Why puberty blockers alone do not show mental health gains

What I was pointing to there is a gap in how the evidence was read, not a gap in the evidence itself. Blockers pause an unwanted puberty: they stop the wrong development, but they don't start the right one. So if you measure mental health at that point, you're measuring a child in a kind of holding pattern, not a child who has arrived anywhere. What NICE did was stop the analysis there. The research that follows, on what happens when young trans people go on to receive hormones and begin developing in a way that matches who they are, is where the mental health gains show up. Stopping the clock on the evidence at the blocker stage and then concluding that the treatment doesn't work is like measuring whether a patient feels better the moment you stop the bleeding, before you've closed the wound.