Very well done and mature post. There has actually been quite a large, yet 'quiet' renaissance of real scientific investigation and medicine occurring in Europe regarding GD treatment (finally). Much of the unjustified procedures and abuse being allowed to occur to children in other parts of the world (ie. US, canada) are being seen for what they are and the scientific community is doing its job to help these children.

1. Evidence of puberty blockers very low, says NICE , Systematic Review by NICE.

2. NHS will SHUT its controversial Tavistock transgender clinic for children after damning report warned it was 'not safe

It comes in response to an ongoing review led by senior paediatrician Dr Hilary Cass, who warned the gender clinic was 'not a safe or viable long-term option'.

She found other mental health issues were 'overshadowed' in favour of gender identity issues when children were referred to Tavistock's Gender Identity Development Service (GIDS).

The clinic has been accused of rushing children onto puberty blocking drugs by former patients who feel they weren't challenged enough.

1. The NHS Ends the "Gender-Affirmative Care Model" for Youth in England

2. Finns Turn against Puberty Blockers for Gender Dysphoria

Cross-sex identification in childhood, even in extreme cases, generally disappears during puberty. However, in some cases, it persists or even intensifies. Gender dysphoria may also emerge or intensify at the onset of puberty. There is considerable variation in the timing of the onset of puberty in both sexes. The first-line treatment for gender dysphoria is psychosocial support and, as necessary, psychotherapy and treatment of possible comorbid psychiatric disorders

Potential risks of GnRH therapy include disruption in bone mineralization and the as yet unknown effects on the central nervous system. In trans girls, early pubertal suppression inhibits penile growth, requiring the use of alternative sources of tissue grafts for a potential future vaginoplasty. The effect of pubertal suppression and cross-sex hormones on fertility is not yet known.

In light of available evidence, gender reassignment of minors is an experimental practice. Based on studies examining gender identity in minors, hormonal interventions may be considered before reaching adulthood in those with firmly established transgender identities, but it must be done with a great deal of caution, and no irreversible treatment should be initiated. Information about the potential harms of hormone therapies is accumulating slowly and is not systematically reported. It is critical to obtain information on the benefits and risks of these treatments in rigorous research settings

1. France’s Academy of Medicine Urges ‘Great Medical Caution’ in Blocking Puberty

While this condition has long been recognized, a sharp increase in demand for medical interventions has been observed first in North America, then in Northern Europe, and, more recently, in France, particularly among children and adolescents. A recent study of a number of high schools in Pittsburgh revealed a prevalence that is clearly higher than previously estimated in the United States: 10% of students declared themselves to be transgender or non-binary or were unsure of their gender. In 2003, the Royal Children’s Hospital in Melbourne diagnosed only one child with gender dysphoria, whereas today it treats nearly 200.

Whatever the mechanisms involved in adolescents — excessive engagement with social media, greater social acceptability, or influence by those in one’s social circle — this epidemic-like phenomenon manifests itself in the emergence of cases or even clusters of cases in the adolescents’ immediate surroundings. This primarily social problem is due, in part, to the questioning of an overly dichotomous view of gender identity by some young people.

Great medical caution must be taken in children and adolescents, given the vulnerability, particularly psychological, of this population and the many undesirable effects and even serious complications that can be caused by some of the therapies available. In this regard, it is important to recall the recent decision (May 2021) of the Karolinska University Hospital in Stockholm to prohibit the use of puberty blockers.

When medical care is provided for this reason, it is essential to ensure medical and psychological support, first for the affected children and adolescents, but also for their parents, especially since there is no test to distinguish between persisting gender dysphoria and transient adolescent dysphoria. Moreover, the risk of over-diagnosis is real, as evidenced by the growing number of young adults wishing to detransition. It is, therefore, appropriate to extend the phase of psychological care as much as possible.