"[...] as gender clinics have come under activists' sway, the treatment they offer has taken an ideological turn. Instead of advising parents to watch and wait with sympathy and kindness, they now work on the assumption that childhood gender dysphoria destines someone to trans adulthood. They recommend immediate 'social transition' – a change of name, pronouns and presentation – followed successively by drugs to block puberty, cross-sex hormones and surgery, often while the patient is still in their teens. This treatment pathway is a fast track to sexual dysfunction and sterility in adulthood."