Puberty blockers cause permanent infertility and loss of sexual function
Lucy Johnston said:
“there are concerns that they could cause long term risks. I know that you might have other ideas that it disrupts the natural alignment of mental, physical and social development. It could lead to permanent infertility, loss of sexual function, and there is a risk of bone health.”
Infertility and sexual dysfunction are serious, concrete harms, and the framing that we lack long-term data sounds like responsible caution. Listing several distinct risks together gives the impression of a well-documented body of evidence.
GnRH analogues have been used for decades to pause puberty in children with precocious puberty, at the same doses and for the same purpose, and that use has never generated a literature of permanent infertility or lasting sexual dysfunction. The gonads pause, not die: when treatment stops, development resumes, and fertility potential is preserved. Bone density does need monitoring, and good clinical care includes exactly that, alongside calcium and vitamin D management, but monitored and temporary reduction in bone density is not the same as permanent damage. Listing three serious-sounding outcomes together gives the impression of documented catastrophe; what the clinical literature actually documents is a medication with a well-understood profile, used carefully, in young people who would otherwise go through a puberty that cannot be undone. Every teenager who hears this framing and walks away from a reversible treatment is the one who ends up living with changes they never chose.
What I said at the time:
“My concerns around that are that how come we've been perfectly able to prescribe the exact same puberty blocker for cisgender children for years and years for precocious puberty, for exactly the same indication to stop puberty? How come we're not worried about the risk of those effects that you talk about which actually aren't true in those children.”
Transgender adolescents and their parents who, hearing this, may refuse or delay a reversible intervention and instead face an irreversible puberty they did not want.