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Puberty Blockers: 17 Hard Questions Parents Should Ask Before a Teen Medical Transition

by | Jan 3, 2026 | Parenting, Politics | 0 comments

I’m going to treat puberty blockers like what they actually are.

Not a team jersey. Not a purity test. Not a hashtag. Not a magic fix.

They’re a medical intervention aimed at changing a kid’s developmental path. If you’re a parent, that alone should trigger your inner skeptic. Not because you hate anybody, but because you love your kid enough to slow down and verify.

This article is based on a video where a dad is trying to get through to his ex-wife about their transitioning teen. It’s messy. It’s emotional. It’s real life. The video: https://youtu.be/j3vHdwKmWsk

And here’s my promise up front: I’m not doing meme-statistics. I’m not doing “the science is settled.” I’m doing questions, evidence, and parental survival.

The real story here is co-parenting under ideological pressure

If you’ve been through divorce, you already know the truth.

You can be dealing with the same child, the same household history, the same mental health landmines, and still live in totally different realities.

In the video, the father feels stonewalled. He thinks the mom is listening to “gender affirming” professionals who won’t seriously challenge the kid’s story. The mom frames the father’s concern as “badgering,” and frames support and affirmation as the path to improved well-being.

That dynamic shows up in my own writing too.

In a Disruptarian post published December 7, 2025, a father describes watching family conflict collide with gender ideology, and he quotes a similar kind of text exchange: the dad wants involvement with the therapist, the co-parent pushes back, and the kid becomes the center of a power struggle. Disruptarian

That’s why this isn’t just about puberty blockers.

It’s also about:

  • who gets to decide,

  • what “support” even means,

  • and whether your family is being guided by careful medicine or by cultural momentum.

If you’re living it, you don’t need a lecture. You need a playbook.

First, a reality check about viral suicide claims

A lot of people use suicide like emotional blackmail.

They’ll tell you: “If you don’t affirm and medically transition, your kid will die.”

Then the other side fires back with: “If you do transition, your kid will die later.”

Both extremes are designed to shut your brain off.

One study that gets cited constantly is the Swedish cohort study (Dhejne et al., 2011) that followed people who had sex reassignment surgery and legal sex change in Sweden between 1973 and 2003.

Here’s what it actually found, without the internet fan-fiction:

  • The cohort included 324 people. PMC

  • Compared with matched controls, the sex-reassigned group had higher risks for mortality and suicidal behavior, and the authors said sex reassignment may alleviate dysphoria but “may not suffice” as treatment by itself, pointing to the need for improved psychiatric and medical follow-up. PubMed+1

That does not equal: “Your teen has a 47% chance of suicide by 18.”

That’s not how hazard ratios work, and it’s not what this paper studied. It’s an adult surgical cohort across decades, in a specific country, during eras with very different clinical practice and social stigma.

But it does support one parent-relevant truth that nobody should ignore:

If someone is struggling enough to pursue major medical steps, mental health support has to remain central long after the medical event. PubMed+1

That’s not ideology. That’s grown-up medicine.

[Image: A parent highlighting a printed study next to a notebook titled “Questions” | ALT: parents reviewing puberty blockers research and long term outcomes]

Why countries disagree, and why you should notice

If you’re confused, that’s normal. Institutions are sending mixed signals.

The Endocrine Society guideline (2017) recommends puberty suppression for adolescents who have entered puberty (Tanner stage 2), and it discusses multidisciplinary assessment and informed consent capacity, noting most adolescents have that capacity by age 16. OUP Academic+1

Meanwhile, in the UK the NHS stopped routine prescribing of puberty blockers for children in gender identity services in March 2024, moving toward research-only access, and the medical debate there has been explicitly tied to the evidence base and safety questions. BMJ+1

So when someone tells you “every reputable country agrees,” they’re bluffing.

What you actually have is a messy landscape:

  • Some authorities lean toward access with safeguards.

  • Others lean toward restriction pending better evidence.

That alone should push parents to ask better questions, not fewer.

Trans identity decline since 2022: what’s real, what’s noise

You asked for “trans identity decline since 2022.”

Here’s my honest take: there are competing claims, and you should treat this topic like a minefield.

