Mason  🏃‍♂️ ✂️

I think nearly all trans kids have mature gametes by the time they start blockers or cross-sex hormones? Gametes mature early, thus how some ten-year-olds can get pregnant. Definitely agree we should automatically preserve gametes as part of the standard of care for trans kids.

Nope, neither males nor females produce mature gametes sans puberty. Some children become pregnant at age 10 because some children go through puberty prior to age 10.

"Five children were prepubertal, no hormone therapy was considered, and they were therefore excluded." It sounds like their inclusion criteria excluded children who had not gone through puberty.

I parsed that as their criteria excluded children for whom hormone therapy was not being considered. If hormone therapy is not considered until puberty has begun, and most kids at the stage where hormone therapy is considered have mature gametes, then that's the pop we care about

My understanding is that the current standard of care involves letting puberty start a little, because some prepubescent dysphoria desists when puberty begins, and then aggressive treatment if the dysphoria does not desist. That means the treated pop is not prepubescent.

I doubt we disagree on much here. Treatment for trans adolescents should likely start after the onset of puberty, to be sure they're not in the pop that desists when puberty begins. But if they're not, they're very unlikely to later desist and benefit from early transition.

At that stage most of them have mature gametes but, for the ones who don't, it's plausibly worth waiting until they do, and gamete preservation should be the default (though I do think kids should have the right to refuse).