I’m going to ignore the insult and stick to the issue.
You still have not answered the fundamental question: what is a successful outcome?
Quoting the trial aims does not answer that. Saying it will measure “quality of life, mental health, gender dysphoria, body satisfaction, cognition, brain development and bone density” is just a list of things being measured. It does not tell us what good looks like.
If the child has gender incongruence, the only genuinely good clinical outcome is that the child no longer has gender incongruence or distress about their sexed body.
Puberty blockers cannot do that.
They cannot make a girl into a boy or a boy into a girl. They cannot reconcile a child to reality. They cannot treat the underlying distress. They can only stop normal puberty.
So what are they actually trying to prove?
If “success” is reduced distress while puberty is suppressed, that proves nothing useful. Of course a child distressed by puberty may feel temporary relief if puberty is stopped. An anorexic child may feel relief if you help her avoid weight gain. A body dysmorphic child may feel relief if you agree the body is the problem. That does not make the intervention good care.
If “success” is later progression to cross-sex hormones, then this is not a pause. It is a pathway.
If “success” is better body satisfaction after stopping puberty, then that is circular: you have medically prevented the very development the child was distressed by.
The trial can measure many things. That does not mean the treatment has a coherent therapeutic endpoint.
And no, it is not true that we have no evidence of harm. We have evidence of compromised bone density during puberty suppression. We have unknowns around brain development and psychosexual development. We have the obvious fact that blocking puberty interferes with normal sexual maturation. We have a real-world pathway where many children who start blockers proceed to cross-sex hormones, with implications for fertility, sexual function and lifelong medicalisation.
That is not “any drug has side effects”. That is interrupting a normal developmental process in children.
You also keep saying “this is how we get evidence”. That is not enough. Research is not automatically ethical because it creates evidence. You still need a plausible benefit, an acceptable risk-benefit balance, and a child capable of meaningful consent to the stakes involved.
An 11-year-old cannot meaningfully weigh future fertility, adult sexual function, bone health, brain development, regret and lifelong medication against immediate distress about puberty.
The Finnish data is also not reassuring. It found that the elevated suicide risk in gender-referred young people was explained by their severe psychiatric morbidity, not by whether they received gender reassignment interventions. Other Finnish follow-up has shown psychiatric morbidity remaining very high or increasing after medical gender reassignment. That supports the obvious conclusion: these are distressed children who need serious whole-child mental health care. It does not show that medical transition solves the underlying problems.
So again: what is the positive outcome?
Not “what domains will the trial measure?”
Not “what does the protocol say?”
What actual good outcome can puberty blockers produce that careful psychological support cannot produce more safely?
Because if the outcome is not “the child no longer has gender incongruence”, then you are not treating the actual problem. You are using drugs to stop a healthy child’s normal puberty because the child is distressed by it.
I think that is horrific. Children should not be experimented on just because adults have built a theory around their distress.