On one side, you’ve got analyses claiming a drop in trans identification among some young cohorts, often referencing the Cooperative Election Study (CES) and other surveys. The CES is a large academic survey run through Tufts, with published methodology and weighting. Tisch College+1

On the other side, you’ve got UCLA’s Williams Institute using federal datasets (BRFSS and YRBS) to estimate the trans population and reporting that youth identification is higher in 2025 than it was in 2022. Their June 2022 report estimated 1.4% of youth ages 13 to 17 identify as transgender. Williams Institute
Their August 2025 update estimated 3.3% of youth ages 13 to 17 identify as transgender, and about 2.7% of ages 18 to 24 identify as transgender. Williams Institute+1

So what does a parent do with that?

You don’t turn it into a victory lap.
You treat it as proof that:

  • survey results can vary by method, wording, and willingness to disclose,

  • the social environment is volatile,

  • and your kid is growing up inside a storm of signals.

In the Disruptarian co-parenting story I mentioned earlier, the father claims “studies show” cooling off since 2022 in the middle of a late-night text war. Disruptarian
That’s exactly how this stuff spreads: somebody sees a chart, then it becomes gospel, then it becomes ammo.

I’d rather you be slower and more accurate than fast and loud.

Where Jordan Peterson fits, whether you like him or not

A lot of parents don’t find Jordan Peterson because they’re looking for politics.

They find him because they feel bullied by language rules, school policies, or “affirmation” demands that don’t allow honest questions.

Two Peterson episodes that line up with this article’s themes:

  • “Trans: When Ideology Meets Reality” (with Helen Joyce) on The Jordan B. Peterson Podcast. Apple Podcasts

  • “Parenting and the Narcissists of Compassion” (with Stephanie Davies-Arai), also on his podcast, aimed right at parenting and the pitfalls of compassion fused with ideology. Apple Podcasts

You can agree or disagree with his framing. Fine.

But the parenting takeaway is simple: if an institution demands you repeat metaphysical claims as a condition of being considered “good,” you should get your wallet and your kid out of that room.

Support is not the same thing as compelled belief.

Puberty blockers: 17 brutal questions parents should ask

I’m going to expand these because a one-line list is worthless when you’re actually living it.

Print this section. Bring it to appointments. Use it as a script when your emotions are running hot.

1) What exactly is the diagnosis, and who made it?

Not “my kid says.” Not “a counselor on Zoom agreed in one session.” A real diagnostic process.

Ask:

  • what criteria were used,

  • what was ruled out,

  • and what the clinician is uncertain about.

Uncertainty isn’t evil. It’s honest.

2) When did distress start, and what changed around that time?

Timeline matters.

Was there:

  • a school shift,

  • a friend group shift,

  • trauma,

  • social media immersion,

  • family breakup,

  • bullying,

  • a sudden change in depression or anxiety?

A kid can be sincere and still be wrong about the cause of their pain.

3) What comorbidities exist, and are we treating them directly?

Depression. Anxiety. OCD. Eating disorders. Trauma. Autism traits. ADHD.

If your clinic treats everything as gender-first, that’s a red flag. It can become diagnostic tunnel vision, where everything gets interpreted as proof of the same conclusion.

4) What does “gender-affirming therapy” mean in this clinic?

This is a trap word.

For some therapists, “affirming” means:

  • reduce shame,

  • explore feelings,

  • stabilize mental health,

  • keep the kid safe.

For others, it means:

  • never challenge the identity narrative,

  • treat questioning as harm,

  • fast-track social and medical steps.

Ask them to define it, in writing if possible.

5) Are puberty blockers being described as “fully reversible”?

Don’t accept slogans.

Ask the clinician to separate:

  • what is known,

  • what is uncertain,

  • what is assumed,

  • what is based on other uses of these drugs.

You’re not being difficult. You’re being a parent.

6) What are the monitoring protocols?

If someone can’t tell you how they monitor:

  • growth and development,

  • bone health,

  • overall health markers,

  • and mental health outcomes over time,

then they’re not running a serious medical program.

7) What are the short-term goals, and what are the long-term goals?

Short-term goals might be relief of distress, improved functioning, better sleep.

