A common claim by those who advocate for so-called “gender-affirming care” is that the effects of the treatments, especially puberty blockers, are reversible. These drugs are simply a way, advocates claim, for gender-confused teens to “push pause” on puberty and buy more time to find out who they are. At any time, teens can stop taking the drugs and resume puberty without consequences.

One group that has long made this claim is the World Professional Association for Transgender Health (WPATH), the leading transgender medical organization. In its Standards of Care, which have become the definitive protocol for “gender-affirming care,” WPATH claims that puberty-blocking drugs, which are supposed to reduce “distress stemming from physical changes that occur when… puberty begins,” are “fully reversible.”

However, in a video recently leaked from WPATH’s September 2022 certification seminar, the truth comes out. According to WPATH-certified pediatric endocrinologist Dr. Daniel Metzger, puberty-blocking drugs aren’t as reversible or noninvasive as advocates claim. In fact, they interrupt teens’ physical development in ways that cannot be reversed.

For example, puberty-blocking drugs decrease bone density. As Metzger noted, “Normally puberty is the time of putting the calcium into your piggy bank. …[P]uberty blockers slow that calcium accrual… back to the prepubertal level.” Those who take puberty blockers, and then either continue with normal pubertal development or go on to “transition,” cannot make up for that lost time or “catch up” in developing bone density.

This harmful side effect has been known for some time. According to a 2017 Kaiser Health News piece, Lupron, a puberty-blocking drug, led to a myriad of bone-related issues among young women. Many women who had taken the drug during adolescence were diagnosed in their 20s with osteopenia (thinning bones) and osteoporosis, had hip and jaw joint replacements, and/or experienced chronic pain.

Metzger also noted that the effect of puberty-blocking drugs on brain development remains largely unknown. There remains a gap in research on the “impact and exact direction of pubertal influence” on the brain. As Metzger puts it, teens undergoing puberty suppression “seem to do reasonably the same as their friends, but we’re not looking at their IQ and their learning ability and lots of other things.”

Even from a so-called “gender-affirming care” perspective, puberty blockers can complicate surgical “transition” interventions later in life. Metzger mentions that those who take puberty blockers often do not develop enough tissue to construct artificial genitals. This means that doctors will need to take tissue from other areas of the body, which often multiplies medical complications.

Perhaps most shocking of all was Metzger’s admission that “[k]ids have zero idea about their fertility.” Those who insist on “transitioning” minors claim that they are capable of consenting to the procedures, but the capability to consent depends on their ability to understand the consequences and risks of their decisions. This understanding has everything to do with future fertility. Minors do not have the maturity or foresight to make this kind of call.

It is notable that Dr. Metzger admits all of this, even if he isn’t revealing anything new. Our bodies are not avatars that can be customized and remodeled without consequence. The medical science cited by a WPATH expert on the irreversible harms of chemical and surgical “transition” interventions confirms this.

Though WPATH admits these truths about our bodies, there is no plan to base treatments on them. As one member of WPATH’s Board of Directors put it, medicine isn’t simply about evidence-based care but about “Ethics, human rights, [and] justice for trans people.” This, of course, is just Orwellian newspeak for advancing these brand-new and dangerous ideologies.

Put differently, WPATH’s model of so-called “gender-affirming care” does not “follow the science.” Despite the growing evidence about puberty blockers’ irreversible effects, the gaps in medical research, and the dangers for children, the lie that puberty blockers are “fully reversible” will continue. An organization whose Standards of Care say one thing when the research proves another should not be trusted; not by doctors, by parents, or by the youth they seek to “treat.”

Thankfully, there are signs that the tide is turning. WPATH membership shrunk by 60% in the last year. Let’s pray that people choose truth over ideology. To learn more about the harms of gender ideology, and the lie that these treatments are “irreversible,” check out our latest Breakpoint Forum, “The Real Facts About Gender Ideology,” featuring child and adolescent psychiatrists Dr. Miriam Grossman and Dr. Stephen Grcevich.

This Breakpoint was co-authored by Jared Hayden. For more resources to live like a Christian in this cultural moment, go to

Image credit: ©GettyImages/Wavebreakmedia

John Stonestreet is President of the Colson Center for Christian Worldview, and radio host of BreakPoint, a daily national radio program providing thought-provoking commentaries on current events and life issues from a biblical worldview. John holds degrees from Trinity Evangelical Divinity School (IL) and Bryan College (TN), and is the co-author of Making Sense of Your World: A Biblical Worldview.

The views expressed in this commentary do not necessarily reflect those of CrosswalkHeadlines.

BreakPoint is a program of the Colson Center for Christian Worldview. BreakPoint commentaries offer incisive content people can't find anywhere else; content that cuts through the fog of relativism and the news cycle with truth and compassion. Founded by Chuck Colson (1931 – 2012) in 1991 as a daily radio broadcast, BreakPoint provides a Christian perspective on today's news and trends. Today, you can get it in written and a variety of audio formats: on the web, the radio, or your favorite podcast app on the go.