Blocking puberty makes sexual development impossible
Kellie-Jay Keen-Minshull said:
“You can't block puberty and also develop your sexual function and fertility. You can't do both of those things at the same time.”
It sounds like basic biology: if you stop the hormonal process that produces sexual development, you cannot also have sexual development. The logic appears airtight to someone unfamiliar with how gender-affirming care actually works in sequence.
The full gender-affirming pathway does both things, in sequence: blockers pause endogenous puberty, and then gender-affirming hormones drive the development of secondary sex characteristics and sexual function appropriate to the person's affirmed gender. That is not a workaround or a consolation prize; it is how the pathway is designed. Fertility is a genuinely serious consideration, one that clinicians discuss carefully with patients and families, and the honest picture is that effects on fertility vary and deserve attention. But the claim that sexual function is categorically lost is not what the evidence shows for people who go through the full care pathway: many trans adults report fulfilling, intimate lives, and the research reflects that. When this claim is taken at face value by a young person or their family, it can push them away from a pathway that might be exactly right for them, on the basis of something that is not the whole truth.
What I said at the time:
“Gender-affirming care is what we're talking about, the whole parcel, not just puberty blocking... We're talking about gender-affirming care, which is switching somebody's hormones, turning off their hormone, um, and giving them the opposite hormone. And I, if you speak to people, adults who are having intimate, consensual, loving sex, transgender people who have gone through a gender-affirming care, um, the research shows they have much better sex, much better- ... because their body...”
Trans young people and their families making informed decisions about care, who may be misled into thinking the outcome is certain permanent sexual dysfunction when the evidence is more nuanced.