The three steps of gender care and what each one means
Dr Helen Webberley on LBC: trans healthcare, with Tom Swarbrick, LBC
Puberty blockers, hormones, and surgery are all the same kind of decision, with the same stakes. People assume that starting any part of gender-affirming care is a point of no return, that a child who takes a blocker has already committed to everything that follows.
WPATH is clear on this, and I think it matters that people actually read it rather than assume. Puberty blockers are fully reversible. Gender-affirming hormones are partially reversible, and the longer someone is on them, the less reversible some effects become. Surgery is irreversible. These are three distinct steps with three distinct levels of commitment, and that graduated structure exists precisely because the decisions get weightier as you go. The whole framework is built around that distinction. Collapsing all three into one undifferentiated "irreversible intervention" is not a reading of the evidence: it is a refusal to read it.
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