Mick Hartley

Medicine is at its most dangerous when medics play God. Development is not a switch to be turned on and off at will; it is a deeply interwoven physiological, psychological, & social process. Yet we are now engaged in indulging ourselves in a reckless experiment—pausing puberty as… https://t.co/UoHYP8Lt3R

— marcus evans (@marcuse99903226) February 28, 2025

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Medicine is at its most dangerous when medics play God. Development is not a switch to be turned on and off at will; it is a deeply interwoven physiological, psychological, & social process. Yet we are now engaged in indulging ourselves in a reckless experiment—pausing puberty as if it were an inconvenience rather than the stage of development that is essential for procreation. But development does not wait. Delaying puberty isolates young people from their peers, severing them from the shared struggles that shape adolescence.

When adults sanction the delay of secondary sex characteristics, they risk undermining a young person’s capacity to cope. The implicit message is: You’re afraid you can’t handle puberty, we agree—you don’t have the resources to manage the identity confusion & uncertainty that accompany the transition from childhood to adulthood. By stopping puberty, medics offer the concrete medical solution these children yearn for—while simultaneously signalling that even adults lack confidence in their ability to find the internal resources to manage. We are also stopping a part of the developmental process that brought them into existence.

This was Dominiqo’s original idea—puberty blockers as a ‘pause for thought’ for adolescents who weren’t ready for puberty. What he didn’t realize was that this approach endorsed an omnipotent belief: that individuals can control the anxiety that comes with developmental change. And that sort of manic psychological defence is difficult to resist—or relinquish.

The GIDS study confirms this. It’s like standing outside a drug rehabilitation service and saying Today, we’re offering psychological support over here, or you can get opium over there. Faced with that choice, the kids didn’t pause puberty and then return to a natural developmental pathway. They continued down the medical route. 95% moved from the allure of puberty blockers to the allure of cross-sex hormones.

And I agree with the article—the consequences won’t be evident in two years, when individuals may still be caught in the euphoria of having seemingly triumphed over their biological development. The real reckoning will come in twenty years, after prolonged use of puberty blockers, cross-sex hormones, and surgical interventions. That’s when we’ll see the full impact of this live experiment.

The greatest mental health scandal of our generation is about to be reopened. Instead of addressing psychological distress at its root, we are interfering with normal developmental processes. Having led the world in putting the lid back on Pandora’s box, we are about to open it again. A tragic display of hubris.

Like the lobotomies of the 1950s, future generations will look back in disbelief, asking: What were they thinking? But it won’t be the researchers and their cheerleaders who are left to pick up the pieces of fractured families and individuals who have lost the developmental opportunities that come with the challenges of puberty. That burden will fall on the next generation of psychotherapists, psychiatrists, and psychologists.

And before anyone starts searching for that mythical figure, the true trans child, let’s be clear: there is only one thing with less prognostic reliability than an adult mental health diagnosis—a mental health diagnosis in children. Psychiatry isn’t like medicine. There is no schizococcus—no biological test to confirm a condition. There are only clusters of symptoms and illness behaviour.

After 46 years in psychiatry, I’ve seen every form of delusional thinking & manic denial employed by the profession. That’s why my first book was called Making Room for Madness in Mental Health. Rather than helping people understand & manage the difficulties that come with development, we promise to remove the pain associated with being human-playing god by denying the facts of life.