Physician’s WeeklyPuberty Blockers Aren’t Curing Gender Dysphoria. They’re Manufacturing It.

Expert Opinion/Commentary Note: This article reflects the views of one physician and advocate. It does not represent a clinical consensus. The AAP, Endocrine Society, and other major medical organizations maintain that gender-affirming care, including puberty blockers, is supported by evidence and appropriate within a multidisciplinary framework. In May 2025, AAP President Susan J. Kressly, MD, commented: “This report misrepresents the current medical consensus and fails to reflect the realities of pediatric care.”

A board-certified pediatrician and SEGM founding member argues puberty blockers entrench rather than resolve gender dysphoria, creating a self-reinforcing medicalization pipeline for vulnerable children. The piece contends the original Dutch Protocol studies that justified the practice contained hidden harms and manipulated outcome measures.

Professional Considerations

• Author argues no randomized controlled trials demonstrate puberty blockers improve long-term mental health outcomes in children with gender dysphoria
• Claims Dutch Protocol researchers excluded participants with serious adverse outcomes from final analyses, including deaths and cases of severe metabolic harm
• Contends pre-medicalization studies showed most gender-nonconforming children desisted without intervention, a pattern reversed after puberty suppression became available
• Article reflects one position in an active clinical and policy debate; AAP and Endocrine Society maintain gender-affirming care remains evidence-supported

Practice Applications

• Review current literature from multiple perspectives before counseling families on puberty suppression
• Assess each patient individually within a multidisciplinary team, including mental health professionals
• Familiarize yourself with both AAP guidelines and emerging evidence reviews informing this evolving debate
• Document shared decision-making conversations with families given the unsettled evidence landscape

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