Fortunately, most doctors no longer think this way. In 2012, Dr. Diane Ehrensaft from the University of California, San Francisco, proposed “true gender self child therapy,” in which even the youngest children are allowed to explore their gender identity, with all outcomes (transgender or not) being treated as equally desirable.

That’s just what happened with Hannah. At 10, after a yearlong psychological evaluation, she underwent a nonmedical “social transition.” This meant changing her name from Jonah to Hannah, wearing girls’ clothes and using female pronouns. She went from the frustrated boy wearing a yarmulke to the bubbly child wearing a dress and joining the girls’ bunk at summer camp.

At this point, data on the benefits of early social transition is scarce. But this year researchers at the University of Washington published a study based on 63 transgender youth who were allowed to socially transition. They found that their levels of anxiety and depression were just about indistinguishable from their non-transgender peers.

Critics point to flawed studies that suggest that roughly 80 percent of prepubescent children ultimately change their minds about being transgender. Even if this were true, would it have been worth forcing Hannah to live as a boy, putting her at risk for depression and perhaps suicide? Though going back to a boy’s name and boys’ clothes would probably be hard, even a small risk of suicide is scarier.

Once transgender youth hit puberty, their gender identity is unlikely to change. At that point, doctors often consider medical interventions. The puberty blocker is the first step. In the unlikely event that a child were to change her mind about being transgender, we could remove the implant, and she would then go through male puberty. The implant has some mild side effects, most notably a decrease in bone density, but that quickly improves after the removal of the implant or the initiation of cross-sex hormones like estrogen or testosterone.

The effects of cross-sex hormones like estrogen are not easily reversible. The hormones can impair fertility, but transgender teens are offered fertility preservation options before that stage, like freezing sperm or eggs. Surgery, which often follows in young adulthood, is also, of course, essentially permanent.

In a Dutch study of 55 transgender people who were given puberty blockers during adolescence, however, none changed their minds and none regretted treatment. All went onto cross-sex hormones around age 16 and later gender-affirming surgery. Psychological functioning improved steadily over the treatment period, and by the end, metrics of happiness and quality of life were on a par with those of the general population. Larger studies are underway in the United States, and early clinical experience agrees with the Dutch results.