Trans physicians admit puberty blockers are not as 'reversible' and 'noninvasive' as 'the media makes it out to be': Report

Top pediatric physicians admit that puberty blockers are not as "reversible" and "noninvasive" as "the media makes it out to be," according to a video obtained by the Daily Caller News Foundation.

During an educational session conducted by the World Professional Association for Transgender Health, a medical organization, prominent physicians acknowledged that puberty blockers can have adverse side effects for minors, including infertility, bone loss, and brain development disruptions, the DCNF reported.

The organization supports so-called "gender-affirming care" for children, including prescribing puberty suppression drugs, cross-sex hormones, and gender-mutilating surgeries, according to its Standards of Care. However, a September 2022 educational session obtained by the news outlet revealed that physicians with the organization admit that these interventions are not entirely harmless for minors.

During a session titled "Foundations in Gender Affirming Hormone Therapy: Adults and Adolescents," Dr. Daniel Metzger, a WPATH-certified pediatric endocrinologist, expressed concerns about puberty blockers disrupting a child's calcium stores, the DCNF reported.

"Normally puberty is the time of putting the calcium into your piggy bank. This is how I explain it to families. You've got a piggy bank for your calcium and you better get it all in by 25 because at 25 you're going to live off that piggy bank," Metzger stated.

"The puberty blockers slow that calcium accrual back into the bones quite a bit, back to the prepubertal level. We do know that even if you look at people now age 22, if you've done all of this and you've gone off and then you go back on the hormones that you want to have, you have not caught up by age 22. Which is about the time you need to fill up your piggy bank. This is a concern that not everybody is getting their piggy bank completely filled up with calcium," he continued.

Metzger also acknowledged that not much is known about how puberty blockers impact minors' brain development.

"Obviously teenagers, their brains are changing. They're unwiring, they're rewiring. And if we've started one kid unwiring and half rewiring, and then we changed their puberty the other way and we're unwiring, people have been trying to figure out what this does for kids' brains," he added. "They seem to do reasonably the same as their friends, but we're not looking at their IQ and their learning ability and lots of other things."

The doctor noted that in order for a male to undergo a sex change operation, he must develop enough genital tissue to surgically create female genitals.

"When you think about vaginoplasty, the creation of a vagina in an assigned male, you need tissue, genital tissue, to create that vagina. And if we are taking an 11-year-old boy, who does not have a lot of genital tissue and blocking puberty right there, we're preventing the growth of the vagina for down the road," Metzger explained.

In another education session, "Foundations in Clinical Care for Transgender and Gender Diverse Adolescents," Dr. Scott Leibowitz, a member of the WPATH Board of Directors, claimed that puberty blockers are not as reversible as advertised, according to the DCNF.

"I think when we just say, 'Oh puberty blockers are just reversible and it's a very noninvasive treatment,' I would say it's more invasive than often times the media makes it out to be or other people," Leibowitz said.

"There's challenges with puberty suppression that we have to acknowledge and that's why it's 'reversible asterisks,'" he continued. "One cannot be on puberty suppression endlessly. You get to a place where physiologically we need hormones."

According to Leibowitz, medical treatments should not be made based on evidence alone; instead physicians should also consider "ethics, human rights, [and] justice for trans people."

"Regardless of the evidence base, as I said evidence is one part of this, there is an ethical human rights component to treating people. We don't rely on evidence for every single treatment we do in medicine," he stated. "We have to look at the whole thing."

Dr. Metzger, Dr. Scott Leibowitz, and WPATH did not respond to the DCNF's requests for comment.

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