To be clear, people do this all the time with medications for suicidal ideation and depression. Those drugs are less effective at preventing suicide than gender affirming care in trans people. If we want to talk about the harms of a medical intervention we always need to keep the harms of the alternative in mind.

I take Warfarin and could therefore have a major bleed where I just don’t stop bleeding. I take it because if I didn’t I would have clotting which would lead to really bad outcomes like a stroke. The stroke is more likely without warfarin than the bleed is with the warfarin, so that is an overall lower risk.

In the same way, if you look at trans kids who are hitting puberty they have two paths, gender affirming care or not. The not path has lots of extra harms, including but not limited to suicide, self harm, depression, anxiety, and so on. The gender affirming care side has bone density issues during the period of puberty blockers, difficulties with accessing medical care, and much much lower rates of the harms available in the not path. The balance is clear, the experts agree, only a vanishingly small minority of politically and financially motivated people push the other way. The parallels to the climate change “debate” are clear. This is not reasonable and rational disagreement, this is ideological and not science based.

I will keep taking my warfarin and I hope the kids impacted by this keep taking their puberty blockers as long as that is beneficial for them.