polly carmichael runs the only nhs service offering child gender medicine to under—18s in england andsed at the tavistock centre in london, it sees many young people with gender dysphoria. often, young people will wish to be read of the secondary sex characteristics, or afraid of them developing, if you like, which don't match the sense of themselves. with the onset of puberty, children experiencing gender dysphoria may fear the beginning of periods, the growth of facial hair, or breast development. for the first stage of medical intervention, it would be in the early stages of puberty, so we would start with a puberty blocker. the use of medication to block puberty, to put it on pause, was pioneered 18 years ago by this clinic in amsterdam. we started for the first time treating adolescents to actually create time and rest for transgender adolescents. it was considered fully reversible treatment, so they had the time to make decisions about more irreversible parts of treatment. it was another ten years before the tavistock centre began prescribing blockers to children in the early st