Cross-sex hormones leave young people irretrievably infertile and sexually impaired
Andrew Neil said:
“the vast majority of those who, um, take the puberty blockers, they can then go on to take cross sex hormones, and that leaves them irretrievably changed, infertile, sexually impaired. That's not reversible.”
The claim that hormones cause permanent infertility is biologically plausible and the word 'irretrievably' carries weight. For a parent, the idea that a teenager could be permanently sterilised is alarming and the concern sounds protective.
Fertility is a real consideration, and good care addresses it directly: people starting hormones are offered the chance to bank eggs or sperm before treatment begins, which is precisely why the conversation needs to happen early rather than never. What the evidence does not support is the claim that infertility is inevitable and total for every person, because outcomes vary considerably depending on when hormones are started and for how long. 'Sexually impaired' is doing a lot of work in that sentence too, and it does not reflect what many trans adults on hormones actually report about their lives. When worst-case possibilities are presented as certainties, the people most likely to step back from care are the ones who could have had a genuine conversation about fertility preservation and made an informed choice for themselves.
What I said at the time:
“gender affirming hormones give you the secondary sex characteristics that align with your gender.”
Trans young people are harmed when fertility risks are presented as certain and total rather than as manageable considerations, because it discourages them from seeking care and from accessing fertility preservation that could address the concern.