The uncritical use of puberty blockers in the US in the treatment of gender dysphoria may be changing.

While concerns have been mounting in much of the developed world, with some countries having scaled back their use, in America doctors who work in transgender clinics routinely claim that prescribing such drugs is both “conservative”, as they claim their effects are largely reversible, and “compassionate”, because they are meant to save children with gender dysphoria (the feeling of being in the wrong body) from enormous distress.

But last week Abigail Shrier, a writer, published interviews in “Common Sense With Bari Weiss”, a newsletter, with two transgender health-care professionals who suggested that some doctors were irresponsible in the way they treated children. The women, both trans, are on the board of the World Professional Association for Transgender Health (wpath), which endorses the use of blockers early in puberty in some cases. Though blockers are often described as operating like a pause button, most children prescribed them go on to cross-sex hormones. This combination can have irreversible consequences, including sterility and the inability to orgasm.