Precocious puberty treatment has decades of research; trans use does not
Lucy Johnston said:
“for those children with precocious puberty, there is a clear indication with decades of research. So it's all about the risks and the benefits.”
It sounds like a principled distinction: the same drug can be appropriate in one condition and not another, and the idea that evidence should be condition-specific is scientifically reasonable.
GnRH analogues have been used in gender dysphoria care since the late 1980s, beginning at the Dutch clinic in Amsterdam, which means there are several decades of longitudinal follow-up data, not a blank page. The pharmacological action is the same whether the indication is precocious puberty or gender dysphoria: the same hormone pathway is being suppressed, and the drug's safety profile does not shift because the patient's gender is different. The principled-sounding distinction between a well-evidenced use and an unproven one collapses once you look at what the evidence base actually contains, because the research is there and it has been reviewed by the major endocrine and paediatric bodies that commission it. When that body of work is set aside, the young people who lose access are not protected from a risk: they go through a puberty that causes them lasting, irreversible harm.
What I said at the time:
“You're saying that it's absolutely okay to use this for cisgender children, but not transgender children. And then the list that you reel off is the list that's not created by medics, not created by gender specialists, it's created by the public.”
Clinicians and policymakers who accept this framing may treat a well-studied intervention as experimental, denying access to young people who would benefit.