From that same paper.
However, use of this intervention has only recently begun, so no other
follow-up studies are available and many questions are still unanswered. Thus, many professionals remain critical about the puberty-blocking treatment (e.g.
25,
41,
42). The primary counterarguments are as follows:
1.
At Tanner stage 2 or 3, the individual is not sufficiently mature or authentically free to take such a decision.
25,
41
2.
It is not possible to make a certain
diagnosisof GD in
adolescence, because in this phase,
gender identity is still fluctuating.
25,
41,
42
3.
Moreover,
puberty suppression may inhibit a ‘spontaneous formation of a consistent
gender identity, which sometimes develops through the “crisis of gender”’ (p. 375).
43
4.
Considering the high percentage of desisters, early
somatic treatment may be
premature and inappropriate.
25
5.
Research about the effects of
early interventions on the
development of bone mass and
growth – typical events of hormonal puberty – and on
brain development is still limited,
7 so we cannot know the long-term effects on a large number of cases.
6.
Although current research suggests that there are no effects on social, emotional and school functioning, ‘potential effects may be too subtle to observe during the follow-up sessions by
clinical assessment alone’ (p. 1895).
25
7.
The impact on
sexuality has not yet been studied, but the restriction of sexual
appetitebrought about by blockers may prevent the
adolescent from having age-appropriate socio-sexual experiences.
41
8.
In light of this fact, early interventions may interfere with the patient's development of a free sexuality and may limit her or his
exploration of sexual orientation.
41,
42
9.
Finally, for trans girls (natal boys with a female gender identification), the blockage of phallic growth may result in less genital
tissueavailable for an optimal vaginoplasty.
44