Long-term goals should include:

  • stable mental health,

  • preserved future options where possible,

  • strong family connection,

  • the ability to thrive as an adult.

If all goals are framed as “identity validation,” you’re not hearing a medical plan. You’re hearing a worldview.

8) What does the evidence base actually look like for this age group?

Ask for primary sources.

Then ask a follow-up:
What’s the quality of evidence?

Because the UK and the US clearly interpret the evidence landscape differently, and policy has shifted accordingly. BMJ+2GOV.UK+2

9) What does “informed consent” mean for a minor?

“Informed consent” gets used like a spell.

In the Endocrine Society guideline, there’s discussion of multidisciplinary confirmation and mental capacity for consent, noting most adolescents have capacity by age 16, but this is still clinically and ethically contested in practice. OUP Academic+1

Ask:

  • how capacity is assessed,

  • what happens if depression or anxiety is severe,

  • whether the kid can articulate tradeoffs in their own words.

10) What are the off-ramps?

If you start any pathway, what are the criteria to pause or stop?

I want concrete answers like:

  • “If X happens, we reassess.”

  • “If mood worsens, we pause.”

  • “If family dynamics destabilize, we slow down.”

If there are no off-ramps, you’re on a conveyor belt.

11) Are we confusing social support with medical escalation?

You can support your kid emotionally without rushing medical steps.

This is where families blow up.
One parent thinks slowing down equals rejection.
The other thinks speeding up equals harm.

Both are trying to protect the kid, just with different fears.

12) How will fertility and future adult outcomes be discussed?

Not avoided. Not dismissed as “irrelevant.”

A teen’s future self is real, even if their current self can’t picture it.

13) What happens if distress spikes while we wait?

You need an actual safety plan.

If your kid is expressing self-harm or suicidal ideation, that’s not a debate club moment. Get professional support immediately.

In the US, 988 exists. Elsewhere, use your local crisis line.

14) What happens if distress spikes after intervention?

Same question, different direction.

A clinic that refuses to discuss regret, uncertainty, or complexity is not doing medicine. It’s doing dogma.

15) Who else is influencing this child right now?

Peers. Online communities. Teachers. Counselors. Activists. Algorithms.

This isn’t “social contagion” as a guaranteed explanation.

It’s simply admitting that teens are influenced by their environment. That’s not controversial unless you’re trying to sell a simple story.

16) What outcomes are we tracking, and how often?

Track reality like an adult:

  • sleep,

  • school performance,

  • anxiety,

  • depression,

  • social connection,

  • family functioning,

  • self-harm risk.

If you’re not tracking, you’re guessing.

17) Who benefits if we rush?

Follow incentives.

Some people get paid.
Some people get status.
Some people get political wins.

Your kid gets one body, one brain, one shot at adulthood.

That’s why puberty blockers demand brutal questions.

[Video: Short explainer on how to ask clinicians about evidence quality and uncertainty | Note: Helps parents stay calm and specific in appointments]

How to talk to your co-parent without turning your kid into a hostage

If you’re co-parenting this, here’s the hard truth.

Your child can survive disagreement.
They may not survive being turned into a messenger or a weapon.

In that Disruptarian father story, the text exchange shows exactly how quickly pain turns into accusations, and how the kid’s therapist becomes a control point in the conflict. Disruptarian

So here’s a framework I use.

The “three sentence” rule

When you need to communicate about puberty blockers, do it in three sentences:

  1. What decision is pending.

  2. What information you need.

  3. A deadline and a next step.

Example:
“I understand you’re considering puberty blockers. I need the clinician’s written plan, monitoring protocol, and consent paperwork. Please send it by Friday so we can both review it before the next appointment.”

No extra rage. No history dump. No courtroom speech.

The “neutral meeting” move

Stop trying to convince your ex via text walls.

Ask for:

  • a joint appointment with the clinician,

  • or a neutral mediator session,

  • or a family therapist session focused on communication.

If they refuse everything, document it. Calmly.

The “support statement” that lowers the temperature

Say this out loud, and mean it:
“I love our kid. I’m not trying to shame them. I’m trying to make sure we don’t rush into something without a full map of risks and alternatives.”

