Researchers in the Netherlands developed a treatment where a youth, before puberty starts,
is given hormone-blocking medication, giving the child the opportunity to grow without the
physical characteristics of their sex assigned at birth emerging.73 This treatment is becoming
increasingly accepted internationally.74 Dr. Rob Garofalo, the Director of the Lurie Children’s
Hospital’s Gender and Sex Development Program, stated, “[Pubertal blockers] allow [. . .] families
the opportunity to hit the pause button, to prevent natal puberty . . . until we know that that’s either
the right or the wrong direction for their particular child.”75 The youth then has the flexibility to
elect later to begin gender transition by taking the sex hormones of the opposite sex or to resume
their natural puberty development.76 Mounting medical evidence from researchers and
practitioners indicates that puberty blocking hormones are the best options for youth aiming to
avoid the angst of developing secondary sex characteristics.
Still, the question remains whether youth have the maturity to make such a life-altering
decision, especially when the drugs’ long-term effects are not fully known yet.77 The stakes are
higher for youth who want to continue their transition by taking cross-sex hormones. The physical
changes these hormones bring may have potentially irreversible, long-term side effects including
the risk of heart disease, diabetes, cancer, and reduced fertility.78 When Kathryn Mathis first began
realizing that Coy may be transgender, she was unsure what to do.79 Seeking advice, Kathryn
reached out on an online messaging board for parenting and a transgender parent told her he “knew
when [he] was two or three.”80 This struck Kathryn, prompting her to reflect upon her child’s
behavior and Coy’s disappointment when asking her, “I’m a girl – why are you calling me a
‘he’?”81 It was then that she was able to begin discussing with Jeremy her theory that Coy was
transgender, allowing the couple to begin looking for help.82
There is a concern in allowing a youth to transition only to later decide to embrace their
biological gender, which is not completely unfounded. Long-term studies have found that only
about fifteen percent of young children with gender dysphoria continue to have these gender-nonconforming feelings as adolescents and adults.83 However, there is no scientific data supporting
the idea that the decision to allow a child to explore their gender-nonconforming feelings causes
those youth to undergo serious or long-term emotional harm later in life.84 On the contrary,
children suppressing their inner gender identity or expression are at risk for serious emotional
73 Alex Spiegel, Q&A: Doctors on Puberty-Delaying Treatments, NPR (May 8, 2008),
http://www.npr.org/templates/story/story.php?storyId=90234780; see also Scutti, supra note 19
(“[T]he medication simply provides an adolescent more time to explore their identity as well as any desire they may
have for gender reassignment.”).
74 BRILL & PEPPER, supra note 53, at 205.
75 Priyanka Boghani, When Transgender Kids Transition, Medical Risks are Both Known and Unknown, P.B.S. (June
30, 2015), http://www.pbs.org/wgbh/frontline/article/when-transgender-kids-transition-medical-risks-are-both-known-and-unknown/.
76 Spiegel, supra note 73.
83 Talbot, supra note 20; see also Alice Dreger, Pink Boys: What’s the Best Way to Raise Children Who Might Have
Gender Identity Issues?, PACIFIC STANDARD (July 18, 2013), http://www.psmag.com/books-and-culture/pink-boys-