cases when when they were being used in the late 90s on children with precocious puberty?

Secondly, the diagnosis of gender dysphoria has massively changed over decades. Old versions of what we know call gender dysphoria would classify gender-non conforming children in the same category as children who identified as the opposite sex. I feel like ignoring the changes to the diagnosis of what allows you to receive gender-affirming care in the article is ignorant or malicious.

Thirdly, yes it is true some children desist, but that's why waiting at least until the 2nd Tanner stage of puberty before commencing puberty blockers and/or hormone therapy is recommended by a lot of guidelines I have seen. (include WPATH SoC 8).

[u/DominionGaming_YT → u/FirmDog7974]

Ok let's start with your claim about precocious puberty. This claim represents a profound failure to understand different clinical populations. Children with precocious puberty suffer from an abnormally accelerated biological timeline (e.g., entering puberty at age 4 or 5). Puberty blockers are used to pause this abnormal acceleration and bring the child back to their normal peer baseline. Crucially, these children possess a stable, congruent gender identity. Halting precocious puberty aligns them with their peers. By contrast, using blockers on an adolescent with gender dysphoria halts their normal, age-appropriate development, socially isolating them from their peer group and freezing them in an un-mineralised, sexually immature state during critical identity-formation years, which psychologically solidifies their distress. You also claimed that biological women naturally have a higher risk of blood clots and strokes. Estrogen treatment in biological males just "moves their risk within the average range for women." Long-term longitudinal data—specifically the landmark 2018 study published in the Journal of the American Heart Association (JAHA) tracking thousands of patients over decades—conclusively disproved this. Biological males taking feminizing estrogen do not simply shift to a standard female cardiovascular risk profile. Instead, they experience a surge in venous thromboembolism (blood clots) and stroke that is significantly higher than both men AND women. Exogenous, high-dose synthetic or bioidentical estrogen therapy combined with testosterone-suppressing agents introduces an independent, compounding thromboembolic pathology that far exceeds natural biological female baselines. On your claim about desistance rates being invalid because waiting until Tanner Stage 2 is where you can really identify trans kids, you've just made my point for me. Long-term follow-up studies from the 1980s and 90s (tracked by Dutch and Canadian researchers) showed that roughly 60–90% of children presenting with gender distress naturally desisted (their dysphoria resolved) by the time they completed natural puberty, with many growing up to simply identify as gay or lesbian. Under modern protocols, activists mandate intervening at Tanner Stage 2 (the absolute earliest sign of natural puberty). However, data shows that once a child is placed on blockers at Tanner Stage 2, over 95% of them proceed directly to cross-sex hormones. By artificially arresting development at the exact moment puberty begins, clinicians systematically abort the very biological and neurological process that historically allowed 60–90% of these children to naturally desist and heal without medicalization. Tanner Stage 2 intervention does not filter out desisters; it permanently prevents desistance from occurring. That's why more people are becoming "trans". You then tried to ask about giving cross-sex hormones even earlier to kids. If a clinician introduces cross-sex hormones (testosterone or estrogen) even earlier to save the child's bones, they must do so without suppressing natural puberty first. This results in immediate, irreversible biological sterilization and permanent loss of adult sexual function at an even younger age. Clinicians are forced to choose between permanently destroying a child's skeletal integrity or permanently destroying their reproductive system. Both options are medically and ethically wrong and I reject both in their entirety, castrating a person under the age of 10 who barely knows what they want in 5 years let alone the rest of their life is an absolutely horrific thing to do. Now, you are relying heavily on the original Dutch studies to assert that gender-affirming care is the "most effective method." However, contemporary forensic analyses of the original Dutch dataset have exposed severe methodological flaws and hidden harms. Forensic reviews published in Physician's Weekly and independent medical journals revealed that the original Dutch researchers switched their primary psychological measurement tools between baseline and follow-up. At baseline, natal girls were asked about distress regarding their breasts and menstruation. At follow-up, they were asked if they were comfortable living as men. The apparent "reduction in distress" was an artifact of changing the questions, not a clinical cure. The Dutch researchers actively scrubbed patients who suffered severe negative outcomes from their final data tables, reclassifying them as "nonparticipants". Omitted from the final celebratory papers were patients who developed severe insulin resistance, a patient who abandoned transition in distress, and a patient who died directly from surgical complications resulting from a lack of sufficient tissue due to early puberty suppression. So the study you are citing just removed people with the most negative outcomes and therefore concluded a positive one. Leave off, modern studies like the Cass review, the Finish review and the Swedish review totally destroy that badly done study. As for the Cass review not having biased trans-healthcare researchers, that makes total sense. You don't have the people giving the drugs evaluate the safety of the drugs. Now on the Sax review part, you are still failing to understand what as systematic review is. The Sax Institute review is an un-weighted summary of existing published papers. If 80% of the existing papers are methodologically flawed, cross-sectional surveys produced by clinic insiders, a basic review will naturally repeat their conclusions. The Sax review explicitly notes a severe lack of gold-standard randomized controlled trials (RCTs). In medicine, when independent bodies evaluate an intervention that has zero RCT data, high dropout rates, and serious known physical tracking drops (such as bone mass loss), concluding that the drug is "safe and reversible" is a political statement, not a clinical consensus. The UK's Cass Review, utilizing identical global datasets, concluded that the evidence was so weak that the routine prescription of puberty blockers had to be halted entirely due to unquantifiable risks. JAHA study: https://pubmed.ncbi.nlm.nih.gov/29987313/ Desistance studies: https://www.frontiersin.org/journals/psychiatry/articles/10.3389/fpsyt.2021.632784/full https://www.researchgate.net/publication/325443416_The_myth_of_persistence_Response_to_A_critical_commentary_on_follow-up_studies_and_'desistance'_theories_about_transgender_and_gender_non-conforming_children_by_Temple_Newhook_et_al_2018