None of the known risks or side effects include cognitive impairment, you are attributing to puberty blockers changes to cognitive development without research demonstrating the causal link between limiting puberty hormones and decreased or slowed cognitive development like the known negative effects. I also wouldn't accept increased cognitive development as a positive effect under puberty blockers without justification either. Until there is sufficient justification for either position we are not justified reaching either conclusion..

This is a fair point and I will admit I did not have any research in mind when I brought it up... however I believe it's fair to say that of the research that has been done very little focuses on this specific application and it's long term effects.

I am concerned there is and will be increased public resistance to what the medical consensus supports because of the political scapegoating trans people are under, and wonder if we were talking about transhumanism in general instead focused specifically on transgenderism would the resistance be the same.

I loathe politcs involving sexuality period. It's one more way to splinter a community. We absolutely agree here.

The discussions you've mentioned would likely start with a child experiencing distress reported to an adult or their parents noticing their distress and working with a medical doctor to identify the causes and treatment plans to consider. In the cases where the distress is related to a lasting pattern of gender dysphoria or gender nonconformity that is one of the criteria for prescribing puberty blockers.

While this is the case care should be given to how that information is interpreted. Toys, clothing choices, even colors can simply be a very neutral and innocent interest and may (from the child's perspective) simply be something they enjoy. We as adults can overly assign meaning and weight to these choices which may impact the child's perspective. Psychology in general can bandwagon quite a bit in this regard. I will say it has improved quite a bit but we're all human. I digress. To your point I still believe that counseling is and should be the first step and medication should be (if used) used sparingly and ideally after some time has passed. I still firmly dislike the "it's just a pause button" mentality people have. It's far more complex than that- it needs to be respected as a weighty decision.