Julia Serano: "The 'experimental' label is most regularly levied against puberty blockers, probably because the average person isn’t familiar with them. However, they’ve been used to treat precocious puberty since the 1980s (Comite et al., 1981; Mancuso et al., 1989) and to stave off unwanted endogenous puberties in trans youth since the mid-to-late-1990s (Cohen-Kettenis & van Goozen, 1998; van der Loos et al., 2023). For anyone interested in learning more about them, I’d recommend Giordano & Holm’s 2020 accessibly written scientific review 'Is puberty delaying treatment ‘experimental treatment’?' as it answers the most commonly asked questions about the method, its efficacy, potential side effects, and so on."
[...]
"In the mid-1990s, doctors in the Netherlands began treating trans adolescents with puberty blockers at the onset of puberty, followed by gender-affirming hormones around age 16. This came to be known as the 'Dutch protocol' or 'Dutch model.' This approach was acknowledged as a potential option by the World Professional Association for Transgender Health (WPATH, formerly HBIGDA) in their Standards of Care version 5 (1998) and version 6 (2002)."
"During the 2000s, numerous groups in the U.S. and elsewhere began adopting the Dutch protocol [and in] 2009, the Endocrine Society published its practice guidelines for trans healthcare that recommended puberty delay followed by gender-affirming hormones for trans adolescents. In 2012, WPATH’s Standards of Care version 7 greatly expanded its section on trans children and adolescents. In addition to continuing to validate the Dutch approach, it included a section on 'Social Transition in Early Childhood,' and explicitly described gender reparative/conversion practices as ineffective and unethical."
"Over the 2000s, as puberty delay followed by gender-affirming hormones was becoming standard practice for many gender clinics, the debate shifted more toward younger children. While the Dutch group was not in favor of any interventions for pre-pubescent gender-dysphoric children (they called this 'watchful waiting'; see de Vries & Cohen-Kettenis, 2012), other trans health practitioners began advocating for social transition for children who are insistent, persistent, and consistent about their gender identity. Several groups began referring to this as an 'affirmed' or 'affirmative' approach (see e.g., Vanderburgh, 2009; Hill et al., 2010; Malpas, 2011; Menvielle and Hill, 2011; Olson et al., 2011) and the label became solidified when researchers from four gender clinics came together to publish 'The Gender Affirmative Model: What We Know and What We Aim to Learn' (Hidalgo et al., 2013), which explains the rationale behind this approach and dispels common myths about it."
"Over the last ten years, the gender affirmative model has become more accepted than watchful waiting [...] As the American Academy of Pediatrics put it in a 2018 policy statement:
Research substantiates that children who are prepubertal and assert an identity of TGD [transgender and gender diverse] know their gender as clearly and as consistently as their developmentally equivalent peers who identify as cisgender and benefit from the same level of social acceptance. This developmental approach to gender affirmation is in contrast to the outdated approach in which a child’s gender-diverse assertions are held as 'possibly true' until an arbitrary age (often after pubertal onset) when they can be considered valid, an approach that authors of the literature have termed 'watchful waiting.' This outdated approach does not serve the child because critical support is withheld. Watchful waiting is based on binary notions of gender in which gender diversity and fluidity is pathologized; in watchful waiting, it is also assumed that notions of gender identity become fixed at a certain age. The approach is also influenced by a group of early studies with validity concerns, methodologic flaws, and limited follow-up on children who identified as TGD and, by adolescence, did not seek further treatment (“desisters”). More robust and current research suggests that, rather than focusing on who a child will become, valuing them for who they are, even at a young age, fosters secure attachment and resilience, not only for the child but also for the whole family."
"studies [show] that children who socially transition at an early age are happy, healthy, and very rarely detransition (see e.g., Durwood et al., 2017; Gülgöz et al., 2019; Olson et al., 2022)"
"In recent years, many health professional organizations have published position statements in support of the gender affirmative approach. Here are some of the more prominent ones:
American Academy of Child and Adolescent Psychiatry (2019)
American Academy of Pediatrics (2018; reaffirmed in 2023)
American Medical Association (2022)
American Psychiatric Association (2020)
American Psychological Association (2024)
Endocrine Society (2017)
Pediatric Endocrine Society (2017)
WPATH Standards of Care, version 8 (2022)
"all of these organizations are inherently conservative, often to a fault. The fact that they all support gender-affirmative care and condemn gender-disaffirming practices nowadays is a testament to how much scientific evidence has been amassed over the last three decades."