I understand the argument for puberty blockers in trans youth. I imagine a lot of adult transitioners who are fully committed to transitioning wish they could roll back the clock and begin the transition earlier, so their bodies developed over time more like they wished them to. Especially regarding things like facial and bone structure, which are heavily hormonally influenced during someone’s growth years. But I’m not convinced that everyone getting these sorts of treatments in their youth would have ended up fully committed to trans if the treatment didn’t occur. Puberty is, in part, nature’s way of trying to unconfuse you about your gender if you’re on the fence about it before puberty kicks in. And the for-profit doctors who benefit from providing this sort of treatment have no real incentive to recommend against it, so there’s a market driver to push kids one direction instead of another.
That market driver appears in all medicine. If you have back problems and go to a chiropractor, they will recommend chiropractic. If you go to an orthopedic surgeon, they will recommend surgery. If you go to a personal trainer, they will recommend dead lifts. And in truth the personal trainers are probably more correct than the other two, even though they make the least amount of money. We see this same dynamic across all fields of medicine. Obstetricians funnel women into cesarean sections instead of live births, for instance, but women have viable alternatives with midwives. For children with amblyopia, ophthalmologists recommend eye patches and surgery while optometrists recommend vision therapy. Where else do possibly-trans kids go for a second opinion? It seems to me as if the only options on the table are either gender transition doctors or church, with no other counterweight to the treatment plan. There’s a case that something like a ”trans midwife” would be valuable, as an alternative to medical interventions.