RT Journal Article SR Electronic T1 Flawed reasoning on two dilemmas: a commentary on Baron and Dierckxsens (2021) JF Journal of Medical Ethics JO J Med Ethics FD BMJ Publishing Group Ltd and Institute of Medical Ethics SP 637 OP 638 DO 10.1136/medethics-2021-107647 VO 48 IS 9 A1 Florence Ashley YR 2022 UL http://jme.bmj.com/content/48/9/637.abstract AB A recent paper by Teresa Baron and Geoffrey Dierckxsens (2021) argues that puberty blockers and hormone therapy should be disallowed before adulthood on prudential and consent-related grounds. This response contends that their argument fails because it is predicated on unsupported premises and misinterpretations of the available evidence. There is no evidence that a large proportion of pubertal and postpubertal youths later discontinue medical transition. Meaningful assent is a viable and commonly accepted alternative to meaningful consent in paediatric bioethics. And finally, the primary purpose of transition-related interventions is to actualise youths’ gendered self-image, not treat an underlying mental illness.