Footnotes

• Contributors I am the sole author of this manuscript.

• Funding The authors have not declared a specific grant for this research from any funding agency in the public, commercial or not-for-profit sectors.

• Competing interests None declared.

• Patient consent for publication Not required.

• Provenance and peer review Commissioned; internally peer reviewed.

• ↵The authors do briefly mention, in closing, the question of whether a patient has, or should have, a right to OPS in situations where the treatment is not expected to provide benefit or is expected to lead to harm, but where the patient makes an autonomous decision to pursue it. In the UK’s National Health Service, there is no right to a particular treatment, and a patient cannot insist on a treatment that a clinician does not think is indicated.

• ↵While the relationship between puberty and neural development is not well understood, recent neuroimaging research plus evidence from non-human animal studies indicates that the hormonal events of puberty exert profound effects on brain maturation and behaviour.

• ↵While it is the case that body-related and sexuality-related anxieties are normative experiences for adolescents, especially for birth-assigned women, such a voluntary and continuous closing-down of pubertal development is rarely seen clinically other than in young people with severe eating disorders.