Many gender dysphoric people "grow into" their gender assigned at birth and even hormone therapy can really damage an individual's ability to reproduce or have a healthy, satisfying sex life, let alone if they have surgery.Under 20 yo are too young to have thought about whether or not they really want children later on. Although puberty blockers, with parental permission might help a child take time to adjust, it can also work like a self fulfilling prophecy: if they don't physically develop alongside their peers to manifest the characteristics of their biological gender, it will be harder for them to relate to that gender, prolonging and cementing the dysphoria. In many cases, people who think they are trans will simply grow up to be gay, lesbian or bisexual individuals who are somewhat masculine or feminine compared to the average person of their biological sex. But they could do lasting damage to their ability to enjoy sex or reproduce later in life, if they do something drastic and irreversible to themselves while they are still developing emotionally, mentally, socially and physically.
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