I'm not sure why you think that bringing up a survey showing moderately reduced bone density following long term puberty suppression and transition (sonething actually referenced by Scientific American, along with a note the cause/effect wasn't settled given that gender dysphoria sufferers also tend to have smaller bone structure than average before starting treatment, plausibly due due exercise effects) is evidence of "brittle bones that break more often" being a significant risk factor, which is your actual claim. For the third time, my point is that the Cass Report concluded that the evidence base that found the treatment safe and regret rates low didn't meet the highest possible bar for quality and coverage, and did not offer supporting evidence of the greater merit of claims made to promote the idea that puberty blockers were unsafe when used for gender dysphoria, relative to other treatments or other use of the same treatment, such as wild insinuations about bone-breaking being a common side effect of their temporary use...

For similar reasons, studies which shows erectile dysfunction is not uncommon in patients who have chosen to continue treatment using oestrogen, (universally agreed to have irreversible consequences; it's literally the point of using puberty blockers rather than going straight to sex hormones) is not a high standard of evidence that using puberty blockers for a few months aged 11 is significantly less reversible than using for a year or two aged nine. The actual claim being made: that the treatment is reversible in the sense that children are able to come off it and go through puberty, isn't really being contested here either.

> The actual claim being made: that the treatment is reversible in the sense that children are able to come off it and go through puberty, isn't really being contested here either.

By this logic cross sex hormones are reversible too: someone can stop taking artificial estrogen and stop taking anti-androgens and their body will resume production of natural hormones. You can come off cross sex hormones just like you can come off puberty blockers, under your interpretation of the word "reversible". But that's obviously not what people are talking about when they describe treatment and reversible.

Puberty blockers do indeed leave permanent effects. Yes, you can go off puberty blockers. But years of skipped puberty will have permanent effects. Puberty blockers are as reversible as cross sex hormones: yes, you can stop taking them and resume your body's normal hormone production but the time spent altering hormones will have permanent effects.

The descriptions of puberty blockers promulgated by activist groups like mermaids were so misinformed that the UK government has to force them to change their language: https://www.theguardian.com/society/2024/oct/24/trans-childr...

> The watchdog asked Mermaids to review its position on puberty blockers, particularly a section on its website stating that the effects of the treatment were reversible. The Cass review found that the evidence base on puberty blockers was “weak”; puberty blockers will now only be prescribed as part of a NHS clinical trial. Mermaids has removed text stating that puberty blockers are an “internationally recognised safe, reversible healthcare option”.

Parents were told for over a decade that puberty blockers were just like a pause button on puberty. Unpause, and puberty would play out and leave their child just like if they had never gone on blockers. This is not the case, and the unfortunate reality is that many parents consented to treatment on account of misinformation.