You’d be shocked how much conflict is fueled by the assumption that questioning equals hatred.

How to vet a clinic without getting labeled a monster

Some clinics do careful, multidisciplinary work.
Some clinics are basically a pipeline.

Here are green flags and red flags.

Green flags

  • They welcome questions.

  • They explain uncertainty without anger.

  • They assess mental health broadly.

  • They have clear monitoring protocols.

  • They respect family dynamics and try to stabilize the home.

Red flags

  • They tell you “the science is settled” and shame you for asking.

  • They refuse to discuss long-term follow-up.

  • They treat comorbidities as irrelevant.

  • They frame any delay as “violence.”

  • They speak like activists instead of clinicians.

If you need proof that activism and policy get mixed into this, look at how legislation and rhetoric show up in media and commentary. Even in my own Disruptarian podcast write-up on gender affirming care legislation, you can see how quickly the debate turns into a collision of evidence claims, moral language, and government action. Disruptarian

What “support” should look like, even if you slow down medically

Let me be blunt: cruelty is evil, and it’s also stupid strategy.

If your kid feels mocked or abandoned, you lose influence. You lose trust. You lose connection.

Support that doesn’t require you to surrender your brain looks like:

  • staying present,

  • asking how they’re doing,

  • working on sleep, routines, school stress,

  • treating depression and anxiety seriously,

  • reducing household chaos,

  • and refusing to turn every dinner into a debate about identity metaphysics.

You can love your kid and still treat puberty blockers as a decision that deserves real scrutiny.

Both things can be true.

A parent’s “evidence map” in plain English

Here’s how I mentally file this issue.

1) Long-term outcomes are complicated

The Swedish cohort shows elevated risks compared to the general population in an adult surgical cohort, and it explicitly points to the need for better psychiatric and medical care post-transition. PubMed+1

That’s not a weapon. It’s a warning: mental health support can’t be treated as optional.

2) Clinical guidelines exist, but they are not the same as certainty

The Endocrine Society guideline outlines a structured approach and criteria, but it’s still a guideline, not a guarantee of outcomes for every kid. OUP Academic+1

3) Policy divergence signals uncertainty

UK policy shifts and restrictions highlight that evidence interpretation differs across institutions and countries. BMJ+1

4) Population trend claims are contested

Williams Institute estimates show increases from 2022 to 2025 in youth identification, while other analyses argue for declines in certain cohorts depending on survey and weighting. Williams Institute+2Williams Institute+2

So the parent stance that makes sense to me is:

  • slow down,

  • stay humane,

  • refuse ideological coercion,

  • and demand long-term thinking.

FAQ for parents who feel like they’re going insane

“Are puberty blockers totally reversible?”

That’s a question for your clinician, but you should demand specifics about what reversibility means in their documentation, plus monitoring and uncertainty.

“If I slow down, am I harming my kid?”

Not automatically. Slowing down while you stabilize mental health and home life can be protective. The harm comes from chaos, cruelty, and isolation.

“If I move forward, am I harming my kid?”

Not automatically either. But you should treat it as serious medicine with serious tradeoffs, not as a social ritual.

“What if my ex says the kid’s mental health improved dramatically after affirmation?”

That can happen in the short term. Even the Swedish cohort paper’s framing acknowledges relief of dysphoria can occur while still calling for long-term psychiatric and medical care. PubMed+1

Short-term relief is not the same thing as long-term outcome certainty.

“How do I keep my relationship with my kid?”

Show up. Be steady. Don’t mock. Don’t disappear. Don’t turn every interaction into a courtroom.

If you want influence, you have to be safe to talk to.

Two internal reads that connect directly to this topic

If you want to see how this plays out in real families and real politics, here are two related Disruptarian pieces that overlap with this article:

Where I land

I don’t trust centralized authority to raise your kid. Not the state, not the school, not the algorithm, not a medical bureaucracy that punishes questions.

And I don’t trust internet mobs to handle nuance either.

So I land here:

  • love your kid fiercely,

  • ask brutal questions about puberty blockers,

  • keep mental health central,

  • and slow the process down enough that truth can catch up.

That’s not hate. That’s parenting.

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