I don't think anorexia, bulimia and BIID have that much to do with each other to begin with... though indeed you often see the comparison to BIID as gender confirmation surgery involves removal of perfectly healthy body parts (though not all trans people take that step), just like people with BIID express a desire for, so if doctors agree to do that in the one case, why not in the other. I think the big difference there is simply in the nature of the desire - one is a rational enough desire (even if until quite recently it was an impossible one), the other very much isn't. Now that medical science does allow one to physically change one's gender, albeit still imperfectly and at a cost, I see no rational reason to block it.

You should still have the freedom to not accept it as normal, of course - that's pretty much the cornerstone of liberal democracy, that people accept opinions and actions of others which they disagree with, as long as such actions don't violate their own rights or those of third parties.

I had to look up Chesteron's Fence, but from what I read just now it has to do with reform in society - changing laws, dismantling institutions, etc. - and how one shouldn't undertake such reform until one understands what the original purpose for said law or institution was, and hence the consequences of changing/removing it. I'm not sure that's very relevant for choices affecting a single individual, except in the blatantly obvious sense that one should take the time and effort to fully and accurately weigh the pros and cons in advance. Which, yes, obviously one should, also in these cases. And sure, the cons now may still be bigger than they will be in the future because we don't know everything yet and puberty blockers still have downsides which maybe could be mitigated with further research. But if you let that factor stop you, there's going to be a whole lot of medical treatments that you'd have to call a halt to.

I could probably have phrased that better. Certainly, not taking puberty blockers means avoiding its side effects and those side effects will impact the patient whether or not they later want to revert to their birth gender. But since those side effects are part of the price to pay to change one's gender, patients who do continue down that path wouldn't regret them, or at least would accept them as part of the price to pay.

But blocking puberty will avoid some changes that would have to be surgically reversed later - if that's possible, obviously some puberty-induced changes can't be reversed at all, as we see in the debates about trans male-to-female athletes.



That's a reason to be more careful and take more time to assess a teenager's desire for puberty blockers, yes, but I don't think it's a reason to automatically always refuse it. Of course there are many other things that teenagers aren't allowed to do until the day they turn 18 and then suddenly they can (and even one rather minor thing which for some absurd reason they have to be 21 for...), but given that puberty blockers are very much a time-dependent thing and that by age 18, in the overwhelming majority of cases, that ship has very much sailed, it makes no sense to put it in that same category.

Though as long as they're below 18 it does mean their parents have more of a say, and it's always going to be difficult to find the right balance about how much say they should have when their parents hold the opposite view. My view is rather different from yours below, but I'm not sure I could draw a clear line anywhere in particular.

I expected something along those lines from Tyr and yourself, indeed.