Dr. Annelu de Vries

What Analu explained in her papers was that when gender dysphoria started in early childhood, it could change, and some kids would grow out of it. The important milestone, according to the Dutch protocol, was puberty. To be eligible for medical intervention, the distress needed to be intensifying as puberty neared.

What Analu explained in her papers was that when gender dysphoria started in early childhood, it could change, and some kids would grow out of it. The important milestone, according to the Dutch protocol, was puberty. To be eligible for medical intervention, the distress needed to be intensifying as puberty neared.

But Analu said that for most kids, their distress would dissipate around that time. And because of that, they should keep options open for as long as possible. So while it was okay to try out wearing different clothes at home or on vacation, kids shouldn't fully socially transition until the early stages of puberty.

But Analu said that for most kids, their distress would dissipate around that time. And because of that, they should keep options open for as long as possible. So while it was okay to try out wearing different clothes at home or on vacation, kids shouldn't fully socially transition until the early stages of puberty.

In part because if they changed their mind, they could avoid having to make the transition back. And so that's the guidance that Manon and her parents were getting from Peggy and her team.

In part because if they changed their mind, they could avoid having to make the transition back. And so that's the guidance that Manon and her parents were getting from Peggy and her team.

It was around this time that Honolulu joined Peggy at the clinic to help lead the assessment process. Yeah.

It was around this time that Honolulu joined Peggy at the clinic to help lead the assessment process. Yeah.

She wrote that the process was designed to track how a child's gender dysphoria developed over time.

She wrote that the process was designed to track how a child's gender dysphoria developed over time.

And to rule out any other psychological issues or things going on in their life that might be another explanation for their distress.

And to rule out any other psychological issues or things going on in their life that might be another explanation for their distress.

At this point, Manon was a strong candidate for puberty blockers. She had felt gender dysphoria from a very early age. She had a supportive family. She didn't have any other psychological issues that needed to be addressed first. And crucially, as she approached puberty, her dysphoria was not going away.

At this point, Manon was a strong candidate for puberty blockers. She had felt gender dysphoria from a very early age. She had a supportive family. She didn't have any other psychological issues that needed to be addressed first. And crucially, as she approached puberty, her dysphoria was not going away.

Manon started having a new conversation with Analu.

Manon started having a new conversation with Analu.

Because the last part of the criteria kids needed to meet to start medical intervention was making sure that they understood the impact the treatment would have on their lives. The papers talked about blockers as a reversible treatment. So if a kid were to stop taking them, they would eventually resume their natal puberty.

Because the last part of the criteria kids needed to meet to start medical intervention was making sure that they understood the impact the treatment would have on their lives. The papers talked about blockers as a reversible treatment. So if a kid were to stop taking them, they would eventually resume their natal puberty.

But the papers also noted there may be risks to pausing what's usually a time of rapid growth, like the impact on bone density and possibly brain development.

But the papers also noted there may be risks to pausing what's usually a time of rapid growth, like the impact on bone density and possibly brain development.