Between 2017 and 2021, the number of American children with gender dysphoria who started taking puberty blockers doubled. In the vast majority of cases, their parents sought medical help because their kids were distressed about their gender—and they were told the drugs’ effects were safe, reversible, and necessary. But now those children are adults, and some are finding that the treatment has long-term consequences that they weren’t prepared for—in some cases permanent and devastating ones.